| Popis: |
1. 1. Physiologic data on patients under the stress of general anesthesia and dental surgery while being operated on in the sitting position have been presented. 2. 2. Base lines of response in terms of physiologic performance on the intravenous barbiturates, Pentothal sodium and Neraval sodium and the parasympatholytic drug, Banthine, have been presented. 3. 3. The average initial doses of the anesthetics were as follows: Pentothal sodium, 276 mg.; Pentothal sodium (with Banthine), 298 mg.; Neraval sodium (with Banthine), 500 mg. The initial dose was observed to be slightly greater than one-half of the total dose given for an operation of approximately seventeen minutes' duration. 4. 4. Continuous electroencephalographic and electrocardiographic monitoring was performed on all patients and revealed changes consistent with those that have been described previously in the literature. 5. 5. In the presence of a vagolytic agent, Banthine, there was an increased pulse rate. However, there was a significantly reduced incidence of arrhythmias. 6. 6. The blood pressure and pulse rates rose rapidly and significantly. Pulse rates reached maximum values in one to two minutes, and the blood pressures reached their peak in six minutes. These findings varied with the anesthetic agents utilized but were consistent within each drug studied. 7. 7. In ten randomly selected patients whose arterial blood was analyzed, there was no evidence of either hypoxemia or significant hypercapnia. 8. 8. The long-accepted fact of significant hypotension following barbiturate anesthesia was not confirmed in our investigations. Rather, a significant elevation of the blood pressure occurred while the patients were undergoing a standardized oral surgical procedure. This suggests the need for a re-evaluation of hypotension and hypertension as related to anesthetic choice and management. |
