RESUMO
Mapleson's A and D are the most efficient semiclosed nonabsorbing circuits used for spontaneous and controlled ventilation. A new device, the MultiCircuit System, allows single-lever selection of Mapleson A or D functions, when used with the conventional two hoses or Mera F coaxial circuit attached. In the A mode, in a study performed on awake volunteers, the MultiCircuit System with two hoses performed comparably to the Magill attachment. When coupled with the Mera F circuit as a coaxial system, the MultiCircuit System was less efficient than the Magill, and had a resistance to expiration exceeding 2cm H2O pressure at a gas flow of 30 l/minute.
Assuntos
Anestesiologia/instrumentação , Ventiladores Mecânicos , Humanos , RespiraçãoRESUMO
Two hundred and seventy patients underwent anaesthesia for 280 renal transplants between October 1977 and October 1982. Their medical records were studied retrospectively. These patients were representative of the end-stage chronic renal failure population, with the usual high incidence of cardiovascular and biochemical abnormalities. Most received general anaesthesia, with an intravenous barbiturate, muscle relaxant, narcotic and volatile supplement sequence being the most common. There were no intra-operative deaths. One postoperative death was felt to be influenced by the anaesthetic management. Four patients had life-threatening cardiac complications and a further four required postoperative respiratory support, three for delayed recovery of neuromuscular function and one for "recurarisation". Less serious complications were considerably more common. General anaesthesia utilising suxamethonium and tubocurarine as the relaxants and halothane as the volatile supplement is least likely to result in complications. Changes to this anaesthetic sequence are likely with the introduction of new agents.
Assuntos
Anestesia , Transplante de Rim , Adolescente , Adulto , Anti-Hipertensivos/efeitos adversos , Transfusão de Sangue , Criança , Feminino , Cardiopatias/etiologia , Humanos , Hipotensão/etiologia , Complicações Intraoperatórias , Falência Renal Crônica/etiologia , Masculino , Pessoa de Meia-Idade , Doenças Musculares/etiologia , Medicação Pré-Anestésica , Transtornos Respiratórios/etiologiaRESUMO
The effects of cryogenic injury on femoral blood vessels and nerves were studied in 28 rats. The femoral neurovascular bundles were dissected out bilaterally and the vessels and nerves subjected to cryogenic injury. The rats were sacrificed at intervals of up to 2 weeks. Damage to the nerves and to a number of femoral vessels was severe and included necrosis and thrombus formation. The results indicate that significant vascular damage can occur during cryotherapy, and the possible complications of this should be considered.