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At least 19 recordsLinked to original sources
PubMed1979

Effect of different types of anaesthesia including percutaneous local anaesthesia on survival of experimental skin flaps.

Local anaesthesia by epicutaneous application of the ketocaine solution A2358 gave survival of experimental skin flaps in the guinea pig which corresponded on average to 71% of the total flap. The survival after pentobarbitone anaesthesia, general anaesthesia with ether, and infiltration of prilocaine without and with adrenalin varied between 41 and 53%. The difference in effect between percutaneous anaesthesia with A2358 and the other procedures was statistically significant (p less than 0.001). Epicutaneous application of A2358 followed by one of the other forms of anaesthesia gave a flap survival that did not differ from that following local anaesthesia with A2358 alone, except when followed by injection of prilocaine with adrenalin. The improved survival after epicutaneously applied A2358 is probably attributable to an effect on the peripheral vascular bed resulting in increasing blood supply and nutrition. It may be possible that A2358, for example, could be used in man as a complement to other forms of anaesthesia to provide enhanced tissue survival in skin flaps.

Anesthesia, General↗
PubMed1976

Haemodynamic interactions of high-dose propranolol pretreatment and anaesthesia in the dog. II: The effects of acute arterial hypoxaemia at increasing depths of halothane anaesthesia.

Beta-adrenergic blockade may impair the normal cardiovascular response to hypoxia occurring during general anaesthesia. The haemodynamic effects of acute hypoxia, induced by a 90-s period of ventilation with nitrogen, were studied during increasing depths of halothane anaesthesia up to a maximum of 2.5% inspired halothane in dogs chronically implanted with intracardiac catheters, a left-ventricular pressure transducer and an aortic blood flow transducer. An untreated group of dogs and a group which had been treated for 3 weeks with propranolol 20 mg/kg/day were compared. The beta-blocked group had lesser cardiac output values, left-ventricular contractility indices, external left-ventricular work and peak left-ventricular power at all depths of anaesthesia except 2.5% halothane, but both groups responded to hypoxia similarly at each depth of anaesthesia. Cardiac performance was enhanced in both groups during acute hypoxia. No adverse haemodynamic effect of the combination of propranolol, halothane and hypoxia was demonstrated.

Anesthesia, General↗
PubMed1978

Glucose tolerance during anaesthesia and surgery. Comparison of general and extradural anaesthesia.

The effects of general and extradural anaesthesia on glucose tolerance and plasma cortisol concentration in the surgical patient were assessed. Normal glucose tolerance and insulin release were observed under extradural anaesthesia, whereas general anaesthesia produced decreases in both glucose tolerance and insulin release. The plasma cortisol concentration was increased in both groups. These results indicate possible nutritional advantages in conducting surgery under extradural anaesthesia.

Adult↗
PubMed1979

Redistribution of body heat during anaesthesia. A comparison of halothane, fentanyl and epidural anaesthesia.

Epidural anaesthesia and high dose fentanyl (50 micrograms/kg) when used to supplement nitrous oxide and oxygen anaesthesia for a standard lower abdominal operation were associated with a mean fall in deep body temperature, as measured in the external auditory meatus, of 0.46 degrees C and 0.6 degrees C/hr respectively. This is significantly different from the mean values of 0.14 degrees C and 0.2 degrees C/hr which were recorded when moderate dose fentanyl (10 micrograms/kg) or 0.5% halothane were used to supplement anaesthesia. When mean skin temperature is combined with the core temperature to provide an estimate for total body heat, there is no difference between the groups. Redistribution of body heat occurs and this may be related to reduced adrenergic stimulation and altered regional blood flow. Where the facilities and environments are inadequate for the maintenance of normothermia, care should be taken in the choice of anaesthetic technique. In the recovery period mean body heat gain showed a wide scatter of results but those patients receiving epidural anaesthesia were slow to rewarm despite a high incidence of shivering in this group. The implications of this are discussed.

Adult↗
PubMed1975

[Clinical experience of Ethrane inhalation anaesthesia compared with halothane inhalation anaesthesia in dogs (author's transl)].

