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At least 667 records · Page 37Linked to original sources
PubMed1992

[Effects of endotracheal intubation on the trachea--usefulness of the evaluation by MRI].

Using an MRI apparatus, we observed the effects of endotracheal intubation on the trachea by measuring T1 value before and after an operation in ten surgical cases. T1 value of the anterior wall at the level of the first tracheal ring was 275.8 +/- 58 msec, and that of the posterior wall was 346.8 +/- 72 msec. The patients were all intubated under general anesthesia. Anesthesia was maintained with inhalation anesthesia such as nitrous oxide-oxygen-enflurane with the aid of vecuronium bromide. Periods of intubation varied between 80 to 46 minutes, and averaged 270 +/- 112 minutes. After the extubation, T1 value showed 312 +/- 62 msec at the anterior wall and 395 +/- 82 msec at the posterior wall. In the case of the posterior wall, T1 value was significantly prolonged compared with that of the pre-intubation period. Prolongation of T1 value is assumed to be related to the increase of tissue free water demonstrating the occurrence of tissue edema. From the findings that T1 value might be prolonged by endotracheal intubation, we conclude that the MRI apparatus is useful for investigating the effects of the intubation procedure on the trachea.

Adult↗
PubMed1999

Recovery and pharmacokinetic parameters of desflurane, sevoflurane, and isoflurane in patients undergoing urologic procedures.

STUDY OBJECTIVE: To compare the pharmacokinetics and the speed of recovery after inhalation anesthesia with desflurane, sevoflurane, and isoflurane in elective surgery. DESIGN: Prospective, randomized study. SETTING: University medical center. PATIENTS: 30 ASA physical status I and II adults presenting for elective surgery. INTERVENTIONS: Anesthesia was induced with etomidate and maintained with desflurane (n = 10), sevoflurane (n = 10), or isoflurane (n = 10) and nitrous oxide. The inhalation drugs were titrated until an adequate clinical depth of anesthesia was reached. At the end of anesthesia, the patients breathed oxygen via the endotracheal tube and after extubation via a face mask. MEASUREMENTS AND MAIN RESULTS: The groups were similar with respect to age, weight, duration of anesthesia, and mean arterial pressure. Mean end-tidal concentration (FA = FA0) at the end of anesthesia was 6.34 +/- 1.15% after desflurane, 1.85 +/- 0.42% after sevoflurane, and 1.10 +/- 0.24% after isoflurane. FA/FA0 decreased significantly faster with desflurane than with isoflurane, while there was little difference between desflurane and sevoflurane. As for the terminal half-life (t1/2), there were no differences among the groups (8.16 +/- 3.15 min after desflurane, 9.47 +/- 4.46 min after sevoflurane, and 10.0 +/- 5.57 min after isoflurane). The time until a command was followed for the first time was the same in all three groups (13.0 +/- 4.7 min after desflurane, 13.4 +/- 4.4 min after sevoflurane, and 13.6 +/- 3.4 min after isoflurane). There was no significant correlation between duration of anesthesia and the time until recovery. CONCLUSIONS: There are only minor differences with regard to the recovery phase in premedicated patients who receive clinically titrated inhalation anesthesia with desflurane, sevoflurane, or isoflurane.

Adolescent↗
PubMed2005

[Efficacy of continuous subcutaneous pentazocine infusion for the postoperative analgesia in lower abdominal surgery].

BACKGROUND: Continuous subcutaneous infusion (CSI) of analgesics may be an alternative for pain control in patients without an epidural catheter. The aim of this study was to investigate the efficacy of CSI using pentazocine in lower abdominal surgery with inhalation anesthesia or with total intravenous anesthesia. METHODS: One hundred forty-seven patients scheduled for gynecological abdominal surgery were analyzed retrospectively. Anesthesia was induced with propofol and was maintained with propofol infusion or isoflurane-nitrous oxide inhalation. All patients received 30-75 mg of pentazocine before incision. At the end of surgery, CSI of pentazocine was begun at a rate of 0.5 ml x hr(-1) x Given regimen was pentazocine 240-390 mg and droperidol 5 mg with 1% lidocaine, and the total amount of dose was 40 ml. RESULTS: Over 80% of patients were assessed to have effective pain relief and minimum side effects. Patients were classified into two groups by anesthetics during anesthesia; propofol, pentazocine, ketamine group (PPK group, n = 61); nitrous oxide, isoflurane, pentazocine group (GOI group, n=88). There were no differences between the two groups regarding postoperative pain relief, while total dose of pentazocine used during anesthesia were lower in GOI group than PPK group. CONCLUSIONS: In patients undergoing lower abdominal surgery, CSI of pentazocine provided effective postoperative pain relief and effectiveness did not depend on anesthetics during anesthesia.

Abdomen↗
PubMedDate not supplied

[Status and prospects of the development of anesthesia-respiratory equipment].

Anesthesia-respiratory equipment (ARE) mainly including assisted ventilation apparatuses, inhalation anesthesia apparatuses, as well as the monitors employed in the use of these apparatuses are and will be the lead on the market of medical equipment in Russia. Therefore it is important to consider the immediate prospects of ARE development. For each of the above three types of ARE, the paper briefly lists the current and promising applications, the sites of their use, procedures, principal quantitative requirement and design. It refers to the most specific Russian and foreign items. The authors outline their own views of the immediate tasks of ARE design in Russia.

Anesthesia, Inhalation↗
PubMedDate not supplied

[Evaluation of the effectiveness of slow-flow anesthesia in children].

Combined total anesthesia by a slow flow of fresh gas (slow-flow anesthesia) was used in 98 children aged 1-14 years with various surgical diseases. The advantages of this method consist in a lower loss of humor and heat from the child's airways during surgery, a lower contamination of the air in the operation room, and a lower cost of anesthesia. If properly monitored, such anesthesia is a sufficiently effective and safe method of inhalation anesthesia, which can be used with good results in routine pediatric surgery.

