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Anesthesia Duration (anesthesia + duration)
Selected AbstractsGeneral Anesthesia and the Ketogenic Diet: Clinical Experience in Nine PatientsEPILEPSIA, Issue 5 2002Ignacio Valencia Summary: ,Purpose: To determine if children actively on the ketogenic diet (KD) can safely undergo general anesthesia (GA) for surgical procedures. Methods: The records of children treated with the KD at Children's Hospital (Boston, Massachusetts) from 1995 to the present were reviewed. The charts of children who had received GA while on the diet were evaluated with regard to demographics, procedure information, anesthesia records, blood chemistries, and perioperative course. Of 71 children on the KD during the period of the study, nine (12.7%) had procedures requiring GA while on the diet. Results: Nine children received GA for surgical procedures ranging from central line placement to hemispherectomy while on the KD. At the time of GA, the children ranged from age 1 to 6 years, and had been on the KD for 2,60 months. The patients received carbohydrate-free intravenous solutions perioperatively. Anesthesia duration ranged from 20 min to 11.5 h; for longer procedures, serum pH, glucose, and electrolyte levels were monitored. Serum glucose levels remained stable in all patients, but serum pH typically decreased; the largest reduction was to 7.16. In three procedures, patients received intravenous bicarbonate because of level of acidosis. There were no perioperative complications. Conclusions: Children on the KD can safely undergo GA for surgical procedures. Although serum glucose levels appear to remain stable, serum pH or bicarbonate levels should be monitored because of the risk of metabolic acidosis. [source] Association between central venous pressure and blood loss during hepatic resection in 984 living donorsACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 5 2009Y. K. KIM Background: Although low central venous pressure (CVP) anesthesia has been used to minimize blood loss during hepatectomy, the efficacy of this technique remains controversial. We therefore assessed the association between blood loss and CVP during hepatic resection, and examined significant determinants associated with intraoperative hemorrhage during hepatectomy in living donors. Methods: Between April 2004 and April 2008, 984 living donors who underwent a hepatic resection were assessed retrospectively. Univariate and multivariate analyses were performed to explore the relationships between intraoperative blood loss and several variables including CVP. Results: The mean intraoperative blood loss was 691.3 ± 365.5 ml. Only four donors required packed red blood cell transfusions (mean, 1.5 U). The mean duration of hepatic resection was 92.1 ± 26.3 min. The mean, maximum, and minimum values of CVP measured during hepatectomy were 4.6 ± 1.7, 5.3 ± 1.8, and 4.0 ± 1.8 mmHg, respectively, and were not significantly correlated with intraoperative blood loss. On multivariate analysis, predictors of hemorrhage were liver fatty change, gender, and body weight, but none of the mean CVP, surgeons, anesthesiologists, anesthesia duration, resected liver volume, hepatectomy type, systolic blood pressure, heart rate, or body temperature were significant. Conclusions: CVP during hepatic resection was not associated with intraoperative blood loss in living liver donors, suggesting that CVP may not be an important factor in predicting blood loss during hepatectomy in healthy subjects. [source] Evaluation of age and American Society of Anesthesiologists (ASA) physical status as risk factors for perianesthetic morbidity and mortality in the catJOURNAL OF VETERINARY EMERGENCY AND CRITICAL CARE, Issue 1 2002DACVS, FACVSc, Giselle Hosgood BVSC Abstract Objective: To evaluate age and American Society of Anesthesiologists (ASA) physical status as risk factors for perianesthetic morbidity/mortality in cats. Design: Prospective cohort study. Setting: Institution teaching hospital. Animals: 138 cats , 6 months of age that received inhalation anesthesia for , 30 min Interventions: Observations were made during the 24 h post-anesthetic period. Measurements and main results: Sixty-one females and 77 males were included. Serious perianesthetic complications occurred in 15 cats (15/138; 