[CHANGES IN THE RESPIRATORY TRACT IN PATIENTS WITH BURNS FOLLOWING INHALATION ANESTHESIA].
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Inhaled anesthesia delivery systems (ADS) have evolved in the past 20 years from simple pneumatic machines to complex computer-controlled devices. For the purposes of this discussion, we will outline some of the potential complications that may result from the use of these systems. Because of the complexity of modern ADS, it is incumbent on the anesthesiologist to be cognizant of potential problems that may arise with their use. Even though it is now more difficult than ever for the practitioner to develop a comprehensive understanding of these machines, it remains essential for the safe practice of anesthesia. When the anesthesiologist understands the basic design differences between products from different manufacturers, it is more likely that the appropriate preoperative checks will be performed and that delivery of a safe anesthetic can be ensured. Although malpractice claims associated with anesthesia delivery systems are rare, when they do occur they may be severe, and they continue to occur. These complications may range in severity from mild hypercapnia to awareness and even death.
During general inhalation anesthesia, neutral phrases including either the color blue or yellow combined with one of two objects, ball or kite, were repeatedly presented to 36 children undergoing eye surgery. Postoperative testing with a coloring and two-choice task was performed to detect preferences for the colors and objects presented under anesthesia. No preference attributable to implicit memory could be demonstrated, and there was no explicit recollection of intraoperative events. Memory of intraoperative events occurring during inhalation anesthesia was not demonstrated with the present methodology in young children.
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To clarify the effects of inhalational anesthesia on cerebral circulation in patients with Moyamoya disease, the authors measured regional cortical blood flow (CoBF), jugular bulb oxygen saturation (SjO2), and frontal regional oxygen saturation (rSO2) by near infra-red spectroscopy under total intravenous and inhalational anesthesia in 13 patients undergoing revascularization procedures. Cortical blood flow decreased in some regions under inhaled anesthesia in all cases, and the mean value decreased significantly (p<0.01). Patients' SjO2 levels rose during inhalational anesthesia in 10 of 11 cases (p<0.01). Frontal rSO2 declined in 9 of 11 cases. Regional CoBF levels may be decreased by inhaled anesthesia in patients with Moyamoya disease, and such anesthesia may provoke intracerebral steal. Total intravenous anesthesia, however, lacked these effects.
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