Subject(s)
Blood Pressure/drug effects , Enflurane/pharmacology , Neuroleptanalgesia/methods , Retinal Detachment/surgery , Adult , Aged , Female , Humans , Male , Middle AgedABSTRACT
The authors give their experiences in nurseling and children brain neuroradiology anaesthesia. Sodium gammahydroxybutyrate has been definitively adopted after multiples anaesthesial protocoles for the gaz tomoencephalographic exam, known for its technical risks. The gamma OH gives a perfect cardiac and pulmonary stability in difficult conditions, with normal intracranial pression, even in children anaesthesia with Halothane (0.5%) for complementary analgesic effect or with fractionate injections of dextromoramide. Pneumoencephalography has been releguated in second place by the even of brain computer tomography except some particular indications. But this exam qualified as painless is usually indicated in fragile and deficient childrens. Though the intravenous iodated contrasted substance injection can improve the scan image quality and may induce secondary effects at 2 cm3/kg dose. It's again gamma OH after correct premedication that gives stable, perfect immobility, cardiac and pulmonary stability in an ideal anaesthesia for non ventilated patients. The only critical aspect of this method consists on a prolonged and imprevisible delay to awake so that it cannot be an ambulatory anaesthesial method. Therefore it appears that gamma OH in spite of brain computer tomographic event, is an interesting anaesthesic drug but non definitive in brain neuroradiological exam for childrens.
Subject(s)
Anesthesia, General/methods , Anesthetics/administration & dosage , Hydroxybutyrates/administration & dosage , Pneumoencephalography , Tomography, X-Ray Computed , Adolescent , Child , Child, Preschool , Drug Evaluation , Female , Humans , Infant , Infant, Newborn , Male , Sodium OxybateABSTRACT
The authors use the Bain Circuit with spontaneous breathing during head surgery (neurosurgery and ophthalmological procedures). Suitable for both adult and pediatric use, it seems to be, due to its unique characteristics, the choice circuit for all anaesthesia procedures in which the physician does not have direct control over the patient's head. Comparative analysis of blood gas levels is effected, on the one hand in children connected to a Digby-Leigh system and Bain Circuit, and on the other hand in adults, some of whom are connected to a two-way system and the other under a filter circuit; all of the patients are then connected to the Bain Circuit. In children the analysis of results shows that for an identical protocol of anaesthesia the quality of spontaneous breathing obtained using the Bain Circuit is the same as that obtained using the Digby-Leigh. In adults anaesthetized using fluothane and with spontaneous breathing, the average level of hypercapnia under filter circuit and Bain Circuit is identical. Also, the same level of alveolar hypoventilation is obtained under spontaneous breathing with the two-way and Bain Circuit systems when there are properly provisioned. Thus this work confirms other studies by showing that the Bain Circuit is particularly well adapted to head surgery because of its low weight and easy manageability. On the other hand, when using spontaneous breathing the level of alveolar hypoventilation, and thus the degree of hypercapnia, is directly related to the level of anaesthesia and independent of the circuit chosen. Only the setting up of controlled breathing would allow the physician to work under the desired level of normo or hypocapnia.
