[Bronchospirometric function tests in ultrasonic aerosol inhalation anesthesia].
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Adolescent↗
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Results for “Anesthesia, Inhalation”
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[Neuroendocrine response in surgery: comparison between inhalation anesthesia (isoflurane) and intravenous anesthesia (propofol)].
The objectives of the study: 1) comparison between the two anesthesiological techniques both of which were applied to the various surgical groups (patients undergoing emergency surgery for abdominal pathologies and patients undergoing bone marrow biopsy); 2) a comparison between pre- and intraoperative stress levels. The experimental design consists of a comparative survey aimed at ascertaining the existence of statistically significant differences in pre- and intraoperative hormone levels (objective 1) and differences in hormone profiles depending on the anesthesiological technique used (objective 2). Patients were artificially ventilated; intraoperative monitoring included: automatic non-invasive AP every 3 minutes; cardiac monitoring; ETCO2; SaO2; all patients showed a normal postoperative evolution. A total of 30 patients were included in the study (mean age 34 years; ASA 1-3) 14 of which underwent bone marrow biopsy and 16 emergency surgery for abdominal pathologies; patients with hormonal pathologies or receiving treatment with drugs capable of influencing hormone response were excluded from the study.
Adrenocorticotropic Hormone↗
[Annual report of perioperative mortality and morbidity for the year 2000 at certified training hospitals of Japanese Society of Anesthesiologists: with a special reference to anesthetic methods--report of the Japanese Society of Anesthesiologists Committee on Operating Room Safety].
The Committee on Operating Room Safety of Japan Society of Anesthesiologists (JSA) sends annually confidential questionnaires of perioperative mortality and morbidity (cardiac arrest, severe hypotension, severe hypoxia) to Certified Training Hospitals of JSA. This report is a special reference to anesthetic methods in perioperative mortality and morbidity in 2000. Five hundreds and twenty hospitals reported perioperative mortality and morbidity referred to anesthetic methods and total numbers of reported cases were 910,007. The percentage of cases reported by each anesthetic method was as follows; inhalation anesthesia 45.47%, total intravenous anesthesia (TIVA) 6.15%, inhalation anesthesia + epidural or spinal or conduction block 24.48%, TIVA + epidural or spinal or conduction block 6.33%, spinal with continuous epidural block (CSEA) 3.67%, epidural anesthesia 1.92%, spinal anesthesia 10%, conduction block 0.47% and others 1.49%. The incidence of cardiac arrest per 10,000 cases due to all etiology (anesthetic management, preoperative complications, intraoperative complications, surgery, others) is estimated to be 6.55 cases in average; 5.36 cases in inhalation anesthesia, 30.72 cases in total intravenous anesthesia (TIVA), 4.62 cases in inhalation anesthesia + epidural or spinal or conduction block, 2.6 cases in TIVA + epidural or spinal or conduction block, 1.2 cases in spinal with continuous epidural block (CSEA), 0.57 cases in epidural anesthesia, 1.65 cases in spinal anesthesia, 2.36 cases in conduction block and 46.38 cases in other methods. However, the incidence of cardiac arrest per 10,000 cases totally attributable to anesthetic management is estimated to be 0.54 cases in average; 0.34 cases in inhalation anesthesia, 1.07 cases in TIVA, 0.58 cases in inhalation anesthesia + epidural or spinal or conduction block, 0.17 cases in TIVA + epidural or spinal or conduction block, 0.9 cases in CSEA, 0.57 cases in epidural anesthesia, 0.99 cases in spinal anesthesia, zero case in conduction block and 1.47 cases in other methods. The incidence of severe hypotension per 10,000 cases due to all