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Anaesthesia ans Analgesia

Shynma Uchida, Yuji Kadoi, Shigeru Saito
Objective: Several reports have shown the negligible adverse effects of low-dose remifentanil on the autonomic nervous system. We propose that the administration of low-dose remifentanil would be beneficial without adverse respiratory and hemodynamic effects. This study aimed to examine the effects of low-dose remifentanil on postoperative pain relief and heart rate variability (HRV) after surgery. Methods: In total, 20 patients, who underwent breast cancer surgery, were analysed for HRV in the post-anaesthesia care unit (PACU)...
October 2017: Turkish Journal of Anaesthesiology and Reanimation
Mirosław Ziętkiewicz, Andrzej Nestorowicz
Modern general anaesthesia is complex and reversible.It involves a temporary loss of consciousness, analgesia,a decrease in muscle tension or complete muscle relaxation,suppressed reactions of the autonomic nervous system,and the provision of amnesia of events after its completion.
April 2012: Anaesthesiology Intensive Therapy
I Korhonen, A Yli-Hankala
Photoplethysmography (PPG), i.e. pulse oximetric wave, is a non-invasive technique that is used in anaesthesia monitoring primarily to monitor blood oxygenation. The PPG waveform resembles that of the arterial blood pressure but instead of pressure it is related to the volume changes in the measurement site and hence contains information related to the peripheral blood circulation, including skin vasomotion, which is controlled by the sympathetic nervous system. Because of this link, skin vasomotor response and PPG amplitude response have been associated with nociception under general anaesthesia...
September 2009: Acta Anaesthesiologica Scandinavica
Christian-Serge Degoute
For half a century, controlled hypotension has been used to reduce bleeding and the need for blood transfusions, and provide a satisfactory bloodless surgical field. It has been indicated in oromaxillofacial surgery (mandibular osteotomy, facial repair), endoscopic sinus or middle ear microsurgery, spinal surgery and other neurosurgery (aneurysm), major orthopaedic surgery (hip or knee replacement, spinal), prostatectomy, cardiovascular surgery and liver transplant surgery. Controlled hypotension is defined as a reduction of the systolic blood pressure to 80-90 mm Hg, a reduction of mean arterial pressure (MAP) to 50-65 mm Hg or a 30% reduction of baseline MAP...
2007: Drugs
Bruno Guignard
Analgesia (pain relief) amnesia (loss of memory) and immobilisation are the three major components of anaesthesia. The perception of pain, and therefore, the need for analgesia, is individual, and the monitoring of analgesia is indirect and, in essence, of the moment. Under general anaesthesia, analgesia is continually influenced by external stimuli and the administration of analgesic drugs, and cannot be really separated from anaesthesia: the interaction between analgesia and anaesthesia is inescapable. Autonomic reactions, such as tachycardia, hypertension, sweating and lacrimation, although non-specific, are always regarded as signs of nociception or inadequate analgesia...
March 2006: Best Practice & Research. Clinical Anaesthesiology
P R Hambly, B Martin
Increasing numbers of patients with spinal cord injury present for surgery or obstetric care. Spinal cord injury causes unique pathophysiological changes. The most important peri-operative dangers are autonomic dysreflexia, bradycardia, hypotension, respiratory inadequacy and muscle spasms. Autonomic dysreflexia is suggested by headache, sweating, bradycardia and severe hypertension and may be precipitated by surgery, especially bladder distension. Patients with low, complete lesions, undergoing surgery below the level of injury, may safely do so without anaesthesia provided there is no history of autonomic dysreflexia or troublesome spasms...
March 1998: Anaesthesia
B G Jørgensen, H E Holm
A case history in which a patient suffering from long-term diabetes mellitus underwent vascular surgery of a lower extremity is presented. Anaesthesia was commenced with an epidural anaesthesia, but due to insufficient analgesia combined with a high thoracal block general anaesthesia was added. The course was complicated because of cardiomyopathy, autonomic neuropathy, difficult laryngoscopy, aspiration of gastric content, and acute renal failure. Anaesthetic implications of long-term diabetes mellitus are discussed...
