Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0278134 (anesthesia)
 110,339 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In 104 premedicated patients undergoing general surgery, anaesthesia was induced either with etomidate 0.3 mg kg-1 preceded by fentanyl 1.25 or 2.5 microgram kg-1 i.v.or diazepam 0.0625 or 0.125 mg kg-1 i.v., or with thiopentone preceded by fentanyl 1.25 microgram kg-1 i.v. Despite the use of fentanyl or diazepam, the frequency of pain on injection in patients receiving etomidate was between 32% and 53%, being rated as severe in 5-20% of patients. No pain was experienced by patients receiving thiopentone. The frequency of involuntary movement was 15-35% with etomidate and 15% with thiopentone. The frequency of both pain and involuntary muscle movements was least when fentanyl 2.5 microgram kg-1 preceded the administration of etomidate. There was no significant relationship between the pain and muscle movement; three of 10 patients given etomidate into a central vein had such movements.
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PMID:Comparison of etomidate in combination with fentanyl or diazepam, with thiopentone as an induction agent for general anaesthesia. 52 82

Celiac plexus block is usually performed under fluoroscopic or tomodensitometric guidance. We report on a new procedure using sonographic guidance. the patient lies in supine position. We use a real-time sonograph with a 3.5 MHz probe. On a transverse plane, the celiac axis is localized emerging from the aorta. Under local anesthesia, the tip of the spinal needle (177 mm, 22 g) is placed close to the aorta (about 5 mm) on both sides. 5 to 10 ml of 1% lidocaine, then 10 to 20 ml of absolute alcohol, are injected on each side. 21 patients (10 males, 11 females, mean age: 61.4) underwent the procedure. They presented with cancer of the pancreas in 14 cases, metastatic nodes from an extra-pancreatic tumor in 5 cases and chronic calcifying pancreatitis (CCP) in 2 cases. No pain relief was secured in 3 patients (14%). One of these presented with CCP, but endoscopic cystic diversion of a small cyst was successful in eradicating pain. Partial pain relief was secured in 5 cases (24%) and total pain relief in 13 cases (62%). No treatment-related complication was observed. We conclude that sonography is a simple and safe method of guidance in performing alcohol block of the celiac plexus. The anterior approach may prevent neurologic complications occurring with other methods of guidance using a posterior approach.
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PMID:[Percutaneous echography-guided alcohol block of the celiac plexus as treatment of painful syndromes of the upper abdomen: study of 21 cases]. 170 57

Celiac plexus block is usually performed under fluoroscopic or tomodensitometric guidance. We report on a new procedure using sonographic guidance. The patient lies in supine position. We use a real-time sonograph (Kontron Sigma 1 AC) with a 3.5 MHz probe. On a transverse plane, the celiac axis is localized emerging from aorta. After local anesthesia, the tip of the spinal needle (177 mm, 22 G) is placed close to aorta (about 5 mm) on both sides. 10 to 15 ml of 1 per cent lidocaine then 10 to 15 ml of absolute alcohol are injected on each side. 21 patients (10 males, 11 females, mean age: 61) underwent the procedure. They presented with cancer of the pancreas in 14 cases, metastatic nodes in 3 cases, cholangiocarcinoma in 2 cases and chronic calcifying pancreatitis (CCP) in 2 cases. No pain relief occurred in 3 patients (14 per cent). On of those presented with CCP but the endoscopic cystic diversion of a small cyst was successful to eradicate pain. Partial pain relief occurred in 5 cases (24 per cent). Total pain relief was obtained in 13 cases (62 per cent). No complication related to the treatment was observed. Sonography is a simple and safe method of guidance to perform alcohol block of the celiac plexus. The anterior approach may prevent neurologic complications related to other methods of guidance.
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PMID:[Percutaneous alcoholization of the celiac plexus under echographic guidance: an alternative to splanchnicectomy? Study of 21 cases]. 192 97