etiology is estimated to be 11.14 cases in average; 11.31 cases in inhalation anesthesia, 36.61 cases in TIVA, 9.29 cases in inhalation anesthesia + epidural or spinal or conduction block, 6.59 cases in TIVA + epidural or spinal or conduction block, 3.59 cases in CSEA, 6.3 cases in epidural anesthesia, 4.39 cases in spinal anesthesia, 2.36 cases in conduction block and 23.56 cases in other methods. On the other hand, the incidence of severe hypotension per 10,000 cases totally attributable to anesthetic management is estimated to be 1.25 cases in average; 0.97 cases in inhalation anesthesia, 0.89 cases in TIVA, 1.39 cases in inhalation anesthesia + epidural or spinal or conduction block, 1.39 cases in TIVA + epidural or spinal or conduction block, 2.09 cases in CSEA, 3.44 cases in epidural anesthesia, 1.87 cases in spinal anesthesia, zero case in conduction block and zero case in other methods. The incidence of severe hypoxia per 10,000 cases due to all etiology is estimated to be 4.8 cases in average; 6.35 cases in inhalation anesthesia, 9.64 cases in TIVA, 3.82 cases in inhalation anesthesia + epidural or spinal or conduction block, 2.26 cases in TIVA + epidural or spinal or conduction block, 0.3 cases in CSEA, 1.15 case in epidural anesthesia, 1.21 cases in spinal anesthesia, zero case in conduction block and 5.89 cases in other methods. On the other hands, the incidence of severe hypoxia per 10,000 cases totally attributable to anesthetic management is estimated to be 1.98 cases in average; 3.09 cases in inhalation anesthesia, 2.32 cases in TIVA, 1.3 cases in inhalation anesthesia + epidural or spinal or conduction block, 0.87 cases in TIVA + epidural or spinal or conduction block, zero case in CSEA, zero case in epidural anesthesia, 0.55 cases in spinal anesthesia, zero case in conduction block and zero case in other methods. The mortality rate of cardiac arrest within 7 postoperative days per 10,000 cases due to all etiology is estimated to be 3.55 (54.2%) cases in average; 3.12 (58.1%) cases in inhalation anesthesia, 19.29 (62.8%) cases in TIVA, 1.17 (25.2%) cases in inhalation anesthesia + epidural or spinal or conduction block, 0.52 (20%) cases in TIVA + epidural or spinal or conduction block, zero cases in CSEA, zero case in epidural anesthesia, 0.33 (20%) cases in spinal anesthesia, zero case in conduction block and 39.76 (85.7%) cases in other methods. On the other hands, the mortality rate of cardiac arrest per 10,000 cases totally attributable to anesthesia is estimated to be 0.07 (12.2%) case in average, 0.07 (21.4%) case in inhalation anesthesia, 0.18 (16.8%) case in TIVA, zero case in inhalation anesthesia + epidural or spinal or conduction block, zero case in TIVA + epidural or spinal or conduction block, zero case in CSEA, zero case in epidural anesthesia, 0.11 (11.1%) case in spinal anesthesia, zero case in conduction block and 0.74 (50%) case in other methods. Five major combinations of listed critical incidents, causes and anesthetic methods were as follows: 18.93 cases in TIVA, preoperative complications and severe hypotension; 18.75 cases in TIVA, preoperative complications and cardiac arrest; 11.07 cases in TIVA, surgery and severe hypotension; 6.79 cases in TIVA, surgery and cardiac arrest; 5.24 cases in inhalation anesthesia, preoperative complications and severe hypotension. In summary: 1. There was no significant difference with regard to perioperative mortality and morbidity due to anesthetic management among anesthetic methods. 2. The percentage of each anesthetic method in 2000 was not different significantly from that in 1999 in spite of increased cases reported. 3. Incidence of severe hypotension due to all etiology of TIVA in 2000 decreased significantly compared with that in 1999 (P < 0.05). This may be attributed to the decreased incidence in preoperative complication (shock) and massive bleeding due to surgery.
Anesthesia↗
[Rapid induction of anesthesia with inhalation of sevoflurane].
