Assuntos
Anestesia por Inalação/métodos , Anestésicos Inalatórios , Anestesia por Inalação/história , Anestesia por Inalação/tendências , Anestésicos Inalatórios/administração & dosagem , Anestésicos Inalatórios/efeitos adversos , Anestésicos Inalatórios/economia , História do Século XIX , História do Século XX , Estrutura Molecular , Federação RussaRESUMO
The literature review concisely considers a relatively new problem of postoperative cognitive disorders occurring in surgical patients. The paper considers the present views of the etiology of postoperative cognitive disorders and their contributing and aggravating factors. Particular emphasis is laid on a factor, such as a surface anesthetic level and sudden intraoperative consciousness recovery, as well as on the prevention of this complication through the monitoring of anesthesia depth.
Assuntos
Transtornos Cognitivos/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Transtornos Cognitivos/etiologia , Transtornos Cognitivos/psicologia , Humanos , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/psicologiaRESUMO
Outpatient surgery presents a number of specific requirements for anesthesia, among which there is safety and that the main point is anesthesia, as well as postanesthesia depression should not be a limiting factor on discharge the patient from hospital. The authors compare 3 current anesthetic methods available in our country: 1) combined general anesthesia based on ketamine, dormicun, and fentanyl, 2) total venous anesthesia (TVA) based on propofol and fentanyl, and 3) anesthesia with sevorane inhalation with preserved spontaneous respiration through a laryngeal mask. Analysis of postoperative cognitive disorders and complications, such as postoperative nausea and vomiting makes combined general anesthesia be excluded from the methods suitable for outpatient operations. TVA and sevorane inhalation anesthesia show comparable results in emergence rate tests, and postanesthetic rehabilitation, the number of postoperative complications. However, less cost and amazing predictability enable the authors to prefer inhalation anesthesia.
Assuntos
Procedimentos Cirúrgicos Ambulatórios , Anestesia por Inalação/métodos , Anestesia Intravenosa/métodos , Dor Pós-Operatória/tratamento farmacológico , Respiração , Adulto , Período de Recuperação da Anestesia , Anestésicos Inalatórios/administração & dosagem , Anestésicos Intravenosos/administração & dosagem , Feminino , Fentanila/administração & dosagem , Humanos , Hipnóticos e Sedativos/administração & dosagem , Masculino , Pessoa de Meia-IdadeRESUMO
To evaluate the efficiency of the anesthetic service of a one-day hospital, the authors analyzed the anesthesias made over 5 years in 3219 (2119 males and 1100 females) patients in the Outpatient Surgery Center (OSC). Based on the given criteria for selecting patients for outpatient surgeries and the assessment of bed occupancy and load on an anesthetist, the author concluded that it is optimal to set up an anesthetic service in the OSC.
Assuntos
Anestesia/normas , Eficiência Organizacional , Unidades Hospitalares/organização & administração , Clínicas de Dor/organização & administração , Adolescente , Adulto , Idoso , Ocupação de Leitos/estatística & dados numéricos , Feminino , Humanos , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Moscou , Qualidade da Assistência à Saúde , Adulto JovemRESUMO
The authors have studied the incidence and possible causes of short-term postoperative mental disorders (STPMD) (in different types of intraoperative protection) that are determined as a nonspecific central nervous system (CNS) lesion characterized by concomitant disorders of consciousness, recognition, memory, emotions, and psychomotor functions, as well as sleep-wakening cycles. Intraanesthetic awakening has been established to play a leading role in the development of STPMD. Under general anesthesia, the incidence of the latter is not higher than that under regional anesthesia, although the causes of STP-MD are likely to be different in either case. And, finally, CNS function monitoring is seemingly considered to be a compulsory component of intraoperative control of a patient's condition during general anesthesia. In addition, it may prevent intraanesthetic awakening episodes and the development of postoperative cognitive disorders in many respects.
