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The Veterinary Clinics of North... Nov 2016Local, regional, and spinal anesthesias are safe, effective, often more desirable procedures for ruminants than general anesthesia. Many procedures can be performed... (Review)
Review
Local, regional, and spinal anesthesias are safe, effective, often more desirable procedures for ruminants than general anesthesia. Many procedures can be performed safely and humanely in ruminants using a combination of physical restraint, mild sedation, and local, regional, or spinal anesthesia. This article focuses on the use of local anesthetics for providing anesthesia for dehorning, procedures of the nose and eye, laparotomy, reproductive procedures, teat repair, and procedures on the distal limb. Local, regional, and spinal anesthesia techniques are safe effective methods for providing anesthesia for common surgical procedures and analgesia for painful conditions in cattle and small ruminants.
Topics: Anesthesia, Conduction; Anesthesia, Local; Anesthesia, Spinal; Animals; Cattle; Goats; Restraint, Physical; Ruminants; Sheep
PubMed: 27719762
DOI: 10.1016/j.cvfa.2016.05.015 -
Clinical Anesthesia 1974Since the first report in 1846 on the use of anesthesia for a surgical procedure, deaths have occurred with practically every agent and technique used. Those mishaps of... (Review)
Review
Since the first report in 1846 on the use of anesthesia for a surgical procedure, deaths have occurred with practically every agent and technique used. Those mishaps of which we are aware are probably just a small segment of those that have actually occurred, since presently there is no widely used method for identifying anesthesia-associated deaths. Several sources of information are available, including the United States National Center for Health Statistics and articles in the medical literature. Neither of these encompasses more than a fraction of the total experience; in addition, the population upon which most reports are based and the number of anesthesias involved are usually not available as a denominator in determining the incidence of mishaps and the magnitude of the problem. Extrapolating from data from community anesthesia study committees and from population and operative figures, we can estimate that there are over 5,000 deaths associated with anesthesia in this country each year. This is 3 times as many as are caused by muscular dystrophy and multiple sclerosis, 15 times as many as with sickle cell anemia, 20 times as many as with myasthenia gravis and 40 times as many with poliomyelitis. We thus must recognize that anesthesia is an iatrogenic disease that deserves serious attention as a public health problem.
Topics: Anesthesia; Anesthesia, Inhalation; Anesthesia, Obstetrical; Anesthesiology; Anesthetics; Chloroform; Drug Hypersensitivity; Female; Fetal Death; Humans; Infant Mortality; Maternal Mortality; Medical Audit; Pregnancy; Public Health; United Kingdom; United States; Vital Statistics
PubMed: 4613516
DOI: No ID Found -
La Revue Du Praticien Jan 1999Close collaboration of an informed anaesthetist with the obstetrician, and respect of the security protocols in every anaesthesia must guarantee the well-being of... (Review)
Review
Close collaboration of an informed anaesthetist with the obstetrician, and respect of the security protocols in every anaesthesia must guarantee the well-being of pregnant women. The development of loco-regional anaesthesia for use in labour analgesia and caesarean section has reduced the indications and the mortality related to general anaesthesia. In the last 30 years, analgesia and control of loco-regional anaesthesia effects have been greatly improved. Loco-regional anaesthesia protocols are now safe for the mother and various. Epidural anaesthesia using low concentrations of local anaesthetics allows parturient ambulation. Intrathecal anaesthesia, with combined spinal-epidural technique, is mostly used for caesarean-section and for the early and late labour.
Topics: Anesthesia, Obstetrical; Delivery, Obstetric; Female; France; Humans; Patient Care Team; Pregnancy
PubMed: 9989153
DOI: No ID Found -
Tierarztliche Praxis 1987Anaesthesia in birds is ordered by law and is also necessary for various operations and manipulations. Anaesthesia by injection of Ketamin, which in special cases may be... (Review)
Review
Anaesthesia in birds is ordered by law and is also necessary for various operations and manipulations. Anaesthesia by injection of Ketamin, which in special cases may be combined with Diazepam, has been found useful. Anaesthesia by inhalation with Halothan, Methoxyfluran or Isofluran is the most careful method. Local anaesthesia has few indications.
Topics: Anesthesia; Anesthesia, Inhalation; Anesthesia, Local; Animals; Birds; Diazepam; Halothane; Injections; Isoflurane; Ketamine; Methoxyflurane
PubMed: 3327199
DOI: No ID Found -
Annales Francaises D'anesthesie Et de... Jun 1999To analyse current data on intravenous regional anaesthesia (IVRA), its benefits and drawbacks. (Review)
Review
OBJECTIVE
To analyse current data on intravenous regional anaesthesia (IVRA), its benefits and drawbacks.