Induction of anesthesia with inhalation of sevoflurane was evaluated in 45 patients. Inhalation anesthesia was induced by a single vital capacity breath followed by spontaneous breathing. The compositions of anesthetic gases were as follows: 5% sevoflurane in oxygen, 5% sevoflurane in 67% nitrous oxide and oxygen, and 7% sevoflurane in 67% nitrous oxide and oxygen. The time (mean +/- SEM) necessary for the loss of consciousness was 85 +/- 6, 56 +/- 4, and 42 +/- 3 seconds, and breathing frequency was 8 +/- 1, 5 +/- 0.6, 1.4 +/- 0.2, in each composition of anesthetic gasses, respectively. Changes in blood pressure and heart rate were relatively small. The technique was found to be acceptable to all of the patients studied. We conclude that the technique of single breath induction with sevoflurane is a safe and acceptable alternative to intravenous induction in cooperative adult patients.
Adult↗
Total intravenous anesthesia. Midazolam-fentanyl vs enflurane-nitrous oxide.
This study was done to compare the hemodynamics, serum catecholamine levels and postoperative analgesia in total intravenous anesthesia with inhalation anesthesia. Thirteen patients for elective upper abdominal surgery, aged from 40 to 75 years, were studied. In the total intravenous anesthesia group (TIVA group, 7 patients), anesthesia was induced with 0.3 mg.kg-1 midazolam and maintained with 0.68 mg.kg-1.hr-1 midazolam for 15 minutes followed by 0.125 mg.kg-1.hr-1. Fentanyl was also administered as necessary. In the inhalation anesthesia group (inhalation group, 6 patients), anesthesia was induced with 5 mg.kg-1 thiamylal and maintained with 0.5-2.0% enflurane and 66% nitrous oxide in oxygen. In the TIVA group, the blood pressure and heart rate were as stable as those in the inhalation group. The serum concentration of catecholamines in the TIVA group rose significantly 60 minutes after intubation, in particular, the serum epinephrine level was higher than in the inhalation group. The time for extubation, respiratory rate and PaCO2 were not different between the two groups. The postoperative analgesic duration in the TIVA group was significantly longer than that in the inhalation group. The elimination half-life of midazolam was 1.675 +/- 0.281 hours in the TIVA group. In this study, TIVA failed to suppress the elevation of serum catecholamine levels, but it achieved stable hemodynamics during upper abdominal surgery and enough postoperative analgesia without affecting the extubation time, the respiratory conditions and the elimination half-life of midazolam.
Adult↗
[Annual report of perioperative mortality and morbidity for the year 1999 with a special reference to anesthetic methods at Certificated Training Hospitals of Japanese Society of Anesthesiologists].
The Committee on Operating Room Safety of Japanese Society of Anesthesiologists (JSA) sends annually confidential questionnaires of perioperative mortality and morbidity to Certificated Training Hospitals of JSA. This report is on perioperative mortality and morbidity in 1999 with a special reference to anesthetic methods. Four hundred and sixty-seven hospitals reported the number of cases referred to anesthetic methods and total numbers of cases were 727,723. The incidences of cardiac arrest per 10,000 cases due to all etiology are estimated to be 6.77 cases in average, 5.33 cases in inhalation anesthesia, 34.26 cases in total intravenous anesthesia (TIVA), 5.26 cases in inhalation anesthesia plus epidural or spinal or conduction block, 5.29 cases in TIVA plus epidural or spinal or conduction block, 0.73 cases in spinal with continuous epidural block (CSEA), 2.85 cases in epidural anesthesia, 1.63 cases in spinal anesthesia, 2.53 cases in conduction block and 46.51 cases in other methods. However, the incidences of cardiac arrest per 10,000 cases totally attributable to anesthesia are estimated to be 0.78 case in average, 0.51 case in inhalation anesthesia, 1.35 cases in TIVA, 0.97 case in inhalation anesthesia plus epidural or spinal or conduction block, 1.51 cases in TIVA plus epidural or spinal or conduction block, 0.73 case in CSEA, 1.71 cases in epidural anesthesia, 0.54 case in spinal anesthesia, 2.52 cases in conduction block and 1.08 cases in other methods. The incidences of severe hypotension per 10,000 cases due to all etiology are estimated to be 16.64 cases in average, 13.61 cases in inhalation anesthesia, 100.36 cases in TIVA, 13.32 cases in inhalation anesthesia