11%), including cardiopulmonary arrest in 3 cats (3/138; 2%), and death or euthanasia in 7 cats (7/138; 5%). Age was not a factor in establishing risk for developing serious or minor perianesthetic complications in the cats in this study. However, ASA status was a risk factor. Cats having an ASA status of 3 or more were nearly 4 times as likely to develop serious perianesthetic complications, even when accounting for the significant confounding effects of anesthesia duration. Conclusions: ASA status, but not age, was a risk factor for the development of serious or minor perianesthetic complications in the 138 cats included in this study. [source] The Salty Dog: Serum Sodium and Potassium Effects on Modern Pacing ElectrodesPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 1 2007RICK McVENES Background: This study was conducted to characterize the behavior of chronic modern endocardial electrodes with capacitively coupled constant voltage pulse generators in canines. Methods: Five animals were studied with chronic paired unipolar microporous platinum, and porous steroid-eluting electrodes in the ventricle. Screw-in and passive fixation electrodes were also implanted in the atrium. IV infusions of 500,800 mL of 50 meq KCl in 500 mL Ringer's solution, and 3% NaCl were given over periods of 120 and 80 minutes, respectively, during separate anesthetized monitors. Results: Mean maximum Na+ and K+ achieved was 158 and 8.3 meq/L, respectively. During KCl infusion, ventricular threshold, current, and energy decreased. In the atrium, half the leads went to exit block at ,7.0 meq/L K+. Others continued to perform acceptably. The atrial electrogram decreased 70% with no change in the ventricular signal. No change in impedance occurred. During NaCl infusion, no changes in atrial or ventricular threshold occurred while current increased 21%,32%. This resulted in a 40%,55% increase in energy due to a 20% decrease in impedance. The atrial electrogram decreased 32%,36% while the ventricular amplitude decreased 25%. Slew rate decreased 19%,27%. Control studies for effects of heart rate, fluid volume, and anesthesia duration did not cause any changes. Conclusion: These data support the conclusion that threshold is a voltage mediated response. Thus, voltage thresholds, not energy, current or pulse duration is the most relevant parameter for safety margin determination. Atrial parameters should be followed during electrolyte imbalances. Correlation in humans is needed. [source] Pulmonary Function After Pectoralis Major Myocutaneous Flap HarvestTHE LARYNGOSCOPE, Issue 3 2002FACS, Yoav P. Talmi MD Abstract Objective The pectoralis major myocutaneous flap is widely used in the reconstruction of surgical defects in the head and neck region. Pulmonary atelectasis has been reported in patients undergoing these procedures, and many of these patients are heavy smokers and drinkers and have associated cardiopulmonary disorders. Flap harvest and donor site closure may lead to impairment of pulmonary function before and after the use of pectoralis major myocutaneous (PMC) in surgical reconstruction in patients with cancer of the head and neck. Methods Patients undergoing extirpation of head and neck tumors with PMC reconstruction were prospectively evaluated. Patient age, smoking history (pack-years), anesthesia duration, percentage predicted pre- and postoperative FEV1, percentage-predicted pre- and postoperative FVC (forced vital capacity), and preoperative SaO2 (oxygen saturation) were evaluated. Preoperative FEV1/FVC ratio was calculated. Chest x-rays were reviewed. Results Only 11 patients, 5 of whom smoked, could be evaluated postoperatively. Preoperative FEV1/FVC was more than 70 and FEV1 more than 75% predicted in all patients. A decrease in FVC was observed in 7 of the 11 patients, which ranged between 2% and 27% without any clinically obvious respiratory manifestations. A baseline SaO2 of more than 96% was noted in all patients. Four of 9 postoperative chest x-rays demonstrated atelectasis. Conclusions PMC harvest and donor site closure may lead to the recorded decrease in FVC measurements. These changes did not manifest clinically. Nevertheless, alternative methods of surgical defect closure should be considered in patients with severe preexisting pulmonary disorders. [source] | ||||||||||