May 1995: Acta Anaesthesiologica Scandinavica
M Kawamoto, A Shimokawa, M Takasaki
Effects of midazolam on the cardiac autonomic nervous system were studied by power spectral analysis of electrocardiographic R-R intervals in patients undergoing elective lower abdominal surgery under spinal anaesthesia. Patients were randomly assigned into two groups: 10 patients in group A received spinal anaesthesia only and 10 in group S received spinal anaesthesia and midazolam of 0.05 mg/kg when surgery started. In the frequency domain power spectra, low (Lo; 0.04-0.15 Hz) and high (Hi; 0.15-0.40 Hz) frequency components were integrated to ascertain sympathetic and parasympathetic activity, respectively...
August 1995: Anaesthesia and Intensive Care
C Prys-Roberts
No abstract text is available yet for this article.
November 1987: British Journal of Anaesthesia
P Hoffmann, B Schockenhoff, P Lierz
Seven different schemes for analgesic anaesthesia were investigated for their clinical applicability, potential side effects, and impacts on circulation parameters of the systemic and pulmonary (peripheral) circulation as well as on the intracranial pressure. In all, so patients per group were treated. The results revealed different reactions of patients, such as a higher incidence of disturbances of the autonomic nervous system and excitation after medication withdrawal. Favourable effects not only on clinical reactions but also on circulation parameters were seen during fentanyl/midazolam or alfentanil/midazolam therapy...
1991: Klinische Wochenschrift
E Crosby, B St-Jean, D Reid, R D Elliott
Improved acute and rehabilitative care and emphasis on integrating patients into society after spinal cord injury is likely to result in increasing numbers of cord-injured women presenting for obstetrical care. Anaesthetists providing care to these women should be familiar with the complications resulting from chronic cord injury and aware that many may be aggravated by the physiological changes of normal pregnancy. These complications include reduced respiratory volumes and reserve, decreased blood pressure and an increased incidence of thromboembolic phenomena, anaemia and recurrent urinary tract infections...
May 1992: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
P Veroli
General anaesthesia alters self-regulation of arterial pressure by lowering the sympathetic tone to his baseline level. More important is the sympathetic stimulation before general anaesthesia, more important will be the decrease in arterial pressure after induction. Epidural anaesthesia always leads to a sympathetic blockade. The extent and the speed of appearance of this blockade condition the magnitude of the decrease of arterial pressure. So, general anaesthesia and epidural anaesthesia both modifying deeply the autonomic nervous system, their association can only be performed on hemodynamically stable patients for a non hemorrhagic surgery...
1992: Cahiers D'anesthésiologie
E Freye
In 70 patients (maxillo-facial-, neurosurgical-, abdominal- and gynaecological operations) the technique of "analgetic anaesthesia" using high doses of fentanyl (0.025 mg/kg body weight) and naloxone as its antagonist (0.02 mg/kg body weight) has been employed. All patients were artificially ventilated with N2O/O2 in a 3:1 ratio. Muscle relaxation was achieved with pancuronium-bromide (0.08 mg/kg). The patients had no apparent heart or lung disease. The youngest patient was 4 years of age, the oldest 82 years of age (average age 48...
April 1975: Der Anaesthesist
W Bayerl, K Fischer
The quadrant-syndrome (Q.S.) is a functional disturbance of the vegetative system, characterized by the distribution of subjective and objective lesions to a quarter of the body (quadrant). The neurological aspect of the Q.S. varies so much in character, that it may mistakenly be considered to be psychogenic in origin. All qualities of peripheral nerve function can be affected singly or collectively and in varying degree. The duration of illness cannot be predicted; it may last from some weeks up to more than 10 years...
June 26, 1977: Archiv Für Orthopädische und Unfall-Chirurgie
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