This study examines the incidence and severity of postoperative pain after gingivectomy using one non-eugenol-containing periodontal dressing, Coe-pak (n = 76) and 2 eugenol-containing periodontal dressings, Wondrpak (n = 64) and Nobetec (n = 86). All patients were subjected to gingivectomy using 1 type of local anaesthesia (lidocaine + adrenalin) only and covering the surgical areas with either of the 3 different dressings in a randomized study. Postoperative pain was assessed on 100 mm visual analogue scales over 5 days starting immediately after surgery. No pain was reported by 22.0% of the patients after Coe-pak, 23.4% after Wondrpak and 30.2% after Nobetec. 13.2% of the patients took analgesics after Coe-pak treatment, 3.1% after Wondrpak and 1.2% after Nobetec. Mean pain score after Coe-pak was higher (P less than 0.05) than after Nobetec 2 h after operation until the morning on the 3rd postoperative day. Mean pain score after Coe-pak was higher (P less than 0.05) than after Wondrpak 3 h to 9 h after operation. No statistically significant difference was found between Wondrpak and Nobetec regarding mean pain score.
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PMID:Effect of non-eugenol- and eugenol-containing periodontal dressings on the incidence and severity of pain after periodontal soft tissue surgery. 239 30

Investigation was carried out on 40 females undergoing dilation and curettage or laparoscopy on outpatient basis. All patients were premedicated with pethidine and atropine. In 20 patients, anesthesia was induced with intravenous propofol 2 mg/kg (Group I), and in the other 20 patients thiopentone 4 mg/kg was used (Group II). Prior to induction of anesthesia, 80 mg of lignocaine (4 ml of 2%) was injected intravenously to be followed by the induction agent. No pain followed the injection of propofol or thiopentone and smooth induction of anesthesia was achieved within 60 seconds. Injection of suxamethonium 100 mg and tracheal intubation was then performed and anesthesia was maintained with 66% N2O in O2 supplemented by suxamethonium drip. In the thiopentone group, SBP decreased after induction and tracheal intubation was followed by a significant increase of SBP and HR. In the propofol group, both SBP and HR decreased after induction and tracheal intubation was also followed by an increase of SBP and HR. However, the increase of SBP was less than that observed in the thiopentone group and the increase of HR was not significant when compared to the control value. At the end of surgery and cessation of anesthesia, recovery was scored. After 10 minutes, all patients in the propofol group were awake and initiated conversation while 12 patients of the thiopentone group were still sleepy. The results suggest that propofol may be preferred to thiopentone for induction of anesthesia in outpatient surgery.
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PMID:Propofol versus thiopentone for induction of anesthesia in patients undergoing outpatient surgery. 263 53

The reflex hemodynamic effects of intracoronary bradykinin were tested in 20 conscious instrumented dogs. When the experiments were performed after full recovery from surgery and anesthesia, graded doses (10-300 ng/kg) of bradykinin always produced graded pressor responses, in the absence of any pain reaction. At the maximum pressor response obtained with 100 ng/kg, mean arterial pressure rose 28 +/- 3% from 89 +/- 4 mm Hg, left ventricular pressure 20 +/- 3% from 121 +/- 2 mm Hg, heart rate 30 +/- 4% from 88 +/- 5 beats/min, rate of change of left ventricular pressure 18 +/- 3% from 2812 +/- 65 mm Hg/sec (P less than 0.01). Higher doses of bradykinin did not produce greater responses. The magnitude of the response was similar when the injection was performed in either the left anterior descending (change in mean arterial pressure 29 +/- 3%) or circumflex (change in mean arterial pressure 27 +/- 2%) coronary artery. The reflex nature of the response was proved by its disappearance after appropriate pharmacological blockades; moreover, after vagotomy, the pressor rise was maintained, the heart rate response was reduced (change in heart rate 10 +/- 2%), and the inotropic response was enhanced (rate of change of left ventricular pressure 24 +/- 3%). This suggested that the afferent pathway of the pressor reflex was in the sympathetic nerves and that a subordinate vagal depressor reflex was also operative. No pain reaction was obtained even when injecting very large amounts (1000-2000 ng/kg) of bradykinin, which, instead, induced arterial hypotension.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Analysis of the pressor sympathetic reflex produced by intracoronary injections of bradykinin in conscious dogs. 397 99

