General Anesthesia Research Papers - Academia.edu (original) (raw)

Objective. To determine whether postoperative symptoms differ between women who undergo abdominal benign hysterectomy in a fast‐track model under general anesthesia or spinal anesthesia with intrathecal morphine. Design. Secondary... more

Objective. To determine whether postoperative symptoms differ between women who undergo abdominal benign hysterectomy in a fast‐track model under general anesthesia or spinal anesthesia with intrathecal morphine. Design. Secondary analysis from a randomized, open, multicenter study. Setting. Five hospitals in south‐east Sweden. Population. One‐hundred and eighty women scheduled for benign hysterectomy were randomized; 162 completed the study; 82 were allocated to spinal and 80 to general anesthesia. Methods. The Swedish Postoperative Symptoms Questionnaire, completed daily for 1 week and thereafter once a week until 5 weeks postoperatively. Main Outcome Measures. Occurrence, intensity and duration of postoperative symptoms. Results. Women who had hysterectomy under spinal anesthesia with intrathecal morphine experienced significantly less discomfort postoperatively compared with those who had the operation under general anesthesia. Spinal anesthesia reduced the need for opioids post...

Background The authors demonstrated previously that isoflurane-nitrous oxide anesthesia attenuates performance improvement on an already-learned spatial memory task and that the effect persists for weeks. This experiment was designed to... more

Background The authors demonstrated previously that isoflurane-nitrous oxide anesthesia attenuates performance improvement on an already-learned spatial memory task and that the effect persists for weeks. This experiment was designed to test the hypothesis that learning of new information is particularly susceptible to prolonged disruption after general anesthesia. Methods Six- (n = 5) and 20- (n = 5) month-old male Fischer 344 rats were anesthetized for 2 h with 1.2% isoflurane, 70% nitrous oxide, and 30% oxygen. Age-matched control rats received 30% oxygen and 70% nitrogen (n = 5 per group). Rats breathed spontaneously, and anesthetic and oxygen concentrations were measured. Spatial learning was assessed daily for 21 days on a 12-arm radial maze (RAM) beginning 48 h after anesthesia. In a post hoc experiment to examine locomotion, swim speed was assessed in a separate group of identically treated rats (n = 3 per group) for 4 days beginning 48 h after anesthesia. Results Aged rats ...

1. The acid–base status of young spontaneously hypertensive rats (SHR) was compared with that of Wistar–Kyoto rats (WKY) in the steady state, after acid loading and after blood pressure had been maintained at normal levels from weaning.... more

1. The acid–base status of young spontaneously hypertensive rats (SHR) was compared with that of Wistar–Kyoto rats (WKY) in the steady state, after acid loading and after blood pressure had been maintained at normal levels from weaning. Whole blood ionized calcium was measured simultaneously. 2. In the prehypertensive stage (4 weeks of age), plasma bicarbonate was significantly lower in SHR than in WKY, while blood pH did not differ significantly. 3. After 6 weeks of age, blood pH and plasma bicarbonate were significantly lower in both anaesthetized and conscious SHR than in corresponding WKY. After 7 days administration of NH4Cl in the drinking fluid, both parameters decreased significantly in both strains and the difference in pH remained constant (0.05 pH unit, P < 0.01). 4. In none of the groups investigated did non-pH-adjusted ionized calcium differ significantly between the SHR and WKY. 5. Prevention of the development of hypertension in SHR by hydralazine treatment from we...

Little is known about the incidence of severe critical events in children undergoing general anaesthesia in Europe. We aimed to identify the incidence, nature, and outcome of severe critical events in children undergoing anaesthesia, and... more

Little is known about the incidence of severe critical events in children undergoing general anaesthesia in Europe. We aimed to identify the incidence, nature, and outcome of severe critical events in children undergoing anaesthesia, and the associated potential risk factors. The APRICOT study was a prospective observational multicentre cohort study of children from birth to 15 years of age undergoing elective or urgent anaesthesia for diagnostic or surgical procedures. Children were eligible for inclusion during a 2-week period determined prospectively by each centre. There were 261 participating centres across 33 European countries. The primary endpoint was the occurence of perioperative severe critical events requiring immediate intervention. A severe critical event was defined as the occurrence of respiratory, cardiac, allergic, or neurological complications requiring immediate intervention and that led (or could have led) to major disability or death. This study is registered w...

