History Of General Anesthesia Research Articles

Effects of video-assisted preanesthetic patient education on preanesthetic interview time; A prospective, single-blinded, randomized controlled trial.

A preanesthetic evaluation interview with an anesthesiologist is essential for patient safety, however, it is not performed adequately owing to the excessive workload of doctors. This study aimed to determine whether video-assisted preanesthetic patient education can reduce patient interview time and solve the problem of excessive labor at a relatively low cost. This study considered relatively healthy patients aged 19 to 65 years who were scheduled for elective surgery under general anesthesia. None of the patients had history of general anesthesia. Patients were randomly assigned 1:1 to Groups V and C. Group V watched the preanesthetic education video, while Group C did not. The duration of the preanesthetic evaluation interview was measured for all participants. The satisfaction of the anesthesiologist and patient with the preanesthetic evaluation procedure, anxiety of the patient, and vital signs during surgery were collected. A total of 33 patients in Group V watched the preanesthetic education video, while 31 patients in Group C did not. Group V spent significantly less time on the preanesthetic evaluation interview with an anesthesiologist than that of Group C (172.42 vs 196.68 seconds; P = .005). There was no difference in patient and anesthesiologist satisfaction between the 2 groups (P = .861 and P = .849, respectively). Patients' anxiety (P = .474), intraoperative mean blood pressure (P = .168), and heart rate (P = .934) did not differ between Groups V and C. Watching the informational video about anesthesia before preanesthetic evaluation could reduce the interview time by an average of 24 seconds, with no difference in patients' or doctors' satisfaction or anxiety compared to patients who did not watch it. Video-assisted preanesthetic patient education indicates that the load on anesthesiologists can be reduced.

Risk Factors of Parkinson’s Disease: A Case-Control Study in Moroccan Patients

Background: Parkinson’s disease (PD) remains a significant health concern in Morocco. Multivariate analysis was not used in any study to evaluate the role of various factors that contributed to the onset of the disease. Objectives: This study investigates the role of family, environmental, and professional factors in PD development. Methods: The present study is an age-matched case-control study with risk estimation based on odds ratios (OR) with a 95% confidence interval (CI). In total, 180 cases were matched with 360 controls. Results: The average age of participants was 68.3 ± 11.2 years. Adjusted logistic regression analysis showed that the family history of PD (ORa = 7.19, CI 95% 3.41 - 15.13), male sex (ORa = 1.92, CI 95% 1.16 - 3.16), spring water consumption (ORa = 3.31, CI 95% 2.05 - 5.34), drug use (ORa = 2.12, CI 95% 1.33 - 3.38), a history of head injury (ORa = 3.38, CI 95% 1.16 - 9.83) and non - consumption of coffee (ORa = 3.04, CI 95% 1.56 - 5.90) were significantly associated with the onset of the disease. In a univariate analysis, well water consumption was observed as a significant risk factor but could not be shown to be significant in a multivariate analysis. Previous work on a farm (ORa = 0.30, CI 95% 0.16 - 0.54) and history of general anesthesia (ORa = 0.47, CI 95% 0.27 - 0.83) were inversely associated with PD risk. No statistical significance was observed in the data on occupational exposure and disease risk, although there was a 30% decrease in risk for the service occupations (ORa = 0.05, CI 95% 0.01 - 0.18). Conclusions: As a result, further research is needed to determine additional risk factors.

Comparison of induction and recovery characteristics of propofol and sevoflurane in day care adult tonsillectomies

Ambulatory anaesthesia is a rapidly growing subspecialty. Although its history is as old as the history of general anesthesia itself, it has emerged as a recognized concept and is evolving over the past couple of decades. Propofol and Sevoflurane have increased the ability of the anaesthesiologist to provide a successful day-care experience. The aim of the study was to compare the induction and recovery characteristics of Propofol and Sevoflurane when they are used as single induction and maintenance anaesthetic agent in adult day care tonsillectomies. This was a randomized prospective study carried out after obtaining ethical committee and institutional approval. 60 patients were randomly allocated to either the Propofol or the Sevoflurane group by lots. Each group had 30 patients and was named ‘P’ for Propofol and ‘S’ for Sevoflurane. Their age ranged from 13 to 40 years. All the patients were assessed and those with normal clinical, biochemical, radiological and haematological parameters were selected. Despite the low blood gas solubility of Sevoflurane, inhalation induction of anaesthesia was slower than intravenous induction with Propofol. Though the incidence of induction complications was more with Sevoflurane group, it did not compromise tracheal intubation or haemodynamics except for bradycardia observed in three patients.

