RESUMO
The measurement of transcutaneous PtcO2 in eight normal adults prove a comparable efficacy of 50 l.min-1 O2 through facial "small mask" (61.5 kPa; 463 mmHg) and 20 l.min-1 O2 through head tent (65.1 kPa; 490 mmHg). First procedure, inexpensive, is very simple to use.
Assuntos
Máscaras , Oxigenoterapia/métodos , Dióxido de Carbono/análise , Feminino , Humanos , Masculino , Oxigenoterapia/instrumentaçãoRESUMO
When tracheal intubation is conducted with traditional laryngoscope PtcO2 fall during the first minute after intubation; when continuous O2 supplied laryngoscope (Laryng O2) is used PtcO2 rise; the difference is statistically significant (p less than 0.001) either the subjects are in curarisation apnea or in spontaneous ventilation. With traditional laryngoscope, the fall is faster with spontaneous ventilation conditions than during curarisation apnea. Likewise in normal conscient subject the same fall is faster (p less than 0.001) during first minute of posthyperoxic spontaneous quiet ventilation than the first minute of voluntary hypocapnic apnea induced by hyperventilation during the same hyperoxia. Such results have to be taken into account for the indications of tracheal intubation technical means if hypoxic conditions are to be suspected, particularly for infants and subjects with cardio-respiratory failure.
Assuntos
Monitorização Transcutânea dos Gases Sanguíneos , Intubação Intratraqueal , Oxigênio/análise , Pressão Parcial , Adulto , Humanos , Laringoscópios , Oxigênio/administração & dosagem , RespiraçãoRESUMO
PIP: The amnesic effect of nitrous oxide was studied in 50 women undergoing induced abortions under general anesthesia at a hospital in France. The request for general anesthesia was made by the practitioner, by psychologists working with the women, or by the women themselves. Patient ages ranged from 13-39 years and averaged 24. All patients were given 1 mg of dextromoramide. During the procedure a mixture of 50% nitrous oxide and 50% oxygen was delivered. The patient was asked to count to 200 and remember a list of 5 words, and questions were posed. The nitrous oxide was terminated at completion of the aspiration. Awakening occurred in under 5 minutes with nitrous oxide and oxygen and at around 10 minutes when halothane was added. 30 minutes after awakening the patient was questioned about the surgery and the preoperative talk and questions. None of the patients recalled insertion of the speculum. In 46 of the 50 cases a total or partial amnesia occurred. Among 20 patients given the nitrous oxide-oxygen mixture only, 15 experienced total, 4 partial, and 1 no amnesia. Among the 30 patients given the same gas mixture and halothane, 25 experienced total, 2 partial, and 3 no amnesia. Nitrous oxide has no effect on longterm memory and probably inhibits the 1st phase of memorization. There are several components of its mode of action: classic analgesia, a potentializing effect with morphinomimetics and other general anesthesias, and an amnesia of painful and disagreeable interventions.^ieng
Assuntos
Amnésia/induzido quimicamente , Anestesia por Inalação/efeitos adversos , Anestesia Obstétrica/efeitos adversos , Óxido Nitroso/efeitos adversos , Aborto Induzido , Adolescente , Adulto , Feminino , Humanos , GravidezAssuntos
Morte Encefálica , Oxigênio , Respiração Artificial/métodos , Gasometria , Humanos , HipoventilaçãoAssuntos
Morte Encefálica , Ética Médica , Experimentação Humana , Transfusão de Sangue , França , HumanosRESUMO
To suppress the risk inherent in laryngeal microsurgery performed with a CO2 laser beam, the authors suggest to use a reinforced silicone endotracheal tube, the cuff of which is protected by a silicone plus aluminium powder shield. The resistance of silicone to fire is augmented during laser shots by a nitrogen flow on the upper side of the shield at the rates of 2 l/min in patients breathing air and 30 l/min in patients give oxygen.
