Surgery anaesthesia

Bone ME, Wilkinson DJ, Young JR, McNeil J, Charlton S. (1990). Ginger root—a new antiemetic. The effect of ginger root on postoperative nausea and vomiting after major gynaecological surgery. Anaesthesia. 45(8) 669-71. 

Phillips S, Ruggier R, Hutchinson SE. (1993). Zingiber officinale (ginger)—an antiemetic for day case surgery. Anaesthesia. 48(8) 715-17. 

Burns R, McCrae AF, Tiplady B. A comparison of target-controlled with patient-controlled administration of propofol combined with midazolam for sedation during dental surgery. Anaesthesia 2003 58 170-6. 

Pitkanen MT, Rosenberg PH, Pere PJ, Tuominen MK, Seppala TA. Fentanyl-prilocaine mixture for intravenous regional anaesthesia in patients undergoing surgery. Anaesthesia 1992 47(5) 395-8. 

Elcock DH, Sweeney BP. Sevoflurane vs. isoflurane a clinical comparison in day surgery. Anaesthesia 2002 57(l) 52-6. 

Broome IJ, Robb HM, Raj N, Girgis Y, Wardall GJ. The use of tramadol following day-case oral surgery. Anaesthesia 1999 54(3) 289-92. 

G. Liu, I. Burcev, F. Pott, K. Ide, I. Horn, and N. H. Sander, Middle Cerebral Artery Flow Velocity and Cerebral Oxygenation During Abdominal Aortic Surgery, Anaesthesia Intensive Care, 27(2), 148-153 (1999). 

Pirttikangas CO, Salo M, Peltola O. Propofol infusion anaesthesia and the immune response in elderly patiens undergoing ophthalmic surgery. Anaesthesia 1996 51 318-23. 

In the rest of the chapter, we will draw heavily on the pioneering work of Rhona Flin and colleagues (Flin, O Connor and Crichton, 2008), who have stndied, analysed and been involved in developing training for non-technical skills in surgery, anaesthesia, aviation, oil and gas indnstry, nuclear power and the military. Non-technical skills are very similar to the safety skills attitudes and behaviours discussed above, but focused more on skills and behaviours that can be identified and trained. Flin, O Connor and Crichton (2008) define nontechnical skills as ... 

Leynadier F, Pecquet C, Dry J (1989) Anaphylaxis to latex during surgery. Anaesthesia 44 547-550... 

Drake HF, Treasure T, Smith B. Continuous display of plasma potassium during cardiac-surgery. Anaesthesia 1987 42(l) 23-9. 

Ethylene when deeply inhaled produces temporary anaesthesia which is almost devoid of unpleasant after-effects hence it has been used for dental surgery, minor operations, etc. 

Gordh, T. Linderholm, H. and Norlander, 0. Pulmonary Function in Relation to Anaesthesia and Surgery Evaluated by Analysis of Oxygen Tension of Arterial Blood. Acta Anaesth. Scand. (1958), 2 15-26. 

Is placebo surgery ethical Should doctors be allowed to administer anaesthesia and make surgical incisions, but then not do any therapeutic intervention Isn t the first rule of medicine to do no harm It is true that informed consent is now required in clin-... 

In situ techniques suffer the disadvantage that the animal is anaesthetised for the duration of the experiment. Surgery and anaesthesia change several physiological factors that can alter drug absorption characteristics. Anderson et al. [117] found the ABL thickness in laparotomised rats to be higher than in conscious non-laparotomised rats. Yuasa et al. [118] reported that... 

The health of the small intestine can also be compromised by poor nutrition or starvation, which can regularly occur in hospital. Patients are normally starved overnight, prior to operation, and starvation may continue well after completion of the surgery because of the nature of the operation or because of the anorexia that can result from surgery or anaesthesia. This will deny adequate nutrition to epithelial cells in the intestine, which can resnlt in slow recovery after surgery and, in addition, may compromise the immune system. Provision of food by the enteral ronte, as soon as possible after injury, surgery, sepsis or bums, is therefore highly desirable (Chapter 18). 

Metformin is a biguanide used to treat diabetes mellitus. It is contraindicated in patients undergoing general anaesthesia since anaesthesia can interfere with renal function. The risk of lactic acidosis associated with metformin increases in patients with renal impairment. Metformin should be stopped before and during surgery where anaesthesia is indicated. Metformin should only be restarted after the renal function has returned to normal. 

Anaesthesia Loss of feehng or sensation. Although the term is used for loss of tactile sensibihty, or of any of the other senses, it is apphed espedally to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU]... 

Fig. 15. Relationship between the alfentanil plasma concentrations and the probability of needing naloxone to restore adequate spontaneous ventilation. The diagram at the upper part shows the alfentanil plasma concentrations of the patients who required naloxone (upward deflection) or did not require naloxone (downward deflection). The plasma concentration-effect curve for this clinical endpoint (lower part) was defined from the quantal data shown in the upper diagram using logistic regression. Bars indicate SE of C5o%. (From Ausems ME, Hug CC, Stanski DR, Burm AGE. Plasma concentrations of alfentanil required to supplement nitrous oxide anaesthesia for general surgery. Anaesthesiology 1986 65 362-73, reproduced by permission.)...

It is a clear, colourless, noninflammable liquid with a mild, sweet odour and considered to be a useful alternative to halothane. Induction of anaesthesia, appropriate for surgery may be achieved within 10 minutes after approximately 4 percent enflurane in inhaled. Arterial blood pressure decreases progressively as the depth of anaesthesia is increased with enflurane, about the same degree as it does with halothane inhalation. The anaesthesia produces rapid induction with quick recovery. 

It is indicated as a narcotic analgesic supplement in general or regional anaesthesia, as an anaesthetic agent with oxygen and skeletal relaxant in selected high risk patients (e.g. open heart surgery). 

As a adjuvant to general anaesthesia (specially in major surgical procedures e.g. abdominal and thoracic surgery, orthopaedic procedures, intubation etc). 

In theory, induction should be rapid, but in practice the inspired vapour concentration must be increased slowly to avoid airway irritation. MAC is 1.15% in 100% oxygen and 0.56% in 30% oxygen, making it less potent than halothane (0.75% and 0.29% at these oxygen concentrations). Isoflurane is the most potent of all the currently available anaesthetic ethers. Recovery from isoflurane anaesthesia is rapid and clear and the drug is suitable for use in day surgery. Cardiovascular system... 

Induction of anaesthesia. Propofoi is the preferred intravenous anaesthetic where a rapid induction with a rapid ciear-headed recovery is desired (as in day surgery). The rapid redistribution of this drug may iead to sub-hypnotic piasma concentrations and great care must be taken to ensure adequate anaesthesia in the eariy operative phase. 

Sedation during surgery under regionai or iocai anaesthesia but the airway and ventiiation must be observed carefuiiy. 

Unlike tubocurarine, pancuronium does not produce ganglionic block or histamine release. For this reason it became popular soon after its introduction and became the drug of choice for use in sick patients. However, it increases the heart rate, arterial pressure, and cardiac output in clinical doses. While this may be advantageous when using high-dose opiate anaesthesia in cardiac surgery, it can be associated with arrhythmias and myocardial ischaemia. The... 

Although the use of pancuronium has decreased markedly, and with good justification, it still retains some popularity in anaesthesia for cardiac surgery in conjunction with the use of high doses of opiates. 

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