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Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In 1943, Olson described a method for administration of thiopental for anesthesia during oral surgical procedures (J Oral Surg 1:197, 1943). Patients were instructed not to eat for 4 hours before the scheduled surgery and to bring an escort. Premedication with atropine or morphine was not routinely used. Following venipuncture, a 2- to 3-mL test dose of thiopental (Pentothal, Abbott Laboratories, North Chicago, IL) was injected. After a pause of 15 to 20 seconds, 6 mL was injected slowly over 40 to 50 seconds. Additional medication was titrated slowly in intermittent doses to maintain an adequate level of anesthesia. The mouth was packed and kept meticulously dry to prevent coughing or laryngospasm. The patient's color and respiration were continually observed and the airway maintained. Initially, a 5% solution was used by Olson; later it was changed to 2%. Use of this concentration made it easier to titrate to "upper levels" of anesthesia because profound depth was not required. Also, adverse effects (eg, coughing, laryngospasm) occurred less frequently, and there was less venous irritation with the 2% solution. Based on his experience of 8,203 cases, Olson claimed that most patients tolerated the anesthetic well, but he recommended avoiding this technique for children younger than 12 years of age.
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PMID:The use of intravenous anesthesia and sedation techniques in oral and maxillofacial surgery. 809 20

Aged persons appear to fear eye operations. Hence both patient and surgeon are more at ease with the use of a general anesthetic, particularly if the anesthetist has visited the patient before the operation and reassured him. Early ambulation, ordinarily so desirable in the aged, is curtailed in most eye operations because the head and eyes must be completely quiet. Since barbiturates are not well tolerated by aged patients, Dramamine is used instead preoperatively. Dramamine adequately sedates but does not cause depression or hallucinations. Morphine is contraindicated because of its pupillary action; Demerol is the drug of choice for preoperative medication. Xylocaine applied directly to the pyriform fossa and vocal cords prevents laryngospasm, coughing and straining. Then, following induction with Pentothal, a Guedel airway is introduced into the oropharynx and through it a continuous flow of oxygen is maintained throughout the procedure. Relaxation of the eyelids is aided by the use of various muscle relaxants, succinylcholine being the relaxant of choice because it is rapidly eliminated. By administering narcotics intravenously during the course of the operation the amount of Pentothal needed can be held to a minimum. To prevent any slowing of the respiration, Nalline is administered in conjunction with the narcotic. In dealing with debilitated patients, Nalline is usually given in conjunction with the preoperative narcotic. Any latent slowing of the respiration can be promptly relieved by an additional dose of Nalline.
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PMID:Anesthesia for eye operations in the aged. 1323 Sep 13