plus epidural or spinal or conduction block, 9.07 cases in TIVA plus epidural or spinal or conduction block, 3.65 cases in CSEA, 6.26 cases in epidural anesthesia, 7.31 cases in spinal anesthesia, 2.52 cases in conduction block and 28.12 cases in other methods. On the other hand, the incidences of cardiac arrest per 10,000 cases totally attributable to anesthesia are estimated to be 2.40 cases in average, 1.65 cases in inhalation anesthesia, 0.81 cases in TIVA, 3.92 cases in inhalation anesthesia plus epidural or spinal or conduction block, 2.77 cases in TIVA plus epidural or spinal or conduction block, 2.56 cases in CSEA, 3.42 cases in epidural anesthesia, 2.71 cases in spinal anesthesia, zero case in conduction block and zero case in other methods. The incidences of severe hypoxia per 10,000 cases due to all etiology are estimated to be 5.32 cases in average, 6.7 cases in inhalation anesthesia, 9.17 cases in TIVA, 5.16 cases in inhalation anesthesia plus epidural or spinal or conduction block, 4.53 cases in TIVA plus epidural or spinal or conduction block, 2.56 cases in CSEA, zero case in epidural anesthesia, 1.08 cases in spinal anesthesia, zero case in conduction block and 1.08 cases in other methods. On the other hand, the incidences of severe hypoxia per 10,000 cases totally attributable to anesthesia are estimated to be 2.39 cases in average, 3.22 cases in inhalation anesthesia, 2.43 cases in TIVA, 2.26 cases in inhalation anesthesia plus epidural or spinal or conduction block, 2.77 cases in TIVA plus epidural or spinal or conduction block, zero case in CSEA, zero case in epidural anesthesia, 0.54 cases in spinal anesthesia, zero case in conduction block and 1.08 cases in other methods. The mortality rates of cardiac arrest per 10,000 cases due to all etiology are estimated to be 3.56 cases in average, 2.82 cases in inhalation anesthesia, 24.55 cases in TIVA, 1.4 cases in inhalation anesthesia plus epidural or spinal or conduction block, 1.51 cases in TIVA plus epidural or spinal or conduction block, zero cases in CSEA, 0.57 cases in epidural anesthesia, 0.27 cases in spinal anesthesia, zero case in conduction block and 42.18 cases in other methods. On the other hand, the mortality rates of cardiac arrest per 10,000 cases totally attributable to anesthesia are estimated to be 0.08 case in average, 0.09 case in inhalation anesthesia, 0.27 case in TIVA, 0.05 case in inhalation anesthesia plus epidural or spinal or conduction block, zero case in TIVA plus epidural or spinal or conduction block, zero case in CSEA, 0.57 case in epidural anesthesia, zero case in spinal anesthesia, conduction block and other methods. The outcomes of cardiac arrest totally attributable to anesthesia are 70.2% of full recovery without any sequelae, 10.5% of death within 7 days, 1.8% of vegetative state and 17.5% of unknown results while the outcome of critical events including severe hypotension and severe hypoxia totally attributable to anesthesia is 94.9% of full recovery without any sequelae, 0.4% of death within 7 days, 0.2% of vegetative state and 4.5% of unknown results. These results indicate that there are no differences in mortality and morbidity totally attributable to anesthesia among anesthetic methods in 1999 at Certificated Training Hospitals of Japan Society of Anesthesiologists.
Anesthesia↗
Reversible mydriasis during strabismus surgery in children.
A study was made of changes in pupil diameter during strabismus surgery performed on 84 children aged from 1 to 12 years. Several factors influencing the appearance of reversible changes in pupil diameter during surgery were examined. The pupil diameters of both eyes were inspected during the course of the operation, and the reactions of manipulated eyes were compared to those of the non-manipulated eyes. Two types of general anesthesia were used, inhalation anesthesia and combined intravenous-inhalation anesthesia, depending upon the patient's body weight. Patient's age and sex, type of anesthesia, surgical procedure and the manipulated eye muscles were documented. The study demonstrated that mydriasis did not occur in patients operated under combined intravenous-inhalation anesthesia, while 74% of those operated solely under inhalation anesthesia developed mydriasis. This mydriasis only occurred during surgical manipulation of the eye muscles. The amount of traction on the other muscles, and the depth of anesthesia were not related to pupil diameter.
