RESUMO
Many interacting forces shape the unique experience of adoption. The adoptive parents' fantasies, fears, and perceived lack of entitlement to the child can detrimentally influence their parenting abilities. The adopted child's often powerful need to master early abandonment may lead to maladaptive behaviors that feed the adoptive parents' fears and fantasies regarding the child's past and future. The therapist familiar with the challenges of adoption can take an empathic stance with the adoptive parents and the adoptive child that can contain their anxieties and conflicts and pave the way toward a better resolution of their individual and shared experience.
Assuntos
Adoção/psicologia , Ansiedade de Separação/psicologia , Transtornos do Comportamento Infantil/psicologia , Relações Pais-Filho , Criança , Pré-Escolar , Características Culturais , Terapia Familiar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Ajustamento SocialRESUMO
The cardiovascular effects of a single dose of ketamine administered during halothane or enflurane anesthesia were studied in 24 patients. During halothane anesthesia, ketamine caused a rapid and significant increase in arteriolar peripheral resistance (p less than 0.01) and a decrease in cardiac output, stroke volume, and systolic diastolic, and mean arterial blood pressures. Heart rate was not significantly changed. Ketamine resulted in similar, though less dramatic and slower developing, changes in patients anesthetized with enflurane. These results demonstrate that general anesthesia blocks the cardiovascular-stimulating properties of ketamine. They also indicate that ketamine has significant cardiovascular-depressant qualities when used during halothane or enflurane anesthesia.
Assuntos
Anestesia Geral , Enflurano/farmacologia , Halotano/farmacologia , Hemodinâmica/efeitos dos fármacos , Ketamina/farmacologia , Éteres Metílicos/farmacologia , Adulto , Idoso , Pressão Sanguínea/efeitos dos fármacos , Débito Cardíaco/efeitos dos fármacos , Volume Cardíaco/efeitos dos fármacos , Depressão Química , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resistência Vascular/efeitos dos fármacosRESUMO
In volunteer human subjects not undergoing surgical operations and breathing spontaneously, the cardiovascular effects of Innovar and of its components, fentanyl and droperidol, were determined when the drugs were administered in minimal amounts necessary to reach an analgesic endpoint. This amount was fentanyl 5 mcg./kg. body weight combined with droperidol 0.22 mg./kg. Innovar, or its components when administered separately, produced minimal cardiovascular changes of consequence during the time of maximum analgesia (about 15 minutes). With the passage of time after administration of a single dose of Innovar, there were some changes in cardiac output, heart rate, and stroke volume, probably representing normal changes of sedated sleep. None of the changes, acute or delayed, was clinically significant. Analgesia could be achieved only when fentanyl was combined with droperidol; and although a certain amount of respiratory depression resulted from the combined drugs, the authors concluded that the observed cardiovascular changes probably represented primary drug effects.