Anesthetic Activities of Scheduled Surgery at CHU Gabriel Touré

Concept: We opted for this study because the hospital unit Gabriel Touré was renovated with 7 surgical specialties. Our study was the very last study before the advent of coronavirus disease 2019 (COVID 19). Goal: Evaluate the anesthetic activities of the planned surgery at the University Hospital Center CHU Gabriel Touré. Method and Material: This was a descriptive prospective study carried out in the cold operating theater of the CHU Gabriel Touré from January to December 2018. It focused on all patients operated on for regulated surgery and who had benefited from anesthesia. Our data was entered and analyzed on SPSS 25 software. Word processing performed on Microsoft WORD® 2016 and graphics on Microsoft EXCEL® 2016. Results: During the study period 1700 patients were operated on in the operating room for scheduled surgery. The age range of 0 to 5 years accounted for (14.8%). The average age was 6.64 years; male predominance (52.6%) of operated patients with a sex ratio of 1.1. A history of general anesthesia was found in 62.1%. The classification of the American Anesthesia Society (ASA) ASA1 class represented 92.7%. Tonsillitis was the most common operative diagnosis (9.5%). Hernia cures and eventrations were the most common surgical technique (11.8%). General anesthesia was achieved in 65.3% of patients. Hypotension was the most common adverse event in the operating room, 44.5%. The intraoperative mortality was 0.11%. Conclusion: Our study covered the entire population anesthetized. It provided an update on the practice of anesthesia in the intensive care unit anesthesia. General anesthesia was the most used technique; a predominance of cardiovascular adverse events, occurring more often in induction and mainly favorable outcome with mortality intraoperative 0.11%. A growing presence of MAR and DES who had performed more than 30% of anesthesia.

Factors that may influence the score in the College Admission Test in China

<b>Introduction: </b> Many factors may influence the score of the College Admission Test. The purpose of this study was to assess the factors that may predict students’ scores in the College Admission Test in China. <br /> <b>Material and methods: </b> We sent out 1000 questionnaires which consisted of the following items: objective data on demographic factors, their scores of the test, the year they attended the test, whether they took a set of “art” subjects or a set of “science” subjects, the monthly salary of the whole family, the highest academic degree obtained by the father and mother, the history of past operations and the name and the times of operations undergone, as well as the type of anesthesia received by those who took the College Admission Test. <br /> <b>Results</b>: Univariate analyses showed that age, gender, household income, parental education, and anesthesia history may influence College Admission Test scores. These variables were subsequently entered into the multivariate linear regression model. Students with a history of local anesthesia are predicted to have a score 8.1 points lower than the average (–8.1, 95% CI: –15, –1) and this effect is statistically significant (p = 0.025). Students with a history of general anesthesia are also predicted to have lower scores (–2.8, 95% CI: –16, 10.2) than the average, but the difference is not statistically significant. <br /> <b>Conclusions</b>: The present findings suggest that the scores in the College Admission Test may be associated with age, gender, father’s education and the use of local anesthetics. Ever receiving local anesthesia had a negative impact on College Admission Test scores.

