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At least 19 recordsLinked to original sources
PubMed2001

Evaluation of word associations as a reliable postoperative indicator of implicit memory formation during the intraoperative period.

Patients expect to receive an anesthetic that prevents the formation of memories during the intraoperative period. Unfortunately, explicit memory formation occurs 40,000 times per year in the United States, while the incidence of implicit memory is thought to be greater. The purpose of the study was to evaluate the effectiveness of word associations as a reliable postoperative indicator of implicit memory formation during the intraoperative period. Forty-eight participants scheduled to undergo general anesthesia for an elective procedure were selected. During the administration of 0.77 +/- .18 microgram/kg per minute of remifentanyl and 0.31 +/- .04 end-tidal volume percent of sevoflurane in air/oxygen, word associations in the form of "Trivial Pursuit" (Hasbro, Inc, Pawtucket, RI) game statements were presented via headphones. Within 24 hours of surgery, each participant was given a postoperative word association test that included the experimental and control word associations. No reports of explicit memory were noted. The experimental word associations were correctly answered 19.3% of the time, while the control word associations were correctly answered 12.8% of the time (P = .014). The findings illustrated that the word association test in the form of Trivial Pursuit game statements/answers may serve as a reliable postoperative indicator of implicit memory formation during the intraoperative period.

Adult↗
PubMedDate not supplied

[The prevention of undesirable changes in the endocrine system in patients in the intraoperative period using stress-preventive preparations].

The functions of the adrenal cortex, thyroid gland and carbohydrate metabolism have been analysed in 20 patients to whom current schemes of premedication and anesthesia have been applied, 20 patients who in the nearest preoperative period and intraoperatively have been administered ganglioblockers and adrenolytics, and 20 patients in whom clophelin has been used during premedication and anesthesia. It has been established that the use of stress-protecting agents for premedication and anesthesia almost prevents hyperergic reaction of the adrenal cortex, thyroid gland and carbohydrate metabolism.

Adrenal Cortex↗
PubMed1990

A second time-study of the anaesthetist's intraoperative period.

This second time-study of the anaesthetist's intraoperative period was conducted at The Ohio State University Hospitals. The study involved a total of 30 anaesthetic procedures. The activities of the anaesthetists were videotaped and analysed independently by three reviewers. Unlike our previous study, the present study was performed at a time when automatic noninvasive arterial pressure monitors, automatic ventilators and patient breathing circuit disconnect alarms were in use. The greatest amount of intraoperative time of the anaesthetist (59.1%) was spent monitoring the patient directly (44.8%) or indirectly (14.3%) via patient monitors. This represented an increase from our previous study attributable to the increased use of technology in the operating room. The anaesthetist still spent about 10-12% of his/her time completing patient records.

Anesthesia↗
PubMed1989

Family needs of patients having coronary artery bypass graft surgery during the intraoperative period.

The purpose of this study was to describe the needs of the spouses and relatives of patients having coronary artery bypass graft surgery during the intraoperative period. Data were collected in a 434-bed Midwestern hospital from a convenience sample of 23 spouses and 45 adult relatives of 30 patients having their first coronary artery bypass graft operation. Using the Critical Care Family Needs Inventory, subjects were asked to rate the importance of 45 needs. On the basis of item means, the 21 highest-ranked needs were rated as very important or important by both spouses and relatives. Of these top 21 needs, 14 concerned the need for obtaining information. The highest-ranking need for both groups was to have questions answered honestly. Eight needs were identified as significantly more important to spouses than to relatives. Nurses were viewed as the most helpful group in meeting the family's needs.

Adult↗
PubMed1986

[Value of glyceryl trinitrate during the intraoperative period in patients operated on for coronary disease. Study of changes in the arterial pressure and heart rate].

The aim of this study was to determine the changes in systemic blood pressure and heart rate observed at induction and during the immediate postoperative period in patients suffering from coronary artery disease who received a percutaneous preparation of nitroglycerin (PCNG) pre-operatively. In this randomized study, 23 patients with mild coronary disease were divided into two groups: in the 12 patients of group I, 30 mg of PCNG were applied 30 minutes before induction. The 11 patients of group II received a placebo. A slight increase in heart rate at induction, and a modest but significant decrease in systolic blood pressure both 15 minutes after application of PCNG and at induction were noted in group I. Systolic blood pressure increased during intubation in group II (placebo), but not in group I (PCNG). The systolic blood pressure recorded 5 minutes after extubation was greater in group II (placebo) than in group I (PCNG): X +/- SD: 141 +/- 13 vs 128 +/- 10 (P less than 0.01). Nitrate therapy should not be discontinued during the operative period in patients receiving oral nitrates for coronary disease; PCNG is a simple measure, particularly suitable for maintaining nitrate therapy in such patients. When administered before induction during the operative period, PCNG provoked neither tachycardia nor important decrease in systolic blood pressure which would mask the potentially beneficial effects of nitroglycerin.

Administration, Topical↗
PubMed1989

Measurement of blood pressure during the intraoperative period.