Adolescent↗
PubMed1989

Interaction between nondepolarizing neuromuscular blocking agents and inhalational anesthetics.

Although many studies have presented data based on administration of nondepolarizing neuromuscular blocking agents to patients given inhalation anesthesia for 30-45 min, no data exist on the interaction in a clinical situation where the relaxant is administered immediately after the start of anesthesia. We therefore studied the effect of the commonly used inhalation anesthetics, halothane and enflurane, on the clinical pharmacology of atracurium, vecuronium, pipecuronium, and pancuronium. No significant influence of the anesthetic technique on the onset time of the various neuromuscular blocking agents was observed. The duration of action of atracurium, pipecuronium, and pancuronium was significantly prolonged during enflurane anesthesia as compared with the other two anesthetic techniques. The duration of vecuronium blockade was not significantly influenced by enflurane. Halothane, in contrast to enflurane, did not significantly prolong the blockade induced by these agents. The prolongation of atracurium blockade was clinically irrelevant. A fact that is statistically significant but clinically irrelevant is that a cumulative effect with atracurium and vecuronium was only seen during enflurane anesthesia and after the fourth maintenance dose. We conclude that there is no clinical indication that the dosage of atracurium and vecuronium during inhalation anesthesia should be reduced, but the doses of pipecuronium and pancuronium should be reduced when prolonged paralysis is not desired.

Adult↗
PubMedDate not supplied

[Oxygen transport parameters in halothane and isoflurane anesthesia with the low gas flow in children].

The efficiency and safety of low flow inhalation anesthesia for children were evaluated on the basis of oxygen transport parameters. Sixty-seven children aged 3 months to 15 years (mean age 5.7 +/- 2.5 years) were subjected to inhalation halothane and isoflurane anesthesia with fresh gas flow of 0.5 liter/min. Oxygen delivery, consumption, and tissue extraction were evaluated. Oxygen transport parameters remained optimal at all stages of anesthesia, which confirmed the safety of this method in children for routine interventions.

Adolescent↗
PubMedDate not supplied

[Methods for increasing the efficiency of aerosol inhalators].

Methods for increasing the efficiency of aerosol inhalation anesthesia and therapy are discussed. Certain aspects of aerosol generation, sedimentation in the respiratory pathways, and regulation of aerosol particle size are considered. Methods of aerosol heating and parameters of heat production in inhalation mixtures are analyzed.

Administration, Inhalation↗
PubMed1992

Pressure support ventilation decreases inspiratory work of breathing during general anesthesia and spontaneous ventilation.

Spontaneous ventilation may offer advantages over controlled mechanical ventilation (CMV), but increase in work of breathing may diminish its usefulness. During general anesthesia, respiratory depression and increased work of breathing often preclude spontaneous ventilation, and patients then receive CMV. We compared the inspiratory work of breathing of anesthetized patients who breathed with pressure support ventilation (PSV) with that associated with a demand gas flow and a standard anesthesia circle system. We studied nine consenting patients who underwent general inhaled anesthesia with or without regional supplementation. An anesthesia/ventilator system (Siemens 900D, Solna, Sweden) provided PSV (5 cm H2O) or demand gas flow during spontaneous inspiration. Gas flow during demand breathing and PSV was initiated when inspiration produced a 2-cm H2O reduction in airway pressure. An anesthesia machine (Dräger Narkomed 3, Telford, Pa.) provided a gas flow rate of 6 L/min through a standard semiclosed circle system. Airway pressure, airway gas flow rate, and esophageal pressure were continuously transduced, and data or signals were conveyed to a computer. Tidal volume and respiratory rate were computed from the flow curve. The inspiratory work of breathing was calculated as the integral of the area subserved by a plot of esophageal pressure and tidal volume during inspiration. Heart rate and mean arterial blood pressure were recorded, and arterial blood was sampled for gas tension and pH analysis. No differences were found in pHa, Paco2, Pao2, tidal volume, respiratory rate, heart rate, or mean arterial blood pressure among the three modes of ventilation.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1997

[The effect of low-dose prostaglandin E1 on intra- and post-operative renal function].

We investigated the effects of low-dose prostaglandin E1 (PGE1) on intra- and post-operative renal function in 109 adult patients undergoing upper abdominal surgery. Anesthesia was maintained with a combination of thoracic epidural combined with inhalational anesthesia. Sixty-seven patients received PGE1 at a rate of 0.2 microgram.kg-1.min-1 throughout surgery. Forty-two patients, who did not receive PGE1, served as control. Pre- and post-operative renal function was evaluated with serum levels of BUN and creatinine (Cr), while intra-operative renal function was evaluated mainly with urine output and urine flow rate during anesthesia. Urinary Na excretion and creatinine clearance (Ccr) were determined during surgery in limited cases. Urine output and urine flow rate during anesthesia were greater in PGE1 group than in control group, whereas infusion volumes and infusion rates were not different between the groups. In PGE1 group, urine flow rate was greater during surgery than before surgery, while in control group, it was unchanged. Na excretion during anesthesia was also greater in PGE1 group than in control group. In control group, Na excretion and Ccr were smaller during surgery than before surgery, while in PGE1 group, they were unchanged. Postoperative serum BUN and creatinine levels were not different between the groups. Decreased Na excretion and decreased Ccr in control group indicated that renal function was depressed during surgery, whereas unchanged Ccr, unchanged Na excretion and increased urine flow rate in PGE1 group indicated that renal function was well-maintained during surgery with PGE1. Low-dose PGE1 thus prevented depression of renal function during surgical anesthesia.

Abdomen↗