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At least 19 recordsLinked to original sources
PubMed1976

Emotional response to intravenous delta9tetrahydrocannabinol during oral surgery.

The administration of delta9THC intravenously as a premedicant to oral surgery resulted in acute pronounced elevations in anxiety states, a predominance of dysphoria over euphoria, and varying degrees of psychotic-like paranoiac thought. Neural effects that appeared to promote these effects included distortions of perception with sensory delusions, and heightened sensory receptiveness including antalgesic impressions of surgery; autonomic and visceral arousal greater than control or placebo levels; lack of overt behavioral signals of distress due to depersonalization; and time disintegration leading to fear-inducing misinformation about real surgical events. Introverted subjects who generally were inclined to rely on drug solutions to their problems tended to respond poorly to surgical pain and anxiety with delta9THC. These results, obtained from subjects considered to have levels of presurgical apprehension that were average or below average, suggest that the environment in which high doses of cannabinols are experienced is a potent factor in determining the quality of the emotional response. A surgical environment containing even the mild stress of outpatient oral surgery appears to have the potential to precipitate undesirable emotional responses among cannabinol-intoxicated patients. There is continued high-level social use of cannabinols inour society, with an estimate of 40% to 55% among the college-age group seen frequently by oral surgeons. Results of this study suggest that clinicians should be prepared to detect the subtle signs of marijuana intoxication to protect their patients from further psychophysiologic complications during surgery.

Adolescent↗
PubMed1977

[History of lumbar sympathectomy from its origin to the present].

The author first recalls the origins of the words "sympathetic" and "neurovegetative system" and then outlines the beginnings of surgery on the autonomic nervous system in general. This started with the section of the rami communicantes introduced by the Australians Royle and Hunter in surgery of the muscle tone. Then nearly at the same time in 1924. Adson in USA and J. Diez in Argentina resected the lumbar sympathetic chains; the latter mainly for treatment of thromboangeitis obliterans. From 1924 on, lumbar sympathectomy met with rapid success as shown at the Cairo Congress of 1935. Physiologic and pathologic effects of lumbar sympathectomy are analysed and the usual techniques are reviewed. The author then lists the specific postoperative complications, including the pain symdroms and the functional sexual disorders in males. Finally the principal indications where lumbar sympathectomy proved useful are named. Chronic obliterative arteriopathies are the first. For these lumbar sympathectomy still holds a palliative, supportive or absolute role. A scheme illustrates its beneficial actions.

Arterial Occlusive Diseases↗
PubMedDate not supplied

[Surgical treatment of autonomous chronic pancreatitis (apropos of 147 cases)].

Surgery in chronic pancreatitis gives only poor results: 40 p. 100 of cures or long-term improvements. Apart from certain mistaken indications, three factors are associated with a poor prognosis: calcification, late operation, persistence of alcoholism. However, mechanical complications, such as jaundice, pyloric stenosis, digestive hemorrhage and pseudo-cyst, are the main undoubted indications for operation. The choice of operation depends mainly on the state of Wirsung's duct. Usually, either part of the gland is removed or an internal digestive fistula is performed. Removal of the left lobe of the pancreas gives good results. Cephalic duodeno-pancreatectomy which is satisfactory in the short term, does not give, in the long run, better results than those of drainage operations. Pseudo-cysts are treated by removal when situated in the body or the tail and a drainage operation in the cephalic form. Simple operations should be preferred.

Adult↗
PubMed2026

Artificial Intelligence for Colorectal Surgeons-Part II: Research Applications, Challenges in Adoption, and Practical Resources.