For the monitoring of arterial blood pressure in the peri-operative period, three different methods are available. The classical approach is the indirect measurement employing a cuff applied to the upper arm as described by RIVA-ROCCI, known as sphygmomanometry. Thanks to the development of automatic devices employing the oscillometric principle, measurement of the mean arterial pressure has now become possible, blood pressure monitoring simplified, and documentation made easy. The particular indications for direct arterial pressure measurement are very low, very high, and widely fluctuating pressure, as well as major and prolonged surgery. Furthermore, arterial catheterisation provides the additional advantage of permitting blood gas analysis, while, properly employed, the rate of associated complications is low. Recently, it has become possible to perform continuous recording of the blood pressure with a non-invasive method known as servo-plethysmomanometry. The device employed for this method (Finapres) measures the pressure in the arteries of a finger using a small cuff incorporating a photoplethysmograph. Experience to date with this method in clinical usage is good. It is thus to be expected that the technique will in future offer an alternative to invasive methods of blood pressure measurement in many cases.

Blood Pressure Determination↗
PubMedDate not supplied

[Nursing diagnosis of patients in the intraoperative period of cardiac surgery].

The purpose of this study was to identify nursing diagnoses of patients in the intra-operative period of cardiac surgery. One instrument was elaborated and validated for data collection. Such instrument was organized according to The Theory of Basic Human Needs. Seventeen adult patients in the intra-operative period of cardiac surgery were evaluated, of whom 09 were males and 08 were females with the average of 58 years old. Following data collection, the nursing diagnoses were identified based on NANDA's Taxonomy I. The nursing diagnoses identified with a higher frequency than 50% were: Risk for infection (100%), Risk for fluid volume imbalance (100%), Impaired gas exchange (100%), Risk for aspiration (100%), Altered protection (100%), Impaired skin integrity (100%), Risk for peripheral neurovascular dysfunction (100%), Risk for perioperative positioning injury (100%) and Risk for altered body temperature (94.1%). It was identified a predominance of the diagnoses related to psychobiological needs.

Cardiac Surgical Procedures↗
PubMedDate not supplied

[The use of dobutamine during the intraoperative period to prevent organ hypoperfusion in non-heart surgery. Administration modality and monitoring].

Dobutamine is strongly recommended in the treatment of critical intensive care patients in order to improve cardiac performance and peripheral perfusion. In non-cardiac surgery there are frequent cases of organ hypoperfusion that could be treated with dobutamine; the drug, however, is not advocated since it is difficult to control without invasive hemodynamic monitoring. This study analyzed the possibilities of using and controlling dobutamine in non-cardiac surgery. The study covered 186 patients ranging from 40 to 80 years of age who were divided into two groups according to ASA class and the type of surgery they were to undergo (Group I ASA 1-2 major surgery, group 2 ASA 3-4 standard and major surgery). Of these, 93 patients were treated with dobutamine infusion, 3 mu/kg/min, started before anesthesia and modulated for the duration of the operation on the basis of the patient's monitoring values. The remaining 93 patients were the controls who underwent the same anesthesiological procedure without receiving the drug. During anesthesia we monitored: mean blood pressure, pulsioxiometry, fraction of exhaled CO2 and heart rate. Analyses were done using a personal computer network connected to the patient monitoring system. For each parameter we calculated the number of times per hour of anesthesia that different readings were taken (higher or lower) with respect to the value recorded immediately after premedication. The following variations were considered significant. 5 mmHg for blood pressure, 10 b/min for heart rate, 4% higher or lower for exhaled CO2; plus or minus 95% for pulsioximetry. The data were evaluated using the chi 2 test. The treated patients showed significantly higher blood pressure, exhaled CO2 and heart rate values, demonstrating that dobutamine infusion can be piloted on the basis of these monitoring parameters. The treated patients had 4% higher exhaled CO2 levels showing the close correlation between exhaled CO2 and the use of the inotrope. The overall results show that dobutamine is easy to use and readily piloted during anesthesia for non-cardiac surgery.

Adult↗
PubMed2001

Postoperative antibiotic prophylaxis in mandibular fractures: A preliminary randomized, double-blind, and placebo-controlled clinical study.

PURPOSE: This study evaluated the difference between the effect of a 5-day postoperative course of oral antibiotics and a placebo on the incidence of postoperative infection in uncomplicated fractures of the mandible. PATIENTS AND METHODS: A prospective, randomized, double-blind clinical study using a placebo control was carried out. Thirty patients were randomly assigned into 2 groups: group 1 (14 patients) and group 2 (16 patients). Each group received penicillin G, 2 million U intravenously, every 4 hours through the preoperative period, intraoperative period, and for 12 hours postoperatively. Group 1 then received penicillin VK, 500 mg every 6 hours for 5 days. Group 2 received oral placebo using the same schedule for the same duration as group 1. The patients were than evaluated for evidence of infection 1, 2, 4, and 6 weeks postoperatively. RESULTS: Two of 14 patients in group 1 (14.3%) and 2 of 16 patients in group 2 (12.5%) developed infections. No statistically significant difference in the incidence of infection was noted between the groups. CONCLUSIONS: In this preliminary study, the use of postoperative oral antibiotics in uncomplicated fractures of the mandible had no benefit in reducing the incidence of infections.

Administration, Oral↗