ABSTRACT
This study compared the effect of general anesthesia or regional vertebral analgesia [subarachnoid or epidural] on postoperative cognitive function in 60 young adult [group A] and 60 elderly [group E] patients undergoing orthopedic and urologic surgery. Wechsler Adult Intelligence Scale-Revised for cognitive functions assessment was done preoperatively, and post operatively; one day and three days after surgery. Variations in heart rate, blood pressure, arterial oxygen and carbon dioxide tensions, and pH as well as serum bicarbonate, sodium and potassium levels, were assessed at the same time intervals. They did not show any significant change from the preoperative levels. Cognitive functions, one and three days after surgery, did not change significantly in young adult patients after either general or regional vertebral nor in elderly patients who received regional vertebral, as compared with the preoperative levels. Only elderly patients who received general anesthesia had significant decline in cognitive function one day after surgery. It significantly improved on the third postoperative day but still was significantly less than the preoperative level. Moreover, significantly better WAIS-R Scores were found in the elderly group one and three days after spinal anesthesia than after general anesthesia. The results indicate that general anesthesia poses a significant risk for the occurrence of early postoperative cognitive dysfunction in elderly patients that can persist for 3 day after surgery. Regional vertebral analgesia is advantageous over general anesthesia for elderly patients in terms of a better postoperative neuropsychological functioning
Subject(s)
Humans , Male , Female , Neurocognitive Disorders , Anesthesia, General , Adult , Aged , Analgesia, EpiduralABSTRACT
Eight infants with congenital esophageal atresia and tracheo-esophageal fistula were anesthetized for surgical correction of the anomaly. Five of them were done in Glasgow and three in Alexandria. The problems encountered in the management of these cases are discussed together with the factors affecting survival. Pneumonia and respiratory failure were the main cause of the 50% mortality encountered in the present study
Subject(s)
Esophageal Fistula , Postoperative ComplicationsABSTRACT
This study was conducted on 60 children who received general anesthesia for minor surgical operations. The effects of different premedicate drugs on the pH and volume of gastric juice at time of induction of anesthesia for these children was studied. The study showed that a combination of cimetidine and magnesium trisilicate was found to be the most efficacious method of premedication in reducing gastric juice volume and acidity, followed by cimetidine, then magnesium trisilicate. Diazepam and promethazine showed no effect on gastric juice volume and acidity