No abstract available.
Anesthesia, General*

Anesthesia, General*

No abstract available.
Anesthesia, General*

No abstract available.
Anesthesia* ; Anesthesia, General* ; Humans

Awake craniotomy is a neurosurgical technique that involves an awake neurological testing during the resection of an intracranial lesion in eloquent cerebral cortical areas representing motor, language, and speech. This technique is highlighted by an intra-operative cortical mapping that requires active participation by the patient and poses unique challenges to the anesthesiologist. The surgical and anesthetic techniques have evolved significantly over time, as the neurosurgeon and the anesthesiologist learn new steps in making this technique safe to achieve reasonable patient satisfaction. A thorough understanding of this surgical technique's rationale will guide the anesthesiologist in planning the anesthetic management depending on the surgery and neurologic testing. Constant communication between the neurosurgeon, anesthesiologist, and the patient will define this surgical technique's success. It is already a well-established procedure; however, factors that contribute to failures in awake craniotomy procedures have not been well characterized in the literature. Failure is defined as the inability to conduct awake neurologic testing during the awake craniotomy procedure because of various factors which will be described. This paper aims to review the challenges in the performance of three (3) cases of awake craniotomies performed in the Philippine General Hospital. The challenges described in these three (3) cases reveal that this can be experienced by the neurosurgeon, neuroanesthesiologist, and most especially the patient in an acute critical condition. Identification of the procedures' failure and the steps taken to manage such situations with the patient's safety in mind are discussed.
Anesthesia, Intravenous ; Anesthesia, General

Authors undertook a quantitative study of the relationship between eye position in the awake state and in the surgical plane of anesthesia in 42 non-paralytic horizontal strabismus patients who were planned to be operated February 1986 through August 1986. The results were as follows: 1. All 42 subjects demonstrated divergence under anesthesia when compared with their pre-anesthesized state. The mean divergence was 15.1 prism diopters. 2. The 33 exotropic subjects had mean divergence of 13.1 prism diopters. 3. The 9 exotropic subjects had mean divergence of 22.7 prism diopters. 4. The more esotropic or less exotropic the preanesthetic position of the eyes were, the more divergent the eyes became under anesthesia.
Anesthesia ; Anesthesia, General* ; Humans ; Strabismus*

BACKGROUND: We hypothesized that induction of general anesthesia using sevoflurane improves the accuracy of non-invasive hemoglobin (SpHb) measurement of Masimo Radical-7(R) Pulse CO-Oximetry by inducing peripheral vasodilation and increasing the perfusion index (PI). The aim of this study is to investigate the change in the SpHb and the PI measured by Rad7 during induction of general anesthesia using sevoflurane. METHODS: The laboratory hemoglobin (Hb(lab)) was measured before surgery by venous blood sampling. The SpHb and the PI was measured twice; before and after the induction of general anesthesia using sevoflurane. The changes of SpHb, Hb(bias) (Hb(bias) = SpHb - Hb(lab)), and PI before and after the induction of general anesthesia were analyzed using a paired t-test. Also, a Pearson correlation coefficient analysis was used to analyze the correlation between the Hb(bias) and the PI. RESULTS: The SpHb and the PI were increased after the induction of general anesthesia using sevoflurane. There was a statistically significant change in the Hb(bias) from -2.8 to -0.7 after the induction of general anesthesia. However, the limit of agreement (2 SD) of the Hb(bias) did not change after the induction of general anesthesia. The Pearson correlation coefficient between the Hb(bias) and the PI was not statistically significant. CONCLUSIONS: During induction of general anesthesia using sevoflurane, the accuracy of SpHb measurement was improved and precision was not changed. The correlation between Hb(bias) and PI was not significant.
Anesthesia, General* ; Perfusion* ; Vasodilation

In pediatric patients with congenital blepharoptosis, intraoperative decision of the amount of levator resection is difficult due to general anesthesia.We performed levator resection in 21 eyes of 17 patients with congenital blepharoptosis to evaluate the usefulness of the formula derived from the margin limbal distance (MLD)which was used to determine the amount of levator resection preoperatively. The amount of ptosis (interpalpebral fissure:IPF)was between 3.5 mm and 7.0 mm (mean 4.9 +/-1.2 mm), and less than 6.0 mm in 14 cases (66.4%).The levator function by Berke method was between 3.0 mm and 8.0 mm (mean 5.3 +/-1.7 mm), and between 5.0 mm and 8.0 mm in 13 cases (61.9%).The margin limbal distance was between 0 and 5.0 mm (mean 1.5 +/-1.4 mm), and less than 3.0 mm in 16 cases (76.2%).The amount of levator resection was between 10.0 mm and 22.0 mm, and between 16.0 mm and 18.0 mm in 10 cases (47.6%)which was most frequent. Of 4 patients (8 eyes)with bilateral blepharoptosis, excellent results (IPF > or= 8.0 mm)were achieved in 5 eyes (62.5%)and the other 3 eyes had fair results with IPF of over 6.0 mm.Three patients (75.0%)with bilateral blepharoptosis had symmetric IPF within 1.0 mm difference.In unilateral blepharoptosis, excellent results were achieved in 10 (76.9%)of 13 patients with IPF difference within 1.0 mm, and the other 3 patients had an IPF difference of 1.5 ~2.5 mm. The MLD formula gives the surgeon a good preoperative prediction of the amount of levator to resect, especially in pediatric patients with congenital blepharoptosis to undergo surgery under general anesthesia.
Anesthesia, General ; Blepharoptosis* ; Humans

No abstract available.
Anesthesia, General ; Oxygen

No abstract available.
Anesthesia, General* ; Shoulder*