BACKGROUND: This is part II of a 2-part series examining artificial intelligence in colorectal surgery. Part I established foundational concepts and clinical applications. Implementation, however, requires understanding research methodologies, available resources, and the specific challenges currently limiting widespread adoption. These topics are the focus of part II. OBJECTIVE: To examine artificial intelligence's transformation of surgical research, provide practical implementation resources, address adoption challenges, and explore future directions in colorectal surgery. METHODS: Comprehensive literature review focusing on artificial intelligence research methodology, implementation barriers, educational resources, and emerging technologies relevant to colorectal surgeons. RESULTS: Artificial intelligence streamlines clinical trial design through predictive modeling and natural language processing, reducing enrollment challenges that contribute to failed or inadequate trial accrual. Machine learning enables heterogeneity analysis within clinical trials, identifying treatment-responsive subgroups. Foundation models unlock analysis of unstructured electronic health record data at scale. Professional societies and universities offer specialized artificial intelligence education programs, with open-access data sets facilitating research participation. However, implementation faces multifaceted challenges: technical infrastructure demands, with real-time processing requiring dedicated graphics processing unit clusters; regulatory frameworks struggling with continuously evolving algorithms; undefined liability distribution for artificial intelligence-assisted decisions; algorithmic bias risking health care disparities; and the "black box" problem limiting clinical trust. Economic barriers include substantial initial costs without clear reimbursement pathways. Future directions include multimodal artificial intelligence integrating imaging, genomics, and histopathology; cognitive robotic systems with real-time decision support; digital twin technology for patient-specific surgical simulation; and global surgical artificial intelligence networks enabling distributed learning across institutions. CONCLUSIONS: Although artificial intelligence offers transformative potential for colorectal surgery research and practice, successful implementation requires addressing technical, regulatory, ethical, and economic challenges. The surgeon's evolving role demands both traditional expertise and computational fluency. Future advances in multimodal integration, autonomous systems, and global collaboration will fundamentally reshape surgical practice but will require thoughtful implementation prioritizing patient benefit and clinical value.

Humans↗
PubMed1976

[Place of neuroleptics in neurosurgical anesthesia-resuscitation].

The interest of neuroleptics in neurosurgery should be examined in the light of physiopathological and pharmacological data concerning cerebral circulatory autoregulation and intracranial pressure. The fairly favourable conclusions permit one to consider their wide use justified, especially, by the feeble hypnogenic effects, without any marked disturbance of the E.E.G., associated with an anticatecholaminergic and stabilizing effect on the autonomic nervous system. They therefore occupy a place of choice, in particular during induction of anesthesia in high risk patients, during operations requiring neurological or continuous E.E.G. investigations, in surgery of intracranial aneurysm and, finally, to obtain sedation and post-operative autonomic control.

Anesthesia↗
PubMed1979

Reduced vibratory perception and corneal sensitivity and metabolic disturbances following intestinal bypass surgery.

Decreased corneal sensitivity and vibratory perception suggesting a diagnosis of polyneuropathy were demonstrated in some of 26 patients who had undergone intestinal bypass surgery. Psychological tests revealed signs of disturbance of the autonomic nervous system. A deficiency of 25-hydroxyvitamin D was demonstrated, clearly related to the frequency of stools and to the weight loss. This deficiency might play a role in the pathogenesis of the polyneuropathy.

Adolescent↗
PubMed1975

Impaired cardiovascular responsiveness in liver disease.

Cardiovascular responsiveness to reflex impaired in patients with cirrhosis compared with control subjects. Peripheral vascular responses to exogenous noradrenaline were also impaired in cirrhotic patients, but peripheral vascular responses to infused adrenaline and to angiotensin II were similar in both groups. Impaired cardiovascular reactivity in patients with chronic liver disease could predispose them to circulatory failure after haemorrhage or surgery and should be considered when prescribing drugs which affect autonomic activity.

Angiotensin II↗
PubMed1979

Respiratory influence on heart rate in diabetes mellitus.

To find a simple and accurate test of autonomic nervous dysfunction in diabetes mellitus, 41 insulin-dependent diabetics and 25 controls were investigated. The diabetics, none of whom had symptoms of autonomic dysfunction, were tested for retinopathy and sensory neuropathy. Each subject also performed maximal deep-breathing procedures while undergoing electrocardiographic recording: in normal subjects the intervals are shortened during inspiration and prolonged during expiration, and a difference in the heart rate between inspiration and expiration of 10% or less seems to indicate autonomic dysfunction. This difference was calculated as an E:I ratio of the mean of the longest R-R interval during maximal expiration to the mean of the shortest during maximal inspiration. Ten of the 18 patients found to have sensory neuropathy had abnormal E:I ratios, and among those with absent ankle reflexes the proportion was even higher (9 out of 11). The E:I ratio also seemed to be as accurate as traditional tests for autonomic dysfunction and easier to perform. Diabetics with autonomic dysfunction have an increased risk of acute cardiorespiratory death during and after surgery, and maximal deep breathing and calculation of the E:I ratio may be a useful test to perform on diabetics at risk.

Adult↗
PubMed1978

Preliminary investigation into a new method of assessing the quality of anaesthesia: the cardiovascular response to a measured noxious stimulus.