Anaesthesia was carried out in fourteen cases as part of the present study, ethrane being used in eight and halothane in six cases. Each group included an experimental dog in which surgery was not performed. The others were patients which had to undergo a surgical procedure. In addition to clinical impressions, the following parameters were recorded: the pulse and heart rates, the electrocardiogram, the systolic pressure and the capnogram. In view of the small number of and marked variation in patients, only cautious conclusions could be drawn. Attention is drawn to the fact that cardiovascular complications may occur when large doses of the anaesthestics are administered. These large doses were constantly required to maintain a sufficiently deep anaesthesia when ethrane was used. The amount of ethrane utilized therefore was definitely larger than was that of halothane. Ethrane had the advantage that recovery from anaesthesia was mor rapid and smoother. Personal experience showed that satisfactory anaesthesia may be produced by either anaesthetic. Secondary considerations may therefore be an important factor in making a choice between the two agents.

Acid-Base Equilibrium↗
PubMed1979

Use of encephabol in anaesthesia and post-anaesthesia resuscitation.

On the basis of good results in a pilot study of 40 patients who had undergone anaesthesia for various surgical operations, infusions of pyritinol was tested under controlled double-blind conditions on 60 further patients. Pyritinol 600 mg was infused immediately after anaesthesia. The aim of this study was to verify the favourable effect on the post-anaesthesia phase. It was shown that pyritinol significantly shortens the wakening time and, furthermore, positively influences the subjective feeling of the patients after anaesthesia.

Blood Pressure↗
PubMed1976

A method of anaesthesia for fractional coagulation of the Gasserian ganglion. Intermittent anaesthesia with propanidid.

A method of anaesthesia is described for fractional coagulation of the Gasserian ganglion. The surgical procedure demands short periods of anaesthesia alternating with periods of full consciousness, during which sensory testing is carried out. In spite of the rare possibility of a hypotensive reaction, propanidid is considered to be the drug of choice for this technique. 31 patients wih typical trigeminal neuralgia have been treated with immediate relief of symptoms, whilst 3 (10%) have been successfully re-treated after recurrence of pain paroxysms. Two patients developed lung emboli, from which they recovered, in the post-operative period, and a third patient had a non-fatal myocardial infarct a week after treatment. Alternative approaches to the problem of intermittent anaesthesia, with and without intubation, are discussed.

Aged↗
PubMed1978

Studies on the duration of local anaesthesia: a possible mechanism for the prolonging effect of dextran on the duration of infiltration anaesthesia.

The mechanism of the prolonged effect of dextran on the duration of local anaesthesia has been studied. Using radio-active mepivacaine it was found that dextran prolonged the duration of infiltration anaesthesia in guinea-pigs by delaying the absorption of the local anaesthetic agent. Experiments in vitro indicate that molecular complexes between the local anaesthetic and dextran may be formed and it is assumed that the delayed absorption might be due to the formation of such molecular complexes. This hypothesis was strengthened by experiments in which dental infiltration anaesthesias were performed in healthy volunteers.

Adult↗
PubMed1976

Anaesthesia for cystoscopy. A comparative study of 3 methods of intravenous anaesthesia: diazepam-fentanyl, thiomebumal and althesin.

Three different methods of anaesthesia for diagnostic cystoscopy are compared in randomly divided series of 100 males each. Group I received diazepam-fentanyl supplemented with Althesin in case of therapeutic transurethral procedures. Group II had thiomebumalnatrium-N2O-O2 and group III had althesin-N2O-O2. Group I had no premedication while the two others were premedicated with morphine-scopolamine mixture. The period during and after anaesthesia was observed independently by the urologist, the anaesthetist, the nurses on the ward and by interviewing the patient the day after the cystoscopy. The anaesthetist was the only one who knew the method to be used. Diazepam-fentanyl proved to give sufficient analgesia. This combination offered the shortest and most uncomplicated period of recovery. Five patients given diazepam-fentanyl remembered the cystoscopy as being painful. All these cases could be related to insufficient coordination of anaesthesia and cystoscopy, which seems to be of major importance for this method.

Aged↗
PubMed1976

Toxicity following methoxyflurane anaesthesia. IV. The role of obesity and the effect of low dose anaesthesia on fluoride metabolism and renal function.

