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Query: UMLS:C0344307 (analgesia)
 28,200 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Within the limits granted, neuroleptanalgesia constitutes a very interesting technique in the major part of management of labour. In particular it has the advantage of preserving maternal consciousness. On the other hand, it allows analgesia of rather long duration, which renders early management of labour possible while still respecting its physiology. The institution of this technique demands the presence at the parturients bedside, not only of the obstetrician and the medwife but also that of a qualified anesthetist. As in all cases of major management of labour it engages the responsability of the obstetrical team which undertakes it and this is even more so, the earlier it is started. To us its indications seem comparable with those of Gamma OH: the early management of labour however has the advantage over the latter of preserving maternal consciouness. Moreover it proved to be particularly interesting in the management of breech presentations. But if its properties are an advantage in the indications which we have just mentioned, they can constitute an invonvenience and restrain its use under different circumstances: its slowness of induction, the absence of narcosis which limits the effect on cervical resistance means that one prefers the Toulouse method using pentothal for the management of labour after 7 centimeters of dilatation. In conclusion, it seems important to us to state that neuroleptanalgesia is not the ideal method for management of labour any more than is thiopental or Gamma-OH. Other techniques merit being studied. Their study must obey strict rules in order to specify the risks and therefore the indications and limits. It should cover different fields which are, pharmacology, the objective assessment, by quantitative criteria, of the effects on uterine contraction, on the mother's clinical and biological state as well as that of the fetus in utero, then that of the child in the first hours of live and up to the first years of his development.
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PMID:[Primary management of labor using neuroleptic analgesia]. 0 85

A simplified, safe and flexible technique of anesthesia, based on a limited number of relatively cheap drugs, and allowing ventilation with air, was applied to 60 patients undergoing operations of at least 60 minutes' duration. The required depth of hypnosis was produced by intravenous diazepam or gamma-OH, whilst droperidol and fentanyl provided a satisfactory degree of sedation and analgesia. Pancuronium bromide was used for muscle relaxation. Spontaneous respiration was resumed immediately after postoperative use of nalorphine and neostigmine. The anesthetic course was smooth and predictable, with cardiovascular stability and an uneventful postoperative recovery. Emphasis is laid on the suitability of this procedure on the Battle Field or in Developing Countries, and on its safety (no toxic volatile liquids). (Acta anaesth. belg., 1976, 27, 25-34).
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PMID:A simple, cheap, effective and safe procedure for general anesthesia. 102 53

An anaesthetic method without intubation has been used for the first time in Hungary in 107 laryngomicroscopic operations. The method includes: Vagolytic, analgetic, sedative, vasodilatator, coronary flow enhancing, antihypertensive and antitussive premedication. Administration of the sedative anaesthetic gamma-OH, void of respiratory depression, in doses of 60 mg/kg body weight (given in 2 portions), combined with diazepam, without relaxation and intubation. Supplemental analgesia and inhibition of reflexes by means of mucosal and nerve-block anaesthesia. The premedication, supplemented by endonasal nitroglycerin, reduced the increase of blood pressure, which is a characteristic feature of laryngomicroscopic operations. The combined premedication was found to be effective as well in preventing the usual cardiac arrhythmias, partly reflectory, partly due to the depression of the sinus node (sick sinus syndrome). Nevertheless, the authors emphasize the importance of continuous ECG monitoring. Operation conditions met requirements in 102 cases (intubation had to be performed in 5 patients). The method's primary field of indication includes the microsurgical manipulation of glottic synechiae, as well of lesions in the interarytenoid space or on the vocal processes. Except for the removal of bleeding papillomas, haemangiomas or cysts, the method is expedient for the microsurgical therapy of benign changes, as well as for the topical diagnosis of malignant neoplasms in other laryngeal structures. The advantages of the method are safety, maintenance of normal oxygenation, easy prevention of aspiration, as well as good visibility and photodocumentation of the free operation field, undisturbed manipulation without time limit and, last but not least, simple performance requiring no additional expensive equipment.
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PMID:[A modified method of anesthesia without intubation in microsurgical treatment of the larynx]. 647 35

The anesthetic management of orthotopic liver transplantation has become a new problem with special requirements. From the anesthetist's point of view the operation is divided into four phases: the first is the phase of removal of the diseased liver, characterized by heavy bleeding; the second is the anhepatic phase, dominated by a sudden reduction of blood return to the heart due to cross-clamping of inferior vena cava; the third is the phase of partial re-establishment of circulation of the donated liver, marked by a progressive drop in body temperature and great changes in acid-base equilibrium and electrolytes, especially potassium, and disturbances of blood coagulation potassium, and disturbances of blood coagulation; the fourth is the phase of release of the clamps from the inferior vena cava, which causes a rise in the central venous and systolic pressures, and may also aggravate the metabolic acidosis. Eight cases of orthotopic liver transplantation for late-stage unresectable hepatocarcinoma have been operated upon under combined neurolept anesthesia in recent 3 years. The age of the patients is between 29-50 years. We think that neurolept analgesia with the combined use of gamma-OH, diazepam, ketamine and gallamine is one of the safest methods of anesthesia, which has a minimal toxicity to the liver, a smooth induction and rapid recovery of consciousness, and puts little burden on the circulation. The postoperative survival of first seven patients was between 6-264 days. There were no postanesthetic complications in our series. The authors conclude that the proper choice of anesthesia, careful monitoring and judicious management of the patients during the various phases of operation, the maintenance of good condition of the donated liver and skillful surgical technique are the basic requirements for successful transplantation.
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PMID:Anesthesia in orthotopic liver transplantation. Report of 8 cases. 702 97