It is suggested that the autonomic response to noxious stimulation may be measured during anaesthesia. The response may be marked despite considerable depression of cortical activity as measured by the cerebral function monitor. Preliminary results suggest that large doses of narcotic analgesics reduce the autonomic response to noxious stimulation and this may be used as a test to compare the potency and duration of action of narcotic drugs during anaesthesia. It is possible that the measurement of beat-to-beat variation in heart rate may be used to monitor autonomic nervous system activity and, indirectly, the degree of stress during surgery, provided that the efferent limb of the reflex arc remains intact. With the aid of the cerebral function monitor and with an index of reflex response to noxious stimulation it should be possible to monitor the effect of anaesthesia on the central nervous system more precisely.

Alfaxalone Alfadolone Mixture↗
PubMed1976

[Sphincter surgery. Etiology and therapy of the anal fissure (author's transl)].

Anal fissures belong to the autonomic diseases. A raised sympathicotonus (spasm dystrophy) is responsible for the origin, the poor healing tendency and the burning pain. This excessive effect of the sympathetic leads first to functional and later to organic disorders of the sphincter in the form of an achalasia. The empirically developed methods of operation have intervention in the autonomic nervous system in common, and only differ in the extent of this "invasion of the autonomic". Functional changes must be treated with local anesthetics or by stretching the sphincter, organic changes by sphincterotomy.

Adolescent↗
PubMed1976

[General anesthesia in major cancer surgery of the upper respiratory and digestive tracts. Significance of a fentanyl-thiamine combination].

Synaptanalgesia uses a polysynaptic inhibitor: thiamine and a powerful analgesic drug with or without nitrous oxide. This type of vigil or sub-vigil anesthesia used in major cancer surgery of the upper digestive tract and the airway, permits one to obtain: -efficacious protection of the autonomic nervous system, in spite of manipulations of highly reflexogenic areas, -a marked reduction in bleeding. The technique used is derived from that of other authors: DE CASTRO, MUNDELEER, VALENI, MAZZONI, GASPARETTO, adapting it to this type of surgery and attempting to simplify it.

Adult↗
PubMed1978

[Approach to a differentiated recurrence prevention following struma surgery].

Changes of the pituitary-thyroid axis were studied in 70 patients (45 with euthyroid goiters, 25 with autonomous adenomas) preoperatively; over a 6-week postoperative interval without thyroid-hormone treatment; under T4 therapy increased stepwise and maintained for 1 year; and over a period of 12 weeks after its withdrawal. The postoperative thyrotropic function obviously depends on the preoperative condition and thereby on the quality of the remaining tissue as well as on the extent of the operation and thus the amount of remaining tissue. The frequency of a "prehypothyroid" status in the early postoperative course is high (77%) after bilateral resection for euthyroid goiter, but decreased 1 year after the operation (47%). After unilateral resection for euthyroid goiters and after bilateral and unilateral resection or enucleation for autonomous adenomas, the remaining tissue is for the most part sufficient to avoid increased pituitary stimulation. Prophylaxis of recurrent goiter with thyroid hormones could be prescribed individually on the basis of the postoperative function of the pituitary-thyroid axis.

Adenoma↗
PubMed1977

Coeliac plexus block with alcohol for relief of upper abdominal pain due to cancer.

One hundred cases of coeliac plexus block in which absolute alcohol was used as a sclerosing agent, performed over a period of 10 years between 1963 and 1973, are analysed. A success rate of 91% in relieving the pain of advanced intra-abdominal malignant disease is claimed and reasons for failures are advanced. The technique described is relatively simple and a 3-day hospital stay is all that is required. It is recommended that this procedure be carried out before the invalid is subjected to repeated injections of narcotic drugs or any form of surgery for pain relief.

Abdominal Neoplasms↗
PubMed1979

Shy-Drager syndrome. A review and a description of the anaesthetic management.

Autonomic failure in patients with the Shy-Drager syndrome may produce cardiovascular instability during anaesthesia and surgery. The syndrome is reviewed and the anaesthetic management of a case is described. The choice between general and regional anaesthesia seems to be less important than adequate cardiovascular monitoring and the maintenance of blood pressure with intravenous fluids. Sympathomimetic drugs, if used at all, should be administered in very dilute solutions to avoid hypertension from denervation hypersensitivity. In the postoperative period, symptoms from orthostatic hypotension may be severe and their control requires prolonged postural training, by elevation of the head of the bed, and therapy with 9-alpha-fludrocortisone.

Anesthesia, General↗