Squamous cell papilloma is a benign proliferation of the stratified squamous epithelium. It is typically an exophytic lesion smaller than 1 cm. Its appearance varies from cauliflower-like to fingerlike, while the base may be pedunculated or sessile. This article describes the case of an 11-year-old girl who presented with an asymptomatic whitish lesion of papillomatous appearance in the oral mucosa distal to the maxillary left permanent first molar. The lesion was removed using an Er,Cr:YSGG laser. For anesthesia, 10 mg of 2% lidocaine with epinephrine 1:100,000 was infiltrated around the lesion. No pain medication was required after surgery, and wound healing was excellent and rapidly achieved. The oral pathology report confirmed the presurgical clinical diagnosis. Laser dentistry is a modern technology that can be used by dental clinicians to treat these kinds of oral lesions and should be considered as an alternative to conventional surgery.
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PMID:Laser treatment of an oral papilloma in the pediatric dental office: a case report. 1743 86

A 38-year-old woman with placenta previa was scheduled for cesarean section. She had no abnormal medical history including neurological deficit before the operation. Prior to general anesthesia, an epidural catheter was inserted in the L2-3 interspace for postoperative analgesia. There was no difficulty in threading the catheter. No pain, paresthesia or bleeding was elicited at any time. After a test dose of 1% lidocaine 1 ml, a bolus of 0.75% ropivacaine 12 ml was injected through the epidural catheter. At the end of the operation, a continuous epidural infusion of 0.2% ropivacaine (the pump speed of 6 ml x h(-1)) was started. On the second postoperative day, sudden sensory loss level to L2 (right lower extremity), L3 (left one) and flaccid paralysis of bilateral lower extremities occurred. MRI and myelogram showed no abnormality of the spinal cord. Her neurological deficit showed slight improvement but her sensory and motor paralysis still remained. Neurotoxicity of ropivacaine may be the cause of this neurological deficit.
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PMID:[Neurological deficit following lumbar epidural anesthesia with ropivacaine]. 1771 88

The irritation fibroma is a benign proliferation that occurs as a response to local irritation. It is an elevated pedunculated or sessile lesion that ranges in size from a few millimeters to a few centimeters and is normal in color, although it may appear to be more pale than the normal mucosa. This article describes the case of a 39-year-old woman with an asymptomatic nodular lesion that involved the left buccal mucosa. The lesion was removed using an Er,Cr:YSGG laser. Only topical anesthesia was applied to the fibroma and adjacent mucosa and no infiltration was required. No pain medication or antibiotics were required after surgery and wound healing was excellent and achieved rapidly. The oral pathology report confirmed the presurgical clinical diagnosis. Laser excision is a modern approach for treating oral soft tissue lesions and should be considered as an alternative to conventional scalpel surgery.
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PMID:Removal of an irritation fibroma using an Er,Cr:YSGG laser: a case report. 1901 24

Local anaesthesia with lidocaine is widely used in dermatology. The aim of this study was to evaluate pain at different times of dermatological surgery when using local anaesthetic agents. 120 consecutive patients were included during a 3 month period in a dermatological day surgery unit. Pain was estimated by a visual analogue scale, before, during and at the end of the operation. At the end, patients were asked about their satisfaction with local anaesthesia or their preference for general anaesthesia. Fifty five patients had lesions on the face and neck. Other localisations were chest (20 cases), limbs (24 cases), perineum (18 cases) and not recorded in 3 cases. Mean diameter of the lesions was 25.3 mm. Pain occurred during anaesthetic injection in 88.5% of the patients and the score was 5 or more in 42 patients. No pain was recorded during and at the end of the operation in 112 and 118 patients respectively. Fifteen patients would have preferred general to local anaesthesia because of intense pain. Local anaesthesia was judged appropriate by 86% of the patients. However, for lesions of the perineum, general anaesthesia would have been preferred by 38.8% of the patients.
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PMID:Evaluation of local anesthesia and pain control in dermatological surgery: a prospective study of 120 patients. 2029 8


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