Meta‐analysis of early nonmotor features and risk factors for Parkinson disease

ObjectiveTo evaluate the association between diagnosis of Parkinson disease (PD) and risk factors or early symptoms amenable to population-based screening.MethodsA systematic review and meta-analysis of risk factors for PD.ResultsThe strongest associations with later diagnosis of PD were found for having a first-degree or any relative with PD (odds ratio [OR], 3.23; 95% confidence interval [CI], 2.65–3.93 and OR, 4.45; 95% CI, 3.39–5.83) or any relative with tremor (OR, 2.74; 95% CI, 2.10–3.57), constipation (relative risk [RR], 2.34; 95% CI, 1.55–3.53), or lack of smoking history (current vs never: RR, 0.44; 95% CI, 0.39–0.50), each at least doubling the risk of PD. Further positive significant associations were found for history of anxiety or depression, pesticide exposure, head injury, rural living, beta-blockers, farming occupation, and well-water drinking, and negative significant associations were found for coffee drinking, hypertension, nonsteroidal anti-inflammatory drugs, calcium channel blockers, and alcohol, but not for diabetes mellitus, cancer, oral contraceptive pill use, surgical menopause, hormone replacement therapy, statins, acetaminophen/paracetamol, aspirin, tea drinking, history of general anesthesia, or gastric ulcers. In the systematic review, additional associations included negative associations with raised serum urate, and single studies or studies with conflicting results.InterpretationThe strongest risk factors associated with later PD diagnosis are having a family history of PD or tremor, a history of constipation, and lack of smoking history. Further factors also but less strongly contribute to risk of PD diagnosis or, as some premotor symptoms, require further standardized studies to demonstrate the magnitude of risk associated with them. ANN NEUROL 2012

Three cases of suspected sugammadex-induced hypersensitivity reactions

Neuromuscular blocking agents have been implicated in 60-70% of anaphylactic events associated with anaesthesia. We report two cases of probable hypersensitivity reaction to sugammadex and an additional suspected but less supported case of possible immune-mediated reaction or other adverse reaction. The patients were given a bolus of sugammadex 100 mg immediately before extubation. In all three patients, a possible allergic reaction was suspected within 4 min of sugammadex administration, but with different degrees of severity. Skin testing was positive in two of these patients. Hypersensitivity to sugammadex unaccompanied by cardiovascular or respiratory symptoms might be missed during the course of anaesthesia. Careful monitoring for possible allergic responses is required in patients who have received sugammadex.

Effect of pressing Hegu acupoint and Neiguan acupoint in preventing PONV in patients after cardiothoracic surgery by general anesthesia

Objective To observe the preventive and therapeutic effect of pressing Hegu acupoint and Neiguan acupoint in patients after general anesthesia in cardiothoracic surgery who got postoperative nausea and vomiting (PONV). Methods 60 cases of patients with a history of general anesthesia cardiothoracic surgery were randomly divided into 2 groups, 30 cases in either group. Control group received routine anesthesia nursing care; care intervention group, routine anesthesia nursing care basically meanwhile pressing bilateral Hegu and Neiguan acupoints 2 days after operation. Postoperative nausea and vomiting symptom in the two groups were observed and compared. Results The incidence of postoperative nausea and vomiting in the care intervention group was significantly lower than the control group (P <0. 01). Conclusions Pressing the acupoints of Hegu and Neiguan will get obviously preventive and therapeutic effects in patients of postoperative nausea and vomiting symptom after general anesthesia cardiothoracic surgery. Key words: Pressing acupuncture point; PONV; Cardiothoracic surgery; General anesthesia

Lesson Learnt: Unpredicted Difficult Airway Should Have Been A Predicted One!

We are reporting a case of a 70 year old lady who presented with worsening of dysphagia after having an esophagoscopy a week before as a part of investigations for sub-acute onset of difficulty in swallowing of three to six months duration. She did not have any other past medical history, was not on any regular medications and had no family history of cancer. On examining she had normal heart rate and blood pressure. She was found to have diffuse surgical emphysema extending from the nipples upwards to the neck area. She did not have any difficulty to speak, stridor or shortness of breath. She was diagnosed by computed tomography (CT) to have an iatrogenic perforation of the thoracic segment of esophagus secondary to flexible esophagoscopy. The CT also showed a small collection of fluid around the perforation, but no tumor or any other pathology. Mrs. K was scheduled to have mediastinal drainage and feeding jejunostomy as an emergency procedure, while being further investigated for her initial symptoms of dysphagia. She was assessed for anesthesia. There was history of general anesthesia with grade 1 laryngoscopy 18 months ago for laparoscopic cholecystectomy. On examining the airway, she had a Mallampati class 1 on opening the mouth, thyromental distance was 7 cms, there was good neck movement and no problem with her teeth. All the routine blood tests were normal except a slightly raised white cell count and the ECG was normal. She did not have any apparent risk of difficult airway, and hence a straight forward rapid sequence induction was planned (RSI). On RSI, the laryngoscopy was grade 3 b (unable to lift the epiglottis) even with a McCoy laryngoscope and it was also noted that the epiglottis was red and swollen. But, she was easy to ventilate with the mask. We decided to use the fibreoptic bronchoscope (FOB) which was difficult to negotiate beyond epiglottis due to swollen and firm epiglottis. Our next plan was to insert the Laryngeal mask airway (LMA), and intubate trachea with FOB. LMA was inserted and ventilation through it was easy as well. On introducing the FOB we were happy to note that the epiglottis was lifted, but the view showed severe inflammatory changes of the supraglottic structures including the laryngeal inlet (Fig.1). The trachea was successfully intubated with the 5.5mm endotracheal tube over the FOB after 2 failed tracheal intubation attempts with 6.5mm and 6.0mm endotracheal tubes over the FOB, and the planned procedures were completed. Mrs. K was transferred to intensive care and reviewed by the ENT surgeons who concluded that the mediastinitis secondary to esophageal perforation and tracking of the inflammation was the reason for the swelling and the narrow laryngeal inlet.