Congenital teratoma of oral cavity in a neonate is a rare condition associated with compromised airway and challenges anesthesiologist in airway mamagement. We report a case of neonate with multiple oral teratoma, cleft palate and bifid... more

Congenital teratoma of oral cavity in a neonate is a rare condition associated with compromised airway and challenges anesthesiologist in airway mamagement. We report a case of neonate with multiple oral teratoma, cleft palate and bifid tongue who presented with respiratory distress. A one day old 2.8 kg female baby with multiple oral mass protruding from mouth, cleft palate and bifid tongue was scheduled for excision of mass. Injection Atropine 0.01mg/kg was given through already secure i.v. line to limit secretions. Oxymetazoline nasal drop were put in both nostrils and then patency of right nare was checked by nasogastric feeding tube. A bigger size mask was selected to ensure proper bag and mask ventilation. Anesthesia was induced by sevoflurane and oxygen in gradual incremental concentration. A check laryngoscopy was done to visualize glottis. As glottis was visible injection succinylcholine 1.5 mg/kg was given and nasal intubation was done with the help of magill’s forcep from...

Background: Odontogenic infections are the most common source for spreading facial space infections. The infections of these potential spaces in the facial planes include acute cellulitis of the soft tissue with or without true abscess... more

Background: Odontogenic infections are the most common source for spreading facial space infections. The infections of these potential spaces in the facial planes include acute cellulitis of the soft tissue with or without true abscess formation. Aggressive incision and drainage (I&D) of all the involved spaces is considered necessary to assure fast resolution of the infection and to eventually maintain a patent airway. An adequate level of anesthesia has been a critical component of the treatment plan. Skin in front of, above, below the ear and anterior aspect of neck is supplied by cervical plexus. A superficial cervical plexus block is an option worth considering in these cases. The injection site is usually far enough away from the intended area for I&D to be performed safely. Material and methods: The study protocol involved incision and drainage of facial space infection involving submandibular, submental, sublingual and/or pharyngeal spaces, performed under MAC and superficia...

Background: Preoperative fasting is a major concern to protect the gastric aspiration which is very dangerous. However overnight fasting is uncomfortable and has many deleterious effects on the human body. In many countries fasting until... more

Background: Preoperative fasting is a major concern to protect the gastric aspiration which is very dangerous. However overnight fasting is uncomfortable and has many deleterious effects on the human body. In many countries fasting until 2 to 3 hours before surgery has been practiced but in Bangladesh, overnight fasting is still being practiced in routine cases.
Objectives: The objective of this study was to compare the effectiveness between preoperative overnight fasting and oral rehydration solution administration until two hours before abdominal surgery under general anaesthesia.
Methods: A total of 100 patients of ASA (American Society of Anesthesiologist) class I and II, age above 18 years, and BMI <30 kg/m2 were scheduled for abdominal surgery under GA (General Anaesthesia) were included in this study. Then all patients were randomized into two
groups as patients who were on overnight fasting for 10 hours (Group A-Controlled, n=50), patients who were on ORS until 2 hours before abdominal surgery (Group B-ORS, n=50). All patients had their last meal at 11 PM before the day of surgery. Patients in group A will not take anything orally or via any route, except their ongoing vital medications if present. Patients in group B received 500 ml of standard ORS in the early morning on the day of surgery after waking up from bed (from 05 AM to 06 AM) and another 500 ml until 2 hour before the surgery (06 AM to 07 AM). As the primary outcome gastric residual volume and gastric fluid pH in both group was measured immediately after anaesthesia induction. Several physiological measures (thirst and hunger, nausea/vomiting, cognitive function) were measured with the help of a preformed questionnaire.
Results: Mean gastric residual volume immediately after induction was statistically significant (p<0.05) between the two groups. However the mean gastric fluid pH was statistically insignificant (p>0.05). The ORS group (Group B) became less thirsty before surgery (P=0.001).
Postoperative nausea/vomiting (PONV) was less in group B (P=0.029) than in group A. The patient’s recovery time was significantly less in the ORS group (P=0.003). Postoperative cognitive performance was better in group B (P=0.001).
Conclusions: Oral rehydration solution administration until two hours before surgery is effective and can be considered routinely before abdominal surgery conducted under general anaesthesia except for delayed gastric emptying.