DATA SOURCES
Articles were obtained from a Medline search using the following search terms: 'intravenous regional anaesthesia', alone or combined with 'local anaesthetic agents', 'toxicity'.
STUDY SELECTION
Following articles in English and in French have been selected: main articles, original articles, update and review articles, letters to the editor and recent editorials.
DATA EXTRACTION
Physiopathological and pharmacological data were extracted for involved mechanisms and means for improving this technique.
DATA SYNTHESIS
IVRA is a reliable and efficient technique with a lower cost than general anaesthesia and well adapted for limb surgery in the ambulatory patient. Depending on the site of the surgical field, the pneumatic tourniquet is set either on the arm, forearm or wrist for the upper limb or thigh, calf or ankle for the lower limb. When set in periphery, less local anaesthetic agent is required. A wide tourniquet requires a lower inflation pressure than a double cuff tourniquet. A single cuff is as efficient as a dual cuff if shape, size and inflating pressure are appropriate. The limb occlusion pressure (LOP) is the minimal pressure required to occlude blood flow. It is assessed with either a pulse oximeter or Doppler for determination of the lowest cuff inflating pressure. The cuff is inflated to 50 mmHg above LOP. Oozing in the surgical field can be decreased by the re-exsanguination technique. Currently, lidocaine is the only local anaesthetic released in France for IVRA. Addition of a muscle relaxant, a NSAID or clonidine allows the dose of local anaesthetic agent to be decreased and improves postoperative analgesia.
Topics: Anesthesia, Conduction; Anesthesia, Intravenous; Anesthesia, Local; Humans
PubMed: 10464534
DOI: 10.1016/s0750-7658(99)80154-3 -
Best Practice & Research. Clinical... May 2022Caesarean section (CS) is one of the most performed operations worldwide. In many parts of the world, there has been a reduction in anaesthetic associated obstetric... (Review)
Review
Caesarean section (CS) is one of the most performed operations worldwide. In many parts of the world, there has been a reduction in anaesthetic associated obstetric mortality, and this has been attributed to the increased use of neuraxial anaesthesia and improved safety of general anaesthesia, alongside improved training and organisational changes. In resource-limited countries, anaesthesia contributes disproportionately to maternal mortality, with one in seven deaths being due to anaesthesia. A major contributory factor to this is the severe shortage of trained anaesthetic providers. Goals for anaesthesia for CS include the woman's comfort and foetal well-being, focusing on strategies to minimise morbidity and mortality for both. Anaesthetic options for CS include neuraxial techniques (spinal or combined-spinal epidural or epidural extension of labour analgesia) and general anaesthesia. There is increasing evidence of the benefit of neuraxial techniques over general anaesthesia in terms of maternal and foetal outcomes. For elective CS, spinal and combined-spinal anaesthesia predominate. General anaesthesia is mainly reserved for Category 1 CS where there is an immediate threat to the life of the mother or the baby. This review discusses the practical aspects of neuraxial and general anaesthesia for CS.
Topics: Anesthesia, General; Anesthesia, Obstetrical; Anesthesia, Spinal; Cesarean Section; Female; Humans; Pregnancy
PubMed: 35659960
DOI: 10.1016/j.bpa.2022.04.007 -
Tierarztliche Praxis 1988Pigs are not only anaesthetized in case of operations but often also if diagnostic and therapeutic procedures are necessary. Choice of the anaesthetic and way of... (Review)
Review
Pigs are not only anaesthetized in case of operations but often also if diagnostic and therapeutic procedures are necessary. Choice of the anaesthetic and way of application depend on the size of the patient and the indication. The only important local anaesthesia in pigs is epidural anaesthesia. It is indicated in all longer lasting painful procedures in caudal regions. The technique of this anaesthesia is described. From the possible methods of general anaesthesias, in practice injection anaesthesia has been generally accepted for several reasons. Together with barbiturate anaesthesia neurolept-analgesia with Azaperone--Metomidate has become more and more important, because with this form of anaesthesia the technically easy intra-abdominal application is possible in pigs under 15 kg of body weight.