Age Factors↗
Influence of anesthetic technique on early postoperative hypoxemia.
In the present study we have compared the incidence and degree of hypoxemia during the early postoperative period and for the first 3 nights after operation occurring after the administration of total intravenous anesthesia with propofol versus inhalation anesthesia with nitrous oxide and isoflurane. We studied 50 consecutive non-obese patients, ages 25-65, ASA I-II, who were scheduled for elective cholecystectomy. Patients received randomly either total intravenous anesthesia with propofol (24 patients) or inhalation anesthesia with nitrous oxide and isoflurane (26 patients). Oxygen saturation was continuously recorded on the night before surgery, for 8 hours after extubation (early postoperative period) and during the first, second and third nights after operation. In the early postoperative period we found statistically significant higher values of mean (P<0.05) and minimum (P<0.01) SpO2 in patients who received total intravenous anesthesia compared to patients in whom inhalation anesthesia was used. Moreover, in the early postoperative period, 4 (16.7%) patients of the intravenous anesthesia group versus 11 (42.3%) patients of the inhalation anesthesia group had at least 1 hypoxemic event (P<0.05). We conclude that the incidence and degree of hypoxemia in the early postoperative period is significantly less when total intravenous anesthesia with propofol is used.
Adult↗
[Effects of cardiac output on PETCO2 and PaCO2 during combined inhalational-epidural anesthesia].
We investigated the effects of cardiac output on PETCO2 in anesthetized patients. We studied 8 adult patients undergoing long-lasting lower abdominal surgery. Anesthesia was maintained with epidural combined with inhalational anesthesia. The minute ventilation volume was kept constant at 10 ml.kg-1 x 10 cycles.min-1. PETCO2, PaCO2, and cardiac index, (CI) by thermodilution method were measured simultaneously. PaCO2 was corrected for body temperature for comparison with PETCO2. Approximate value of alveolar dead space to tidal volume ratio was calculated as VD/ VTalv = (PaCO2-PETCO2)/PaCO2. The measurements were repeated every 10 to 20 minutes under the steady body temperature. One hundred and six sets of data were obtained from these patients. PETCO2 as well as PaCO2 correlated positively with CI, while VD/VTalv did not correlate with CI. PETCO2 correlated positively with PaCO2, while it did not correlate with VD/VTa1v. When examined in individual patients, PETCO2 correlated positively with CI in 7 patients. PaCO2 correlated positively with CI in 6 patients, while VD/VTa1v correlated negatively with CI only in 2 patients, in whom CI showed a large fluctuation. PaCO2 correlated positively with PETCO2 in 8 patient, while VD/VTa1v correlated negatively with PETCO2 only in 1 patient. By multiple regression analysis, VD/VTa1v change accounted for only 20.0 +/- 15.3% of PETCO2 change, while PACO2 or PaCO2 change accounted for 79.3 +/- 16.7%. Decreased CI was associated with a decrease in oxygen uptake (VO2), and PaCO2 correlated positively with VO2. Decreased CI was also associated with an increase in VA/Q, and PaCO2 correlated negatively with VA/Q. Thus, PETCO2 decreased with decreasing cardiac output. A decrease in PACO2 explained the decrease in PETCO2 better than an increase in VD/VT did. Decreased cardiac output caused hypocapnia through decreased CO2 production and/or increased ventilation to perfusion ratio i.e. relative hyperventilation.
Adult↗
Cardiovascular homeostasis during inhalational general anesthesia: a clinical comparison between sevoflurane and isoflurane. On behalf of the Italian Research Group on sevoflurane.
