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Arzneimittel-Forschung Oct 1997During the past three decades anaesthesia-related mortality has been reduced to an extent which is more or less exclusively governed by human error. This improvement has... (Review)
Review
During the past three decades anaesthesia-related mortality has been reduced to an extent which is more or less exclusively governed by human error. This improvement has been achieved by nearly equal progresses in drug development as well as in the development of technical devices, especially in monitoring. Nearly 80% of all anaesthetics which are used today in an anaesthetic university department were developed in the last 30 years. The search and research for better controllable compounds has caused the necessity to develop also devices which are able to deliver these substances continuously. One might therefore reason that the term pharmaceutical which today is entirely based on the term compound has in the future to be based on a combination of compound and device. The pharmacist of today and yesterday may in the future become a high-tech microsystems engineer. From an academic point of view it is unsatisfactory that the degree of therapeutic success can only be achieved and documented very incompletely. Partially this is due to the fact that the anaesthesiologists are not able to formulate their therapeutic goals, stating which higher integrative brain functions have to be reduced to what degree to guarantee an optimum therapeutic level.
Topics: Anesthesia; Anesthesiology; Anesthetics; Animals; Humans
PubMed: 9454560
DOI: No ID Found -
Journal of Neurosurgical Anesthesiology Oct 2014The results of several retrospective clinical studies suggest that exposure to anesthetic agents early in life is correlated with subsequent learning and behavioral... (Review)
Review
The results of several retrospective clinical studies suggest that exposure to anesthetic agents early in life is correlated with subsequent learning and behavioral disorders. Although ongoing prospective clinical trials may help to clarify this association, they remain confounded by numerous factors. Thus, some of the most compelling data supporting the hypothesis that a relatively short anesthetic exposure can lead to a long-lasting change in brain function are derived from animal models. The mechanism by which such changes could occur remains incompletely understood. Early studies identified anesthetic-induced neuronal apoptosis as a possible mechanism of injury, and more recent work suggests that anesthetics may interfere with several critical processes in brain development. The function of the mature brain requires the presence of circuits, established during development, which perform the computations underlying learning and cognition. In this review, we examine the mechanisms by which anesthetics could disrupt brain circuit formation, including effects on neuronal survival and neurogenesis, neurite growth and guidance, formation of synapses, and function of supporting cells. There is evidence that anesthetics can disrupt aspects of all of these processes, and further research is required to elucidate which are most relevant to pediatric anesthetic neurotoxicity.
Topics: Anesthesia; Anesthesiology; Anesthetics; Brain; Child; Humans; Neurotoxicity Syndromes
PubMed: 25144504
DOI: 10.1097/ANA.0000000000000118 -
European Journal of Anaesthesiology Nov 2013Preoperative assessment and premedication represent important preparatory steps to ensuring a smooth and effective induction of anaesthesia. A thorough review of the... (Review)
Review
Preoperative assessment and premedication represent important preparatory steps to ensuring a smooth and effective induction of anaesthesia. A thorough review of the child's medical history, previous anaesthetics, medications, allergies and family history is essential to design the optimal anaesthetic for the child and his/her surgery. Risks must be addressed with the parents as appropriate based on the local standards. Preoperative anxiolysis may assume several strategies, with premedication with a pharmacologic agent very common and most successful. This review focuses on the preoperative assessment and premedication for children undergoing elective surgery.
Topics: Anesthesia; Anesthesiology; Anesthetics; Anti-Anxiety Agents; Child; Child, Preschool; Humans; Infant; Medical History Taking; Parents; Pediatrics; Premedication; Preoperative Care; Preoperative Period; Risk
PubMed: 24022595
DOI: 10.1097/EJA.0b013e328360c3e2 -
British Journal of Anaesthesia Nov 1958
Topics: Anesthesiology; Anesthetics; Ethers; Humans; Midwifery; Obstetrics; Pregnancy
PubMed: 13607895
DOI: 10.1093/bja/30.11.545 -
Anesthesiology Nov 1948
Topics: Anesthesia; Anesthesiology; Anesthetics; Humans; Thorax
PubMed: 18099924
DOI: 10.1097/00000542-194811000-00008 -
Anaesthesia Aug 2018
Topics: Anesthesia; Anesthesiology; Anesthetics; Biomedical Research; Clinical Trials as Topic; Humans; Observational Studies as Topic; Terminology as Topic
PubMed: 29280142
DOI: 10.1111/anae.14200 -
Anaesthesia Jan 1953
Topics: Anesthesiology; Anesthetics; Humans; Publications
PubMed: 13008029
DOI: 10.1111/j.1365-2044.1953.tb12288.x -
Anaesthesia and Intensive Care Dec 2001
Topics: Anesthesiology; Anesthetics; Ethanol; Europe; History, 19th Century; Humans
PubMed: 11771597
DOI: 10.1177/0310057X0102900601 -
British Journal of Anaesthesia Jan 1949
Topics: Anesthesia; Anesthesiology; Anesthetics; Death; Humans
PubMed: 18115864
DOI: 10.1093/bja/21.3.107 -
Transactions - Pennsylvania Academy of... 1965
Topics: Anesthesia; Anesthesiology; Anesthetics; Otolaryngology; Surgical Procedures, Operative
PubMed: 14279441
DOI: No ID Found