Seven obese and five normal weight patients were studied before, during and after one hour of methoxyflurane-nitrous oxide anaesthesia during peripheral surgical operations and compared with eight patients of normal weight anaesthetized with nitrous oxide-meperidine and d-tubocurare. Estimates were made of renal function, including serum and urinary electrolytes, osmolarity, uric acid, urea and creatinine. Renal clearances for the latter three substances were also calculated. Serum and urinary inorganic and organic fluoride concentrations were measured, as were renal clearances. This low dose methoxyflurane anaesthesia resulted only in a decrease in uric acid clearance among all the measures, when compared to the meperidine-nitrous oxide controls. The clearance of uric acid remained depressed for longer in the obese patients, but otherwise they did not differ from the normal weight patients. It is possible but not proven that depressed uric acid clearance may be related to the organic fluoride metabolite and an early indicator of methoxyflurane renal toxicity. The previously documented biotransformation of methoxyflurane was seen in this study. A double peak in serum inorganic fluoride was shown in all patients but one. Rather large differences in peak levels of serum inorganic fluoride occurred. The only significant difference between the obese and normal weight patients as far as fluoride metabolism was concerned was a greater variability in the serum inorganic fluoride levels in the obese patients. It would appear that the obese patient metabolizes methoxyflurane in a quantitatively if not qualitatively different fashion than the normal weight patient, perhaps because of fatty infiltration of the liver. Caution is advised in the use of methoxyflurane for more than 90 minutes of low concentration administration in view of the unpredictability of the biotransformation.

Anesthesia↗
PubMed1976

Haemodynamic interactions of high-dose propranolol pretreatment and anaesthesia in the dog. III: The effects of haemorrhage during halothane and trichloroethylene anaesthesia.

We have examined the haemodynamic effects of 0.8% trichloroethylene and 1% halothane anaesthesia in a control group of five dogs, chronically implanted with cardiovascular flow- and pressure-measuring apparatus and compared them with a similar group of six dogs pretreated for 3 weeks with oral propranolol (20 mg/kg/day). The effects of graded haemorrhage of 25% of the estimated blood volume and re-transfusion were studied. Cardiovascular function was satisfactory at all stages of the study except during trichloroethylene anaesthesia in the beta-blocked dogs when the response to blood loss was impaired severely. Therefore the use of trichloroethylene in the presence of propranolol may not be advisable in clinical practice.

Anesthesia, General↗
PubMed1976

General anaesthesia for the mentally handicapped. A study based on anaesthesia for dental surgery.

The establishment of a general anaesthetic unit for dental surgery in a hospital for the mentally subnormal is described. The problems encountered in sedating the mentally handicapped patient in such a way as to permit an unhindered induction of anaesthesia are described together with the evolution of a technique of premedication using nitrazepam and droperidol. The medical problems complicating anaesthesia found in this group of patients are enumerated and their effects on the development of a suitable anaesthetic technique are described.

Adolescent↗
PubMed1977

Glomerular filtration rate during halothane anaesthesia and epidural analgesia in combination with halothane anaesthesia.

Pre- and peroperative determination of glomerular filtration rate (GFR) was performed in nine patients operated during light halothane anaesthesia (group A) and in nine patients operated during epidural analgesia in combination with light halothane anaesthesia (group B). In group A, the mean GFR decreased insignificantly by 7% and the mean arterial blood pressure increased significantly by 10%. In group B, the mean GFR decreased significantly by 19% and the mean arterial blood pressure decreased significantly by 15%. It is suggested that the difference in change in GFR between the two groups was caused by differences in mean arterial blood pressure.

Adult↗
PubMed1992

Effect of epidural and general anaesthesia compared with general anaesthesia alone in large bowel anastomoses. A prospective study.