STUDY OBJECTIVE: To obtain more information on cardiovascular homeostasis and patient discharge from the recovery area after general anesthesia with either sevoflurane or isoflurane as the main anesthetic. DESIGN: Prospective, randomized, multicenter study. SETTING: Inpatient anesthesia at 13 University Departments of Anesthesia. PATIENTS: 247 ASA physical status I, II, and III patients, aged 18 to 85 years, receiving general anesthesia for elective urological, orthopedic, ENT, vascular, and low abdominal surgery. INTERVENTIONS: General anesthesia was maintained using a 60% nitrous oxide in oxygen mixture with either isoflurane (n = 125) or sevoflurane (n = 122) adjusted according to hemodynamic variables. MEASUREMENTS AND MAIN RESULTS: Occurrence of hypotension [systolic arterial blood pressure (SBP) decrease >30% from baseline], hypertension (SBP increase >30% from baseline), bradycardia [heart rate (HR) <50 bpm], or tachycardia (HR>100 bpm) provoked stepwise changes in the inspired concentration of the study drug. If this action proved to be ineffective after an adequate stabilization period, a specific treatment was given, and the need for pharmacological treatment was recorded as a hemodynamic side effect by an independent observer. No differences in duration of anesthesia were observed between sevoflurane (126 +/- 76 min) and isoflurane patients (139 +/- 60 min). Mean duration from anesthetic discontinuation to fulfillment of discharge criteria was shorter after sevoflurane (21 min; 25(th) to 75(th) percentiles: 27 to 13 min) than isoflurane (27 min; 25(th) to 75(th) percentiles: 17 to 35 min) (p < 0.0005). Hemodynamic side effects requiring therapy occurred in 18 sevoflurane patients (14.6%) and 26 isoflurane patients (20.8%) (p = NS). The risk for hemodynamic side effects increased with age (>50 vs. < or OFFyrs: odds ratio 2.5; 95% CI 1.2 to 5.4; p = 0.015) and ASA physical status (III vs. I and II: odds ratio 2.2; 95% CI 0.9 to 5.7; p = 0.048). When only patients over 50 years of age were considered (72 in the sevoflurane group and 79 in the isoflurane group), the incidence of hemodynamic side effects was higher with isoflurane (29.1%) than with sevoflurane (15.2%) (odds ratio 2.3; 95% CI 1.0 to 5.2; p = 0.04). CONCLUSIONS: Sevoflurane provided equally safe and effective control of cardiovascular homeostasis as isoflurane, with a more rapid discharge from the recovery area. Interestingly, patients over 50 years of age showed a lower risk for hemodynamic side effects when receiving sevoflurane than isoflurane.
Adolescent↗
Exodontia for children with inhalation general anesthesia.
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Anesthesia, Dental↗
[Continuous monitoring of hemoglobin oxygen saturation of the hepatic vein in patients undergoing laparoscopic cholecystectomy].
We monitored of hemoglobin oxygen saturation of the hepatic vein (ShvO2) continuously in 6 patients undergoing laparoscopic cholecystectomy under inhalation anesthesia only, and in 6 patients under combined epidural and inhalation anesthesia. In inhalation anesthesia only group, arterial blood pressure increased and ShvO2 values decreased immediately after intraperitoneal insufflation with CO2, demonstrating the mean lowest ShvO2 value of 25 percent. In combined anesthesia group, arterial blood pressure and ShvO2 values were unchanged after the intraperitoneal insufflation compared with values obtained before the insufflation. The results indicate that hepatic blood flow may be better preserved with combined epidural and inhalation anesthesia than with inhalation anesthesia only, suggesting that sympathetic block by epidural anesthesia may contribute to this favorable effect on ShvO2.
Adult↗
Outpatient surgery and anesthesia.
Outpatient surgery and anesthesia are offered as a means of reducing the costs of health care delivery. Certain principles for outpatient anesthesia are apparent. Inhalational anesthesia is preferred over many intravenous agents. If intravenous agents are used, the doses must be limited. Intravenous agents that are quickly metabolized or redistributed in the body away from the brain are preferred. Inhalational anesthesia inductions that avoid or minimize intravenous agents are preferred. Nerve blocks are useful for outpatient surgery, but may require supplementation with intravenous agents, which in turn may slow recovery.
