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At least 1,081 records · Page 60Linked to original sources
PubMed1995

[Local anesthesia for cataract surgery in adults. Retrospective study of peribulbar, subconjunctival and topical anesthesia].

PURPOSE: A retrospective analysis of 4 methods of local anaesthesia for adult cataract surgery compares the efficiency of: peribulbar anaesthesia injection, subconjonctival anaesthesia injection, both of these techniques and eye topical anaesthesia. No sedation is used. All patients are classified in ASA I or ASA II grade of the anaesthesiologist classification. All the surgeries are performed in an out patient center. The anaesthetic solution combines equally bupivacaine 0.5%, lidocaine 2% and hyaluronidase 250 UI. Phacoemulsification is performed through a scleral small incision. METHODS: 390 patients are separated in 4 groups. Analgesia and Akinesia are evaluated in 3 levels: total, partial and absent. RESULTS: They show that a single peribulbar injection less of 8 ml is sufficient in 86.5% of cases. In case of a unique subconjonctival injection 2 ml are used with a rate of full success of 67.8%. When combining these 2 methods the surgery is easily possible in 97.9% of cases. A complementary subconjonctival injection is necessary in 4.9% of eyes receiving only the inferior peribulbar infiltration and in 13% of eyes anaesthezied by the single subconjonctival injection. 20.3% of eyes receiving only topical anaesthesia need a complementary subconjonctival injection during surgery. But the study covers the first series of patients operated with this new method, most of these cases are men. Results are better with experience, confidence and corneal incision. CONCLUSION: Local anaesthesia is a safe procedure offering very few local and general risks. General sedation or premedication is not necessary. The choice depends on the akinesia factor which is far more difficult to obtain with so few anaesthetic volumes than the analgesia.

Adult↗
PubMed1995

[Complications of pediatric anesthesia. Survey carried out by the Study Group SIAARTI for anesthesia and intensive therapy in children].

This study was designed to asses in a prospective survey the intra and post-operative adverse outcome of paediatric patients in Italy. The data was carried out in representative samples of anaesthetics performed in different Italian Institutions, which were chosen by the National Study Group for Paediatric Anaesthesia, and included: paediatric, general, specialistic hospitals and departments. A total of 9289 anaesthetics were collected and studied. The mean age of the patients was 62.5 months. In the 320 cases (3.4%) 299 minor (3.2%) and 21 major (0.2%) complications occurred during or within 24 hours of surgery and anaesthesia. Seven of the major complications resulted in the exitus of the patients (0.07%). Fifty percent of the accidents regarded respiratory and twenty percent cardiovascular systems. The major incidence (risk factors) of the minor complications was present in patients less than 6 months, ASA group 2-3-4, emergency surgery, patients with associated pathology, long duration of anaesthesia and high risk operations. The incidence of the major complications appears closely related to: patients age and clinical assessment, weight, ASA group, kind of the operation, indications and durations of the surgery, while in the exitus group the major risk factor is the preoperative pathology, surgical procedures, and then: age, weight, ASA and finally surgery.

Anesthesia↗
PubMed1994

[Anesthesia with the closed PhysioFlex system in comparison with conventional anesthesia procedures].

So far the anaesthetic technique of the closed circuit system in clinical routine could not be used adequately, because suitable mixtures of respiration gas components were not available and the maintenance of a sufficient gas volume in the anaesthetic circle system was not possible with the standard anaesthesia machines. The anaesthesia machine PhysioFlex was especially constructed to deliver anaesthetics in a closed circuit system. In this anaesthesia machine the concentrations of the respiratory gases and the gas volume in the circle system are automatically controlled by a feedback mechanism. We compared the closed circuit system (CC group), with a high-flow system (HF group) and a low-flow system (LF group)--each system on 10 patients. It was noted that the respiratory gas concentrations were adjustable and held constant to a greater degree precise in the circuit system. After the induction the desired inspiratory oxygen-concentration was reached within 5 minutes, the expiratory isoflurane-concentration within 10 minutes in the CC group and was maintained reliable. The consumption of liquid isoflurane was 12.9 ml/h in the HF group, 7.5 ml/h in the LF group and 5.3 ml/h in the CC group. The anaesthetic management was possible without any problems in all three groups.

Adult↗
PubMedDate not supplied

[Topical laryngo-tracheal anesthesia and intraocular pressure in anesthesia for ophthalmic surgery].

OBJECTIVE: The reflex response to orotracheal intubation provokes an increase of arterial pressure accompanied by an increase of chorioides volume and a consequent ocular hypertone. There are several methods to reduce the reflex response due to intubation. One of the most effective is topical anaesthesia of larynx and trachea. Experiments were directed to evaluate the efficacy of topical anaesthesia to reduce the intraocular hypertone due to orotracheal intubation. DESIGN: A prospective randomized mask study was conduct on patients undergoing ophthalmologic (anterior segment) surgery at the Eye Clinic of Florence University. METHODS: Intraocular pressure was measured by a Goldman tonometer at four times: T0 = basal, T1 = 2' minutes after induction of general anaesthesia, T2 = 2' minutes after laryngoscopy, T3 = 2' minutes after orotracheal intubation. At the same moments, systolic blood pressure, heart rate, rate pressure pro duct were measured. Patients were randomly divided in two groups: Group L (n = 10) in which was evaluated the efficacy of laryngotracheal topical spray of lidocaine 4% (2 ml) and Group F (n = 10) in which saline was used instead of anesthetic. The filling of the LTA kit (Abbott) was made by a person not involved in the experiments. DATA ANALYSIS: Student's t test for unpaired data. RESULTS: Topical anaesthesia reduces the increase of intraocular pressure, hypertension and rate pressure product due to intubation. The intraocular pressure reduces to 13% less than basal value in Group L and increase to 50% more than basal value in Group F. CONCLUSION: The topical anaesthesia of larynx and trachea is effective to reduce the intraocular hypertension due to the reflex response evoked by orotracheal intubation.

Adult↗