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Results for “Anesthesia, General”

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PubMed1990

[Epidural conduction anesthesia versus general anesthesia. A critical evaluation of outcome studies using as examples cesarean section and patients with hip fractures].

In the field of anaesthesiology, outcome studies are undertaken to investigate the influence of different anaesthetic techniques on the intra- and postoperative course of patients in special clinical situations. The design of these studies should follow high methodological standards. In the past, most studies were undertaken in patients during Caesarean section and in the treatment of hip fractures in the elderly. Up to now, results do not clearly indicate the use of certain techniques in concrete clinical situations. Decisions must be made in accordance with clinical aspects, individual experience and in cooperation with the patient and the surgeon.

Adult↗
PubMed2005

General anesthesia versus epidural and general anesthesia in radical cystectomy.

INTRODUCTION: The aim of this study is to compare two different anesthetic techniques in radical cystectomy with regard to blood loss, transfusional requirements, intraoperative complications and the quality of analgesia. MATERIALS AND METHODS: 50 patients scheduled for radical cystectomy were randomized to two groups: group GA - general anesthesia, n = 25 and group CEGA - combined epidural and general anesthesia. The patients were monitored and hemodynamic changes, intraoperative bleeding, transfusional requirements, quality of analgesia and postoperative complications were evaluated. RESULTS: There were no significant differences between the demographic characteristics of the two groups. Intraoperative bleeding which was 874.8 +/- 190.7 ml in the CEGA group and 1,248.3 +/- 343.4 ml in the GA group was statistically different (p < 0.05). Significantly more intraoperative blood transfusions in terms of units were required in the GA group. Analgesia was better in the CEGA group, with VAS values at 0, 1, 2, 4, 6, 12 and 24 h significantly (p < 0.05) lower than those observed in the GA group. No significant differences in intraoperative hemodynamic parameters or postoperative complications were noted between the two groups. CONCLUSIONS: Statistically significant differences in intraoperative bleeding were observed between the two groups: CEGA provides lower intraoperative bleeding and a better postoperative analgesia. Major operations such as radical cystectomy, which also is associated with considerable blood loss, a combination of general and epidural anesthesia may allow for less blood loss, with a better postoperative analgesia and without any increase in complications.

Anesthesia, Epidural↗
PubMed2006

Local Anesthesia With Monitored Anesthesia Care vs General Anesthesia in Thyroidectomy: A Randomized Study.

BACKGROUND: Early in the 20th century, thyroid surgery was performed using local anesthetic techniques. When general anesthesia became safer, surgeons started performing thyroidectomy exclusively under general anesthesia. However, recent descriptions of thyroidectomy under local anesthesia claim similar results to thyroidectomy under general anesthesia. Surgery conducted under local anesthesia can result in early discharge, ie, a hospital stay of less than 8 hours. HYPOTHESIS: Thyroidectomy can be performed under local anesthesia with monitored anesthesia care (MAC) with results similar to general anesthesia in an outpatient or inpatient surgery setting. DESIGN: A prospective randomized study comparing local anesthesia with MAC vs general anesthesia in adult patients undergoing thyroidectomy in a potential outpatient setting, defined as same-day discharge. Patients were excluded if they were not able to receive local or general anesthesia. In addition, we performed an outcome evaluation of the use of local anesthesia with MAC for thyroidectomy and the use of outpatient surgery for thyroidectomy. We compared 58 consecutive thyroidectomies performed prior to the study with 58 consecutive thyroidectomies performed after the study. SETTING: A 486-bed university-affiliated hospital. RESULTS: Fifty-eight patients undergoing thyroidectomy received random assignment: 29 to local anesthesia with MAC and 29 to general anesthesia under study protocol. Fifty-one surgical procedures (88%) were completed as outpatient surgery. No significant differences were found between the 2 study groups in demographics, postoperative adverse symptoms, complications, hospital admission, or patient satisfaction. Patients in the general anesthesia group spent, on average, more time postoperatively than patients in the group that received local anesthesia with MAC in the outpatient surgery center until same-day discharge (P = .02). When compared before the study, we found a significant increase after the randomized study in the use of local anesthesia with MAC (P<.001) and outpatient thyroidectomies (P<.001). CONCLUSIONS: Thyroidectomy can be performed in the studied patient population under either general anesthesia or local anesthesia with MAC, expecting similar operative results, clinical results, and patient satisfaction. In addition, local anesthesia with MAC can reduce the postoperative time spent in an outpatient surgery setting with potential health care cost savings.

Adult↗
PubMed2003

The observation of response to cardiovascular system at periextubation period after continuous epidural anesthesia combined with general anesthesia.

The observation of cardiovascular response at peri-extubation period after continuous epidural anesthesia combined with mild general anesthesia was studied. Fifty patients of carcinoma esophagus were randomly divided into two groups, general anesthesia + epidural anesthesia combined group and control group (only general anesthesia), each 25 cases in one group, using a multifunctional monitor, continuous monitoring and recording was done for ECG, systolic pressure (SP), diastolic pressure (DP), heart rate (HR), oxygen saturation (Spo2) and rhythm of heart during the peri-extubation period. Severe cardiovascular instability was detected in control group during peri-extubation period, especially at the time of extubation, even higher than the baseline values (p<0.05). In combined group, the cardiovascular instability was far less, only a slight increase was noted at the time of extubation (p>0.05). The use of halothane was far less in combined group than that in control group (p<0.05). Mild general anesthesia combined with continuous epidural anesthesia is a good modality of anesthesia that can obviously decreased cardiovascular instability during peri-extubation.

Adult↗
PubMed1992

[Pediatric surgery. A comparison of spinal anesthesia and general anesthesia].

Forty patients aged 2 to 5 years who were admitted for paediatric operations were randomly assigned to have either spinal or general anaesthesia. Spinal anaesthesia was achieved with isobaric bupivacaine 0.5% at a dose of 0.5 mg/kg. General anaesthesia was induced with thiopentone 2-5 mg/kg and continued with low-dose fentanyl (1-2 micrograms/kg, oxygen/nitrous oxide/isoflurane (30/70/0.1-0.5%), vecuronium normoventilating the patients. The time spent in the operation room was shorter in the spinal anaesthesia group because the children were awake and could immediately be transferred. The haemodynamic pattern and respiratory function were stable during spinal anaesthesia. After general anaesthesia, respiratory function deteriorated as indicated by arterial desaturation (< 90%), which was detected in 11 of the 20 patients after general anaesthesia. Vomiting (2), sore throat (4) and micturition difficulties (2) were the adverse events associated with general anaesthesia. Three patients were restless after spinal anaesthesia. It can be concluded that spinal anaesthesia is a suitable anaesthetic technique for paediatric surgery.

Anesthesia, General↗