Assuntos
Intubação Intratraqueal/instrumentação , Laringe/cirurgia , Terapia a Laser , Adolescente , Adulto , Idoso , Dióxido de Carbono , Criança , Feminino , Humanos , Neoplasias Laríngeas/cirurgia , Laringite/cirurgia , Masculino , Microcirurgia , Pessoa de Meia-Idade , Pólipos/cirurgiaRESUMO
The authors relate their experience of 61 inhalation anesthesia of children from 5 months to 15 years years old. Head-tent is usually employed for intensive care as a method to administrate pure oxygen. Children are often afraid of the face-mask and tolerate head-tent easier. Three different protocols were studied: Nitrous oxide and oxygen mixture at different level (50 p. cent oxygen, 50 p. cent nitrous-oxide; or 30 p. cent oxygen, 70 p. cent nitrous oxide). The authors also used halothan in the inhalated mixture. The rebreathing level of CO2 in the head-tent according to the gas flow was measured. No incident, nor accident are related. This new anesthetic apparatus is easy to use, well accepted by children.
Assuntos
Anestesia por Inalação/instrumentação , Adolescente , Adulto , Anestesia por Inalação/psicologia , Dióxido de Carbono/análise , Criança , Pré-Escolar , Medo , Feminino , Halotano/administração & dosagem , Cabeça , Humanos , Lactente , Masculino , Espectrometria de Massas , Pessoa de Meia-Idade , Óxido Nitroso/administração & dosagem , Oxigênio/administração & dosagem , Oxigênio/análiseRESUMO
Using a spectrometer for the study of exhaled gases and a monitor of transcutaneous oxygen pressure, our purpose has been to quantify our ideas about physiological apneas in the conscious voluntary adults. We compared the apneas, concerning the duration and the induced fall of peripheric oxygen pressure, after normoventilations in air and in oxygen, then after hyperventilations in air and in oxygen. These experiences confirm the tiny interest of previous normoventilation in oxygen compared with in air, the danger of hypoxemia by previous hyperventilation in air and the possibility of prolonged but safe apnea after hyperventilations in oxygen, that we can advocate in the induction of anaesthesia for some circumstances.
Assuntos
Apneia/fisiopatologia , Hiperventilação/fisiopatologia , Oxigênio/fisiologia , Adulto , Ar , Gasometria , Dióxido de Carbono/análise , Humanos , Masculino , Espectrometria de Massas , Pessoa de Meia-Idade , Oxigênio/análise , Pressão Parcial , Fatores de TempoRESUMO
The authors relate their experience of 61 rectal anesthesias with ketamine (10 mg/kg) and diazepam (0.25-0.5 mg/kg). Rectal anesthesia is well accepted by children who are afraid of percutaneous injection. When ketamine is used alone, they obtained only 76 p. cent good result. When diazepam is associated, good results arise to 95 p. cent. Diazepam added to ketamine allows surface surgery during 10 to 15 minutes.
Assuntos
Anestesia Retal , Diazepam/administração & dosagem , Ketamina/administração & dosagem , Adolescente , Anestesia Retal/métodos , Criança , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Procedimentos Cirúrgicos Menores , Fatores de TempoRESUMO
Sixty patients undergoing major digestive surgery received the same amount of drugs for induction of anesthesia; neuroleptic, morphinomimetic and pachycurares were used and calculated in mg/kg. A randomisation list permitted to define 45 patients who received in double blind (by means of a long electrical cord), an electrical current varying for each protocol; the control group (15 patients) did not receive an electrical current. Statistical study of the amount of drugs used for follow of anesthesia shows no real effect of electrical analgesia for digestive surgery.
Assuntos
Analgesia/métodos , Adulto , Idoso , Encéfalo , Ensaios Clínicos como Assunto , Diazepam , Procedimentos Cirúrgicos do Sistema Digestório , Método Duplo-Cego , Droperidol , Estimulação Elétrica , Eletronarcose , Humanos , Período Intraoperatório , Masculino , Pessoa de Meia-Idade , Pancurônio , FenoperidinaRESUMO
The authors have made a critical study of the respective advantages and disadvantages of the various methods of access to the internal jugular vein. These have been classified under 3 headings: frontal access, lateral access and rear access. They outline their experience of the technique described by Boulanger and Delva in 1977. This method of access seems to be favoured on two scores, its simplicity and the absence of immediate serious complications. These encouraging results lead them to advocate this as the technique they would choose especially in urgent cases.