thiopental and Hernia--Inguinal

We have studied 40 infants with a post-conceptual age of less than 60 weeks undergoing general anaesthesia for herniotomy. Patients were anaesthetized with 1 MAC equivalent values for age and agent and allocated randomly to receive halothane, savoflurane or thiopental for induction, and halothane, sevoflurane or desflurane for maintenance of anaesthesia. At induction, both time to acceptance of a face mask and loss of eyelash reflex were recorded. Emergence times were noted by a blinded observer. Induction and emergence times were similar between the halothane and sevoflurane groups but were consistently shorter in the desflurane group compared with the halothane or sevoflurane groups. There were no problems at extubation or significant apnoea in any group. Induction of anaesthesia in this population was no quicker with sevoflurane than with halothane and the method used for induction did not influence recovery time. Maintenance of anaesthesia with desflurane resulted in a shorter recovery time in infants in whom anaesthesia was induced with halothane or thiopental. Desflurane maintenance may be particularly beneficial in the neonate.

Topics: Anesthesia Recovery Period; Anesthetics, Combined; Anesthetics, Inhalation; Anesthetics, Intravenous; Desflurane; Halothane; Hernia, Inguinal; Humans; Infant; Isoflurane; Methyl Ethers; Postoperative Complications; Respiration Disorders; Sevoflurane; Single-Blind Method; Thiopental

In order to evaluate the impact of minor surgery on platelet aggregability and the effect of anaesthesia on this parameter, we allocated 14 otherwise healthy men for inguinal herniotomy to either general anaesthesia (n = 7) or lumbar epidural anaesthesia (n = 7). Platelet aggregation threshold to adenosine diphosphate (ADP-threshold) was measured before and after anaesthesia, prior to surgery, at the end of surgery and during the following hours as well as on the first post-operative morning. General anaesthesia did not affect ADP-threshold while epidural analgesia itself induced a significant increase. During and soon after surgery the ADP-threshold increased in those receiving general anaesthesia while in those receiving epidural analgesia the ADP-threshold returned to pre-operative levels. On the first post-operative morning both groups showed a significantly lower ADP-threshold as compared to the pre-operative level. Surgery induced an increase in 3'5' cyclic-adenosine monophosphate (cAMP). This adrenergic response was attenuated by epidural analgesia.

Topics: Adenosine Diphosphate; Adolescent; Adult; Aged; Anesthesia, Epidural; Anesthesia, Intravenous; Bupivacaine; Cyclic AMP; Droperidol; Erythrocyte Volume; Fentanyl; Hernia, Inguinal; Humans; Hydrocortisone; Male; Middle Aged; Minor Surgical Procedures; Platelet Aggregation; Platelet Count; Stress, Physiological; Thiopental

Topics: Anesthesia, General; Anesthetics, General; Apnea; Bradycardia; Epilepsy, Generalized; Epilepsy, Tonic-Clonic; Hernia, Inguinal; Humans; Hyponatremia; Infant, Newborn; Isoflurane; Male; Seizures; Thiopental

Myocardial infarction still represents a major cause of morbidity and mortality following surgical procedures. Continuous computerized on-line vector-ECG has previously been shown to be useful in the detection of myocardial ischaemia, in acute myocardial infarction and unstable angina pectoris and for ischaemia monitoring after PTCA procedures. This method was presently tested for the possible influence of anaesthesia and surgery during cholecystectomy under general anaesthesia (n = 9), and during inguinal hernia repairs using a spinal block (n = 5). The patients had no history, symptoms or signs of ischaemic heart disease. Analyses of vectorcardiographic changes were made in relation to predefined standardized anaesthetic and surgical procedures, all of which potentially could influence the vector-ECG. Three vectorcardiographic trendparameters were studied: QRS-vector difference, ST-vector magnitude and ST-change vector magnitude. The overall vectorcardiographic changes were minimal and smaller than vectorcardiographic changes previously reported during myocardial ischaemia and infarction. Since anaesthetic and surgical procedures per se had only minor effects on the vector ECG recordings, it is concluded that continuous computerized on-line vectorcardiography will not be skewed by these procedures. Hence, vectorcardiography has the potential of becoming a new monitor for the detection of perioperative myocardial ischaemia.