Little is known about the incidence of severe critical events in children undergoing general anaesthesia in Europe. We aimed to identify the incidence, nature, and outcome of severe critical events in children undergoing anaesthesia, and... more

Little is known about the incidence of severe critical events in children undergoing general anaesthesia in Europe. We aimed to identify the incidence, nature, and outcome of severe critical events in children undergoing anaesthesia, and the associated potential risk factors. The APRICOT study was a prospective observational multicentre cohort study of children from birth to 15 years of age undergoing elective or urgent anaesthesia for diagnostic or surgical procedures. Children were eligible for inclusion during a 2-week period determined prospectively by each centre. There were 261 participating centres across 33 European countries. The primary endpoint was the occurence of perioperative severe critical events requiring immediate intervention. A severe critical event was defined as the occurrence of respiratory, cardiac, allergic, or neurological complications requiring immediate intervention and that led (or could have led) to major disability or death. This study is registered w...

Ropivacaine is an amide-type long acting local anaesthetic. According to experimental and human data, its toxicity for Central Nervous System (CNS) and Cardiovascular System (CVS) is considered lower than toxicity related to bupivacaine,... more

Ropivacaine is an amide-type long acting local anaesthetic. According to experimental and human data, its toxicity for Central Nervous System (CNS) and Cardiovascular System (CVS) is considered lower than toxicity related to bupivacaine, the now-a-days accepted golden standard for long acting local anaesthetics. Nevertheless, reports about this kind of accidents are fairly numerous. Aim of this short paper is to describe, primarily from a subjective point of view, CNS symptoms a patient (one of the Authors) suffered by an acute toxic reaction during an epidural block, and to stress the need to pay attention to safety measures in the practice of loco-regional anaesthesia and epidural blockade.

A varieties of medications have been suggested to prevent hemodynamic instabilities following laryngoscopy and endotracheal intubation. This study was conducted to determine the beneficial effects of gabapentin on preventing hemodynamic... more

A varieties of medications have been suggested to prevent hemodynamic instabilities following laryngoscopy and endotracheal intubation. This study was conducted to determine the beneficial effects of gabapentin on preventing hemodynamic instabilities associated with intubation in patients who were a candidate for coronary artery bypass surgery (CABG). This double blinded randomized, parallel group clinical trial was carried out on 58 normotensive patients scheduled for elective CABG under general anesthesia with endotracheal intubation in Shariati Hospital. Patients were randomly allocated to two groups of 29 patients that received 1200 mg of gabapentin in two dosages (600 mg, 8 hours before anesthesia induction and 600 mg, 2 hours before anesthesia induction) as gabapentin group or received talc powder as placebo (placebo group). Heart rate, mean arterial pressure, systolic and diastolic blood pressure were measured immediately before intubation, during intubation, immediately afte...

The congenital gingival granular cell tumor (CGCT), also as known as congenital epulis, is an unusual benign oral mucosal lesion in newborns. A two-day-old female patient was admitted to the Department of Pediatric Dentistry at Gulhane... more

The congenital gingival granular cell tumor (CGCT), also as known as congenital epulis, is an unusual benign oral mucosal lesion in newborns. A two-day-old female patient was admitted to the Department of Pediatric Dentistry at Gulhane Medical Academy, Ankara, Turkey with her family, and an intraoral examination showed a CGCT located in the buccal region of the maxillary right first primary molar. In this report, we present a case of CGCT in a newborn.