RESUMO
This study evaluates spontaneous breathing and CO2-monitoring under sevoflurane anesthesia with a cuffed oropharyngeal (COPA) or laryngeal mask (LMA) as airway. Forty patients (ASA I-II) scheduled for varicose vein surgery were given 2 mg.kg-1 propofol for insertion of a COPA or a LMA. Anesthesia was maintained with sevoflurane at 2.5 vol% in 40/60% O2/N2O, while the patients breathed spontaneously. Arterial and end-tidal CO2 partial pressures (PaCO2, PE'CO2), respiratory rate (RR), tidal volume (VT) and expired minute volume (EMV) were recorded at different times before and during the procedure. The dead space (VD) was calculated from the modified Bohr equation. The PaCO2 and the PE'CO2 were generally lower in the LMA group as compared to the COPA group during most of the procedure. EMV was also higher in the LMA group as compared to the COPA group. This difference becomes statistically significant 5 min. before the end of surgery (6.22 +/- 0.34 vs. 5.23 +/- 0.39 L.min-1). RR was consistently higher in the LMA group, while VT and VD were similar. Correlation of PE'CO2 and PaCO2 was 0.87 when measured in the COPA group and 0.88 in the LMA group. The prediction of PaCO2 by PE'CO2 was more sensitive in the LMA group as compared to the COPA group. We conclude that spontaneous breathing is better with the LMA.
Assuntos
Anestesia por Inalação/instrumentação , Capnografia , Máscaras Laríngeas , Respiração , Anestésicos Inalatórios , Feminino , Humanos , Masculino , Éteres Metílicos , Pessoa de Meia-Idade , Orofaringe , SevofluranoRESUMO
One hundred and twenty-eight patients underwent discography in our department over a period of 3 years. Eighty-four of them were treated by chemonucleolysis. All the patients were punctured by a postero-lateral approach of the intervertebral disc under fluoroscopy. Although several contraindications to chemonucleolysis are known, in our study, only one case of spondylodiscitis was noted. Overall success rate was 72.6%. Twenty-three patients (27.4%) experienced similar or increased pain after treatment.
Assuntos
Quimopapaína/uso terapêutico , Quimiólise do Disco Intervertebral , Disco Intervertebral/diagnóstico por imagem , Ciática/diagnóstico por imagem , Adolescente , Adulto , Idoso , Meios de Contraste , Feminino , Humanos , Iohexol , Masculino , Pessoa de Meia-Idade , Radiografia , Ciática/terapiaAssuntos
Hiperalgesia/etiologia , Hiperestesia/etiologia , Terapia PUVA/efeitos adversos , Modalidades de Fisioterapia/métodos , Adulto , Idoso , Feminino , Humanos , Hiperalgesia/fisiopatologia , Hiperalgesia/terapia , Masculino , Pessoa de Meia-Idade , Vias Neurais/fisiopatologia , Nociceptores/fisiopatologia , Propriocepção , PeleRESUMO
PIP: A comparison of foreign labor migration patterns in Belgium and the Federal Republic of Germany is presented for the period from the 1960s to the 1980s. The authors note that this migration follows a structural pattern, which they classify as the life cycle of economic migration, and is strictly linked to trends in the economy. However, a cyclical pattern of migration exists in Germany but not in Belgium. The reasons for the differences observed are considered, and the authors suggest that these differences may be due to the longer tradition of economic immigration existing in Belgium. Thus, immigrants are more integrated into the Belgian economy, whereas they are more separated in Germany and therefore more susceptible to ebbs and flows caused by changing migration policies.^ieng