Ambulatory Care↗
Inhaled nitric oxide as a selective pulmonary vasodilator in clinical anesthesia.
Inhaled nitric oxide (NO) is a selective pulmonary vasodilator in adult and pediatric patients. Inhaled NO diffuses into the pulmonary vascular smooth muscle where it results in vasodilation via stimulation of guanylyl cyclase. Systemic hemodynamics are not altered because inhaled NO is rapidly inactivated by hemoglobin. Oxygenation is also increased in certain patients as inhaled NO only vasodilates those segments of the pulmonary vasculature which are ventilated. There is growing evidence that inhaled NO may be a useful therapeutic agent in the treatment of pulmonary hypertension and hypoxemia from a variety of causes. Areas of greatest interest to anesthesia and critical care personnel may involve treatment of persistent pulmonary hypertension of the newborn (PPHN), adult respiratory distress syndrome (ARDS), and postoperative pulmonary hypertension secondary to cardiac disease. The potential toxicity of inhaled NO, particularly on immature and developing lungs, must be considered. While inhaled NO exerts acute beneficial effects, it is unclear if there are long-term benefits. Multicenter trials are currently underway to determine if inhaled NO decreases mortality from PPHN or decreases morbidity associated with ARDS.
Administration, Inhalation↗
[Catabolic stress response during and after abdominal surgery. Comparison between two anaesthesia procedures].
BACKGROUND: The purpose of the study was to investigate the effect of modified neuroleptanesthesia (NLA) with fentanyl/midazolam on the catabolic responses during and after abdominal surgery. METHODS: A total of 13 patients undergoing cystoprostatectomy received either modified NLA ( n=7) or inhaled anesthesia with isoflurane (ISO, n=6). Glucose and urea production rates were assessed before, during and 1 day after the operation. Plasma concentrations of glucose, urea, lactate, insulin, glucagon and cortisol were also determined. RESULTS: In contrast to isoflurane anesthesia, modified NLA prevented an increase in plasma glucose concentration and glucose production during ( P<0.05), but not after surgery. There were no differences in perioperative urea production rates or plasma concentrations of urea, insulin, glucagon and lactate between the two groups. Modified NLA suppressed the intraoperative increase in plasma cortisol concentration as observed in the ISO group ( P<0.05). CONCLUSION: Modified NLA inhibits the increase in plasma glucose concentration and glucose production as seen during isoflurane anesthesia. However, NLA does not influence the catabolic response on the first postoperative day.
Abdomen↗
[Diazepam (Valium) in the endovenous induction of general anesthesia by inhalation].
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Anesthesia, General↗
[Complications related to anesthesia method in the University of Occupational and Environmental Health Hospital].
BACKGROUND: Complications related to anesthesia remain a problem. We studied the incidence of complications during anesthesia in 2758 patients who had undergone anesthesia in the University of Occupational and Environmental Health Hospital. METHODS: We checked the anesthesia records retrospectively and analyzed the collected data for the incidence of complications during anesthesia. RESULTS: The total incidence of complications during anesthesia was 12.2%. The incidences of complication are estimated to be 13.4% in inhalation anesthesia, 11.9% in inhalation anesthesia plus epidural, spinal or conduction block, 8.9% in CSEA, zero % in epidural anesthesia and 7.5% in spinal anesthesia. CONCLUSIONS: The incidence of complications in inhalation anesthesia was almost as same as that in inhalation anesthesia plus epidural, spinal or conduction block. More study should be necessary to prevent complications related to anesthesia.
Anesthesia↗
AN AUTOMATIC INHALATION-ACTUATED AEROSOL ANESTHESIA UNIT: A NEW METHOD OF APPLYING TOPICAL ANESTHESIA TO THE OROPHARYNX AND TRACHEOBRONCHIAL TREE.
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Aerosols↗