Biomedical subjects
Publications and source records attributed to G H Hanegreefs.
A 32-year-old parturient developed severe headache with subsequent convulsions on the third day after the delivery under epidural anesthesia. Neuroradiological investigations were negative. All complaints disappeared promptly after the performance of an epidural blood patch.
The haemodynamic effects of propofol-fentanyl anaesthesia for elective coronary bypass surgery were studied in 15 patients with good left ventricular function. The induction dose of propofol was 1.5 mg kg-1. The mean infusion rate during maintenance was 5.15 mg kg-1 h-1 (range 4.05-8.82 mg kg-1 h-1). The total dose of fentanyl given in the pre-bypass period was 32 micrograms kg-1. Induction of anaesthesia was associated with significant (P less than 0.05) decreases in systolic (-28%) and diastolic (-23%) pressures, systemic vascular resistance (-25%) and left ventricular stroke work index (LVSWI) (-32%). The decrease in LVSWI (P less than 0.05) during induction and maintenance with unchanged filling pressures, indicated myocardial depression. Clinical signs that could reflect myocardial ischaemia were not observed during the operation. There were no changes in the concentrations of the cardiac enzymes in the postoperative period and ECG morphology was unchanged.
The hemodynamic effects of a balanced anesthetic technique where a moderate dose of fentanyl (32 micrograms/kg) is supplemented with isoflurane were studied in 15 patients with good left ventricular function. Mean inspired isoflurane concentration was 0.63% during induction and 0.74% during maintenance. Induction of anesthesia was associated with a significant decrease (p less than 0.05) in systolic and diastolic pressure and left ventricular stroke work index (LVSWI). During maintenance systolic blood pressure and LVSWI remained significantly depressed. It is concluded that isoflurane-fentanyl anesthesia has myocardial depressant properties. There is a reduced incidence of break-through hypertension during noxious stimuli, when compared with high-dose fentanyl anesthesia. During maintenance, clinical signs that could reflect myocardial ischemia were not observed. Heart enzymes remained within normal range postoperatively in all patients and ECG morphology was unchanged.
The use of computers in the practice of anesthesiology appears to be very promising--therefore the time has come to reflect on ways to utilize the possibilities of computers in this field. The anesthesiologist is faced with an existing "medical information science" and system developments and must now address these questions: How do computers fit in these systems? What is the kind of support and help one can expect from the use of computers? Next one attempts to define the needs for computer support, taking into account the specific working conditions of various anesthesia teams. A description is made of how a system for medical information is automatized--and by way of an example--how such a computer system for anesthesiologists is linked to a larger regional facility. Advantages and disadvantages of such a system are discussed.
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