Topics: Adult; Aged; Anesthesia, Intravenous; Anesthesia, Spinal; Bupivacaine; Cholecystectomy; Female; Fentanyl; Hernia, Inguinal; Humans; Intraoperative Complications; Male; Microcomputers; Middle Aged; Monitoring, Intraoperative; Myocardial Ischemia; Online Systems; Posture; Thiopental; Vectorcardiography

We compared the hemodynamic response to laryngoscopy and intubation, as well as emergence and recovery times, when propofol or thiopental were used for rapid intravenous induction of anesthesia in 59 infants undergoing repair of inguinal hernia. An intravenous catheter was inserted under N2O analgesia and atropine 0.01 mg/kg was administered to all patients. Subsequent induction with propofol (3 mg/kg), thiopental (5 mg/kg), or halothane (2%) was followed with succinylcholine (2 mg/kg) and tracheal intubation. Ventilation was manually assisted during surgery, and tracheas were extubated when patients were completely awake. Infants who received propofol showed less hypertensive response to intubation than those who received thiopental or halothane. In the 1- to 6-mo age group, emergence (extubation) time was significantly longer for infants who received thiopental (10.2 +/- 1.4 min) than for those who received propofol or halothane (5.5 +/- 2.5 and 6.2 +/- 1.3 min, respectively). Infants who received thiopental induction had a higher incidence of perioperative airway complications than all others. There was no significant difference in the recovery and discharge times among the three groups. We conclude that when rapid intravenous induction is required for infants, propofol is more effective than thiopental in obtunding the hypertensive response to intubation, and in young infants (1-6 mo) it results in more prompt emergence after short surgical procedures.

Topics: Anesthesia, Intravenous; Blood Pressure; Elective Surgical Procedures; Hernia, Inguinal; Humans; Infant; Male; Propofol; Thiopental; Time Factors

Topics: Alfentanil; Anesthesia Recovery Period; Anesthesia, Intravenous; Child; Diseases in Twins; Female; Hernia, Inguinal; Humans; Postoperative Period; Propofol; Thiopental; Twins, Monozygotic

Topics: Anesthesia; Blood Glucose; Child; Glycogen Storage Disease; Halothane; Hernia, Inguinal; Humans; Male; Nitrous Oxide; Thiopental

Topics: Adult; Anesthesia, General; Blood Glucose; Cholecystectomy; Fatty Acids, Nonesterified; Gastroenterostomy; Hernia, Inguinal; Humans; Hydrocortisone; Insulin; Mastectomy; Middle Aged; Nitrous Oxide; Surgical Procedures, Operative; Thiopental; Vagotomy; Varicose Veins

Topics: Acidosis; Adolescent; Alkaline Phosphatase; Anesthesia, Inhalation; Anesthetics; Appendectomy; Aspartate Aminotransferases; Basal Metabolism; Clinical Enzyme Tests; Creatine Kinase; Fever; Halothane; Hernia, Inguinal; Humans; Hypercapnia; L-Lactate Dehydrogenase; Liver; Male; Muscular Diseases; Nitrous Oxide; Pneumothorax; Succinylcholine; Thiopental

Topics: Anesthesia; Anesthesia, General; Anesthesia, Spinal; Bronchitis; Cyclopropanes; Ether; Halothane; Hernia, Inguinal; Meperidine; Muscle Relaxants, Central; Nausea; New York; Nitrous Oxide; Pneumonia; Postoperative Complications; Respiratory Tract Infections; Surgical Procedures, Operative; Thiopental; Toxicology; Urinary Catheterization; Vomiting