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Biomedical subjects

B Smalhout

Publications and source records attributed to B Smalhout.

8 recordsLinked to original sources
PubMed1992

A haemodynamic comparison of epidural versus intrathecal sufentanil to supplement general anaesthesia for abdominal aortic surgery.

The present study was designed to evaluate the influence of epidural sufentanil (ES) and intrathecal sufentanil (IS) on the peri-operative haemodynamic responses during abdominal aortic surgery. Twenty-four ASA Grade II patients without clinical symptoms of coronary artery disease received, randomly, epidural (n = 12) or intrathecal (n = 12) sufentanil combined with light general anaesthesia for elective bifemoral grafting for aorto-iliac occlusive disease. The IS group contained significantly more hypertensive patients than the ES group. This resulted in a significantly higher systolic and mean blood pressure, which remained constant from the start to the end of the study. Following a single bolus injection of 150 micrograms of sufentanil epidurally or intrathecally, there was a significant decrease in heart rate (HR), systolic, mean and diastolic blood pressure, systemic vascular resistance (SVR) and coronary perfusion pressure in both groups. This suggests that IS and ES must be used with caution in patients with cardiovascular disease. The abdominal incision restored the haemodynamic changes produced by sufentanil administration, but these did not exceed pre-sufentanil values. There were no significant changes in filling pressure, cardiac index (CI) and left ventricular work after aortic cross-clamping in the two groups. Revascularization produced significant differences in HR, SVR and CI in both groups in comparison with the pre-declamping period. Notable was the maintenance of systemic blood pressure following revascularization due to preservation of sympathetic activity. It was concluded that both epidural and intrathecal sufentanil produce comparable and stable haemodynamics in this category of patients.

Aged↗
PubMed1990

A postoperative analysis of the patient's view of anaesthesia in a Netherlands' teaching hospital.

A postoperative questionnaire was used in 129 patients who had undergone a wide range of surgical procedures in order to investigate their personal experience of anaesthesia. The most frequent complaints were of feeling cold on waking up, sore throat, vomiting and muscle pains, all of which are capable of reduction by a change in anaesthetic technique. The total number of patients who had one or more complaints was 107 (82.9%). More than a third of the patients were afraid of the anaesthetic, as distinct from the operation. Most had received a pre-operative visit from the anaesthetist which was greatly appreciated. A few patients believed they could have been better informed of possible sequelae. More than 30% were not visited by the surgeon before the operation. A routine postoperative interview, using a preformulated questionnaire, is a good way to assess and maintain a high quality of anaesthesia.

Adolescent↗
PubMed1978

Successful treatment with CPAP of two infants with bronchomalacia.

Two children with severe bronchial collapse secondary to bronchomalacia improved dramatically after institution of continuous positive airway pressure (CPAP). Treatment was discontinued after 14 weeks without reappearance of symptoms. Repeated bronchoscopy revealed a diminution in the bronchial collapsibility. It is suggested that CPAP should be given if generalised bronchomalacia is present to tide the children over a bad period while the bronchus is becoming more stable.

Bronchi↗
PubMed1978

The importance of monitoring in anesthesia.

A plea is made for continuous electronic monitoring of every patient undergoing an anesthetic. Such monitoring is far superior to clinical observation by means of the natural sensors. A continuous record of the vital phenomena is indispensable. Routine monitoring of the following is advised: ECG, heart rate, capnogram, plethysmogram, temperature, oxygen percentage and indirect blood pressure. Big operations demand central venous pressure and direct blood pressure monitoring, in addition. In the Institute of Anesthesiology in Utrecht all electronic monitors are built into a single unit which is used during every anesthetic. Capnography it dealt with in some detail and its value as a universal monitor demonstrated. The routine use of electronic monitors improves the quality of anesthesia and increases the safety of the patient.

Adolescent↗
PubMed1978

Safe anesthesia: some general considerations.

Most of the articles on safety in anesthesia take the mortality as the criterion. This is fallacious. The anesthetist's area of responsibility must be clearly defined before his contribution to any given mortality can be assessed. The development of the field of anesthesiology has extended this area enormously. As a result, the techniques employed and the results obtained need to be reviewed and reconsidered. Outdated attitudes must be resolutely abandoned, particularly with regard to monitoring. The use of a coding system for anesthetic complications helps towards an objective assessment of the degree of safety achieved. The results obtained by this means in the Institute of Anesthesiology in Utrecht are reported.

Anesthesia↗