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Anaesthesia

Patients Memories Of Events During General Anaesthesia

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Abstract

Awareness remains a serious complication of general anaesthesia with potential adverse psychological sequelae. Even during seemingly adequate general anaesthesia, implicit memory may be retained along with the ability to subconsciously process auditory stimuli. As a result behaviour may be modified and postoperative progress influenced. We shall discuss the structure of memory and the effects of increasing doses of general anaesthesia on cognitive processes. In addition methods of assessing the depth of anaesthesia will be reviewed...

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Occupational Health Guideline for Phenyl Ether

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Basis for original (SCP) IDLH: No evidence of an IDLH for phenyl ether exists in the available toxicological data. Patty [1963] reported that phenyl ether’s vapors do not present a toxicological problem, but may be a nuisance because of its disagreeableness. For this draft technical standard, therefore, respirators have been selected on the basis of the assigned protection factor afforded by each device up to 100 ´ the OSHA PEL of 1 ppm (i.e., 100 ppm); only the “most protective” respirators are permitted for use in concentrations exceeding 100 ppm. High concentrations of the vapor are unlikely to be encountered in the workplace because of its high boiling point and low vapor pressure....

See Also: : CDC Immediately Dangerous to Life or Health Concentrations (IDLH)

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Crisis Management During Anaesthesia: Pulmonary Oedema

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Abstract

Background: Pulmonary oedema may complicate the perioperative period and the aetiology may be different from non-operative patients. Diagnosis may be difficult during anaesthesia and consequently management may be delayed.

Objectives: To examine the role of a previously described core algorithm “COVER ABCD–A SWIFT CHECK”, supplemented by a specific sub-algorithm for pulmonary oedema, in its management occurring in association with anaesthesia.

Methods: The potential performance of this structured approach for each of the relevant incidents among the first 4000 reported to the Australian Incident Monitoring Study (AIMS) was compared with the actual management as reported by the anaesthetists involved.

Results: Pulmonary oedema was identified in 35 (<1%) of the first 4000 reports to AIMS. The most frequent presenting sign was hypoxia (46%) and the most specific sign was the presence of frothy sputum (23%). The core algorithm, although successful in the management of the initial physiological upset,...

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Pulmonary Edema And Hemorrhage As Complications Of Acute Airway Obstruction Following Anesthesia.

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Abstract

Airway obstruction is a quite common complication while its conditioned pulmonary edema--rare. Causes associated with anesthesia are various. Forced inspiratory efforts against an obstructed upper airway generate peak negative intrathoracic pressure. This may cause pulmonary edema and in some cases pulmonary hemorrhage. Last-mentioned is extremely rare. Pulmonary edema may arise soon after airway obstruction as well as later, after some hours. Damage of bronchi is found seldom during bronchoscopy in case of pulmonary hemorrhage, while more often alveolar damage is observed due to alveolar membrane damage. Hemorrhage is conditioned by hydrostatic pressure level, level of hypoxia, damage to bronchi or alveoli (disruption of alveolar membrane). Early diagnosis of negative-pressure pulmonary edema or pulmonary hemorrhage is very important, because this affects postoperative morbidity and mortality of the patients. Two cases of pulmonary edema and hemorrhage after upper airway obstruction as well as literature overview are presented in this article. Pulmonary hemorrhage developed during anesthesia...

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