OBJECTIVE: To find out whether patients did better after operations that entailed a large bowel anastomosis if they were given combined epidural and general anaesthesia with spontaneous ventilation rather than standard general anaesthesia with muscle relaxation and ventilation. DESIGN: Prospective randomised trial. SETTING: Specialist unit, teaching hospital. SUBJECTS: 80 patients undergoing large bowel anastomoses. MAIN OUTCOME MEASURES: Incidence of chest infection, wound infection, anastomotic breakdown, urinary tract infection, deep vein thrombosis, pulmonary embolism, median hospital stay and death. RESULTS: There were no differences between the groups, but the results were better during the trial period (1985-89) than during the period 1978-83. CONCLUSION: Factors that influence anastomotic healing are complex and improved surgical techniques, postoperative monitoring and patient care may account for the improvement in results compared with the earlier period.

Aged↗
PubMed1978

Halothane anaesthesia and suxamethonium III. Atropine 30 s before a second dose of suxamethonium during inhalation anaesthesia: effects and side-effects.

The protection against bradycardia afforded by atropine given intravenously just prior to a second dose of suxamethonium during halothane inhalation anaesthesia was studied in 100 healthy, adult patients randomly allocated to one of five groups characterized by dosage of atropine. ECG monitoring was continuous, and regular determinations were made of serum potassium, PaCO2, PaO2 and blood pressure. Slowing of the heart rate was seen in more than 50% of patients in each group, but bradycardia (heart rate less than 60 beats/min) was seen only in patients receiving the lowest dose of atropine--0.0075 mg/kg. In the other four groups (atropine 0.01 mg/kg-0.02 mg/kg), bradycardia prophylaxis was effective, but at the cost of serious ventricular arrhythmias in 15% of the patients. The incidence of these arrhythmias seemed to increase with increasing atropine dosage. Marked tachycardia was also seen. Because of the incidence of side effects in this and other studies, no absolute recommendation can be made about suxamethonium bradycardia prophylaxis during halothane inhalation anaesthesia, but our present experience suggests that atropine in a dose not exceeding 0.01 mg/kg, given 30 s prior to a second dose of suxamethonium is best.

Anesthesia, Inhalation↗
PubMed1979

[Effects of general anaesthesia with halothane and neuroleptic anaesthesia on free plasma amino acids (author's transl)].

Changes of plasma amino acids in animal studies were observed after administration of different narcotic drugs. In a randomised study the effects of neuroleptic anaesthesia and general anaesthesia with halothane on free plasma amino acids in respect to liver toxicity were investigated in patients during microsurgery of the middle ear. 24 hours postoperatively in both groups a significant increase of branched chain amino acids and of phenylalanine as metabolic sign of stress was found. Typical changes of amino acids as shown in hepatic failure could not be seen in both groups. The study showed that none of the narcotics used had a toxic effect on liver function as measured by the levels of free plasma amino acids and that for disagrees with the results of animal studies.

Adolescent↗
PubMed1977

[Electrolyte balance in major abdominal surgery. II. Observations under combined general and regional anaesthesia versus enflurane anaesthesia (author's transl)].

In 20 patients undergoing selective proximal vagotomy using a combination of methohexitone-nitrous oxide-pancuronium-anesthesia and intercostal block, and in 33 patients undergoing large abdominal surgical procedures under enflurane anesthesia, we found a mean decrease in serum potassium after the start of anesthesia of 0.25 mval/l which was maintained during the time of anaesthesia and operation. In spite of an unchanged potassium balance we noted a reduction in red cell potassium in both groups by about 7 mval/l. Serum sodium decreased by about 6 mval/l and base-excess by a mean of 2 mval/l. In both groups we found a nearly indentical and strong correlation between sodium infused and retained. In conclusion changes of serum potassium, serum sodium, base excess, red cell potassium and of sodium and potassium balance are typical of those occurring during large abdominal surgical procedures and the infusion regimen applied. They are, however, not influenced by the type of anaesthesia.

Abdomen↗
PubMed1977

Anaesthesia for dilatation, evacuation and curettage in outpatients: comparison of subanaesthetic doses of ketamine and sodium methohexitone-nitrous oxide anaesthesia.

Sub-dissociative doses of ketamine compared unfavourably with methohexitonenitrous oxide anaesthesia for dilatation, evacuation and curettage. We could not separate the desirable effects of analgesia and amnesia from the unwanted dream effects and visual disturbances. Although the time of clinical recovery was similar, the Trieger Motor Test revealed a delay in return to normal in both groups.

Adolescent↗