O primeiro a utilizar anestesia em cirurgia não foi um dentista. Foi o m édico Crawford Williamson Long

The history of the discovery of anesthesia is not totally explained, but it is easy to establish that Crawford Williamson Long was the first to use sulfuric ether to operate several patients with no pain and to perform obstetric procedures. History is a bridge connecting the past to the present and should be studied and understood from its first pillars. So, it is justifiable to recall or get to know who was Long, certainly a name almost unknown for many of us, and which has been his participation in the discovery of anesthesia.Why and how Crawford Williamson Long became the first physician to operate with no pain four and a half years before Morton are discussed, in addition to the role he played in one of the major Medical discoveries. Long's biography is narrated, stressing his character, competence, dedication, modesty, altruism and a certain unconcern with conquests and glories. Circumstances leading him not to immediately publicize his discovery are described. Long's involvement in the discussion about the discoverer of anesthesia is analyzed and his passing away is reported. Finally, numerous honors to Long by the USA and other countries are described.W.T.G. Morton is often considered the discoverer of general anesthesia, especially for being the first to make a successful public demonstration in a major hospital in Boston (USA). However, it has been proven that Long has been the first to use surgical anesthesia and he is acknowledged in several regions of his country as the father of surgical anesthesia and 'its discoverer'. It is also necessary to revert the fact that Long is almost unknown among us and give him the place he is entitled to in the history of general anesthesia.

Remifentanil compared with morphine for postoperative patient-controlled analgesia after major abdominal surgery

This randomized, double-blinded clinical study was designed to compare the efficacy and safety of remifentanil and morphine administered using intravenous (i.v.) patient-controlled analgesia (PCA) for postoperative analgesia after major abdominal surgery during the first 24 postoperative hours. Sixty-nine patients were randomly allocated into two groups, each receiving remifentanil or morphine. The first group received i.v. remifentanil PCA with a loading dose of 45 microg, a maintenance dose of 1 microg min(-1), a bolus dose of 15 microg and a lockout interval of 10 min during the first 24 postoperative hours. The second group received i.v. morphine PCA with a loading dose of 5 mg, a maintenance dose of 0.3 mg h(-1), a bolus dose of 1 mg and a lockout interval of 15 min. Age, weight, sex, history of general anaesthesia, duration of surgery and time spent in the post-anaesthesia care unit were recorded. Preoperative pulse rate, systolic and diastolic blood pressures (BP), respiration rate and arterial blood gases were collected. Pulmonary function was tested before induction of anaesthesia, as well as at 4 and 26 h after operation. Pulse rate, systolic and diastolic BP, respiration rate, arterial blood gases, sedation and visual analogue scores, and presence of side-effects in the recovery room and on the ward for 24 h were recorded at 0, 1, 2, 4, 6, 12, 18 and 24 h after operation. Total drug use, number of boluses delivered, number of boluses demanded and delivery/demand ratio were collected. Sixty patients were evaluated. The groups did not differ in age, weight, sex, history of general anaesthesia, duration of surgery or time spent in the recovery unit. There were also no clinically relevant differences between the groups with regard to haemodynamic and respiratory parameters as well as sedation and visual analogue scores (P > 0.05). More bolus doses were demanded and delivered and the delivery/demand ratio was significantly higher in the remifentanil group (P < 0.05). There was no finding suggesting acute opioid tolerance during remifentanil or morphine PCA. The i.v. remifentanil PCA with the chosen dosage regimen after abdominal surgery produces postoperative analgesia and has cardiovascular side-effects similar to those achieved with i.v. morphine. Special attention must be given to respiratory depression during establishment of PCA with remifentanil.