Topics: Anesthesia; Anesthesia, Epidural; Anesthesia, General; Animals; Azaperone; Barbiturates; Imidazoles; Injections; Neuroleptanalgesia; Swine
PubMed: 2897138
DOI: No ID Found -
Tierarztliche Praxis Aug 1993In reptiles anesthesia is recommended not only for painful treatment but also for diagnostic procedures like radiology, sonography, endoscopy and MRI. Special attention... (Review)
Review
In reptiles anesthesia is recommended not only for painful treatment but also for diagnostic procedures like radiology, sonography, endoscopy and MRI. Special attention should be directed to the anesthetic regimen because of anatomical and physiological differences to mammals. To achieve optimum body temperature (normally 25-30 degrees C) preanesthetic heating is useful. In most cases ketamine hydrochloride is used as an injectable anesthetic. Our own anesthesias (n = 263) are compared to those in the literature. Important disadvantages are species-specific dosages between 15 and 220 mg/kg body weight and poor relaxation. The results of 132 anesthesias performed by the authors using Isoflurane are discussed with reference to the literature. The main advantages were independence of species-specific problems and excellent analgesia and relaxation. Due to total relaxation, manual intermittent positive-pressure ventilation (IPPV) is necessary.
Topics: Anesthesia; Animals; Body Temperature; Immobilization; Intermittent Positive-Pressure Ventilation; Preanesthetic Medication; Reptiles
PubMed: 8211965
DOI: No ID Found -
Anaesthesia May 2022Neuraxial anaesthesia is widely utilised for elective caesarean section, but the prevalence of inadequate intra-operative anaesthesia is unclear. We aimed to determine... (Review)
Review
Neuraxial anaesthesia is widely utilised for elective caesarean section, but the prevalence of inadequate intra-operative anaesthesia is unclear. We aimed to determine the prevalence of inadequate neuraxial anaesthesia for elective caesarean section; prevalence of conversion from neuraxial anaesthesia to general anaesthesia following inadequate neuraxial anaesthesia; and the effect of mode of anaesthesia. We searched studies reporting inadequate neuraxial anaesthesia that used ≥ ED95 doses (effective dose in 95% of the population) of neuraxial local anaesthetic agents. Our primary outcome was the prevalence of inadequate neuraxial anaesthesia, defined as the need to convert to general anaesthesia; the need to repeat or abandon a planned primary neuraxial technique following incision; unplanned administration of intra-operative analgesia (excluding sedatives); or unplanned epidural drug supplementation. Fifty-four randomised controlled trials were included (3497 patients). The overall prevalence of requirement for supplemental analgesia or anaesthesia was 14.6% (95%CI 13.3-15.9%); 510 out of 3497 patients. The prevalence of general anaesthesia conversion was 2 out of 3497 patients (0.06% (95%CI 0.0-0.2%)). Spinal/combined spinal-epidural anaesthesia was associated with a lower overall prevalence of inadequate neuraxial anaesthesia than epidural anaesthesia (10.2% (95%CI 9.0-11.4%), 278 out of 2732 patients vs. 30.3% (95%CI 26.5-34.5%), 232 out of 765 patients). Further studies are needed to identify risk factors, optimise detection and management strategies and to determine long-term effects of inadequate neuraxial anaesthesia.
Topics: Anesthesia, Epidural; Anesthesia, General; Anesthesia, Obstetrical; Anesthesia, Spinal; Cesarean Section; Female; Humans; Pregnancy
PubMed: 35064923
DOI: 10.1111/anae.15657 -
La Revue Du Praticien Apr 2001Anaesthesiology is a recent medical speciality, established in 1965, that is formally termed in French Anesthésie-réanimation (Anaesthesiology-intensive care). Since...
Anaesthesiology is a recent medical speciality, established in 1965, that is formally termed in French Anesthésie-réanimation (Anaesthesiology-intensive care). Since its creation, the discipline has had a range of activity including anaesthesia, intensive care, prehospitalisation emergencies, acute and chronic pain and diverse follow-up. In France 8 million anaesthesias are performed per year, by 8,500 physicians specialised in anaesthesiology, assisted by 7,500 anaesthesiology nurses. It is estimated that each year 13.5% of the French population undergoes anaesthesia, with variations related to sex and age. Over 15 years, the number of anaesthesias performed increased 2.2 fold, due to the increase in certain types of surgery (especially orthopaedics) but also obstetrics (35 times more peridural anaesthesias) and the explosion of GI endoscopy (50 times increase). This increased activity involves patients at the extreme ranges of life, young women and fragile persons. Local and regional anaesthesias represent 21% of those performed, and outpatient anaesthesia is 12 times that of 15 years ago.
Topics: Adult; Aged; Ambulatory Surgical Procedures; Anesthesia, General; Anesthesiology; Child; Female; France; Humans; Male; Middle Aged; Practice Patterns, Physicians'; Surgical Procedures, Operative
PubMed: 11387683
DOI: No ID Found