General anesthesia is a state of reversible, descending depression of the central nervous system that is induced by inhalational or intravenous drugs. Components of general anesthesia include hypnosis, analgesia, amnesia, and muscle relaxation. Recognized anesthesia providers include CRNAs and anesthesiologists. Improvements in pharmacologic agents, technology, and education of providers have sharply reduced morbidity and mortality associated with anesthesia.
The saline leaf extract of Bryophyllum pinnatum was investigated on neuropharmacological activities to ascertain claims of local use. When tested in mice, it produced a dose-dependent prolongation of onset and duration of pentobarbitone-induced hypnosis, reduction of exploratory activities in the head-dip and evasion tests. Moreover, a dose-dependent muscle in-coordination was observed in the inclined screen, traction and climbing tests. It delayed onset to convulsion in both strychnine- and picrotoxin-induced seizures in addition to minimal protection against picrotoxin seizures.
The effect of neuromuscular block on the anaesthetic depth of hypnosis is an elusive question. We simultaneously investigated the influence of neuromuscular block on the bispectral index, a measure of hypnosis during general anaesthesia, and on the electroencephalogram. Patients were anaesthetized with sevoflurane. Noxious tetanic electrical stimulation was applied on two occasions: before and after profound neuromuscular block achieved with rocuronium.
BACKGROUND: Spectral entropy is an electroencephalogram-based monitoring technique with a frequency band enlarged to include the electromyogram spectrum, which is intended to help to assess analgesia. Although its correlation with hypnosis has been shown, its performance during a noxious stimulation and the influence of neuromuscular blockade have not been described. METHODS: In this prospective, open, multicenter study, 105 patients received propofol then remifentanil target-controlled infusion for induction of anesthesia, with randomized remifentanil targets ranging from 2 to 8 ng/mL.
Tidsskrift for Den Norske Lægeforening: Tidsskrift for Praktisk Medicin, Ny Række
BACKGROUND: There has been a breakthrough in the understanding of anaesthetic drug effects during the last two decades, and new monitors aimed at quantifying such effects have been developed. MATERIAL AND METHODS: This review is based on publications from the last 15 years, oral presentations, and rewritten parts of the author's PhD thesis. RESULTS: General anaesthesia can be regarded as a combination of hypnosis (sleep), analgesia and muscle relaxation. Modern anaesthetic drugs aim at each of these effects separately.
The nature and origin of disorders of masticatory muscles and temporomandibular joint are discussed. Their psychosomatic origin is suggested. Methods of direct and indirect psychotherapy as well as psychopharmacotherapy were included in complex rehabilitation. Computer videoautotraining with biological adaptive feedback was used. 105 patients (31 men and 74 women) at the age of 16-70 years (mean age 34,9+/-1,3 years) were examined. For the first time dysfunction computer arthrophonography of joint sound was used.
OBJECTIVES: To review the most frequent recommendations, doses and routes of administration of sedatives, analgesics, and muscle relaxants in children, as well as the methods for monitoring the level of sedation. SOURCES: Review of the literature using the MEDLINE database and review of the experience in pediatric intensive care units. SUMMARY OF THE FINDINGS: The continuous administration of analgesics and sedatives prevents the development of undersedation and is less demanding in terms of care than intermittent administration.