Intellectual and emotional functioning in college students following mild traumatic brain injury in childhood and adolescence.

To investigate whether college students with a history of mild traumatic brain injury (TBI) in childhood or adolescence show residual deficits in intellectual functioning, approaches to studying, or emotional stability. Participants with a history of mild TBI and two control groups. Volunteers were recruited from students taking an introductory psychology course. 79 students with a history of mild TBI, 75 students with a history of general anesthesia, and 93 students with no history of either TBI or general anesthesia. Participants carried out tests of verbal memory, nonverbal memory, verbal fluency, and nonverbal fluency; in addition, they completed a short form of the Approaches to Studying Inventory and the Symptom Checklist-90-Revised (SCL-90-R). In comparison with the two control groups, the students with a history of mild TBI produced similar scores on the cognitive tests and similar orientations to studying. However, they showed a significantly higher level of emotional distress on the SCL-90-R. College students with a history of mild TBI in childhood or adolescence are intellectually unimpaired and approach their studying in a similar manner to their uninjured classmates. Nevertheless, they report more severe distress in terms of their general personal and emotional functioning.

Magnetic resonance imaging findings in asymptomatic volunteers and symptomatic patients with temporomandibular disorders

Internal derangement has been suggested to be a cause of temporomandibular disorders. This study compared magnetic resonance imaging findings in 82 asymptomatic volunteers and 263 symptomatic patients. Disk displacement was observed in 33% of the asymptomatic volunteers and 84% of the symptomatic patients. The prevalence of trauma, headache, and other joint problems was more common in symptomatic patients. A history of general anesthesia and orthodontic treatment was not increased in the symptomatic population compared with asymptomatic volunteers. This study suggests that disk displacement is more common in symptomatic subjects.

Risk factor and behavioral differences between vascular and Alzheimer's dementias: the pathway to end-stage disease.

Differences between vascular dementia and Alzheimer's dementia may be present in both risk factors and in behavioral manifestations. Behavioral distinctions may be apparent only at particular stages of the disease process, but comparisons at different stages require a large number of subjects. The California Alzheimer Disease Diagnostic and Treatment Center Program has collected data on a large number of subjects with dementia. We examined differences in risk factors and in behaviors in 502 subjects with vascular dementia and 810 subjects with probable Alzheimer's dementia. With respect to risk factors, vascular dementia subjects were more likely to have a history of general anesthesia. We found no difference in history of closed head trauma, family history of dementia, or cigarette smoking, suggesting that these factors are less likely to have a disease-specific etiologic role. With respect to behaviors, subjects with vascular dementia were more likely to have depression in all stages of dementia. Subjects with Alzheimer's dementia were more likely to exhibit wandering in the middle or late stages. Subjects were similar in five other behavioral factors in the three stages studied. We conclude that general anesthesia is a risk factor for vascular dementia and that depression is more prevalent in vascular dementia, while wandering is more characteristic of Alzheimer's dementia.

A case of neuroleptic malignant syndrome with a history of general anesthesia

AbstractAntidepressant was given to treat a patient with manic‐depressive psychosis, depressed type (ICD‐9). Following the treatment, she manifested the alteration of the consciousness, autonomic dysfunction, extrapyramidal sign, muscular hypertonicity, hyperthermia, and elevated serum CPK levels. This condition was consistent with the neuroleptic malignant syndrome. Then, along with interruption of medication she was treated with supportive measures and improved progressively.In her past history, she underwent general anesthesia for operation of mitral valve replacement and at that time she manifested tachycardia, hyperthermia, elevated CPK levels, etc. In the case of patients who manifest a malignant hyperthermia‐like state or neuroleptic malignant syndrome‐like state, special care is required in selecting anesthetics and psychotropic drugs.