1/3. Cerebral complications following induced hypotension.Over an 8-year period (1977-1984), 1,802 otorhinolaryngological procedures were performed under controlled hypotension. Four patients showed symptoms of cerebral damage post-operatively. One patient had pre-operative unrecognized stenosis of the internal carotid artery, another a hypoplastic vertebral artery. In this female patient, the head had been strongly rotated to the side to expose the surgical field, and the internal jugular vein removed. She died of general ischaemic brain damage on the seventh post-operative day. In the remaining two patients, symptoms of cerebral ischaemia did not occur until the third and eleventh day, respectively, so that the causative role of hypotensive anaesthesia is uncertain. The cases described represent a cerebral morbidity of 4:1,802 (0.22%) and a mortality of 1:1,802 (0.06%). It is concluded that controlled hypotension is a safe technique if the indication is stringently applied, and any risk-bearing factors are carefully excluded.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/3. observation of curative effects of huatuojiaji in the treatment of 300 cases of apoplexy.Huatuojiaji are extra-channel acupoints which are first described in A Handbook of prescriptions for emergencies, and the clinical application of which has been expanded a great deal in modern times. In the end of 1970s, the successful application of Huatuojiaji points in acupuncture anaesthesia brought the research on Huatuojiaji points to its climax; and in recent years, great progress has been made in the study of clinical application, improvement of curative effects and functional mechanism of Huatuojiaji points. According to the theories of acupuncture and moxibustion that puncturing Huatuojiaji can dredge channels, promote flow of qi, regulate yin and yang, and activate the Du Channel and the urinary bladder Channel, 300 cases of apoplexy were thus treated with good curative effects. There are altogether 56 points, 28 on each side of the spine, 0.5 cun lateral to the spinous process. The prescription for apoplexy includes C1-7, T1-9 and L2-4. Of the 300 cases of apoplexy, 100 were cured, 107 markedly effective, 87 improved, and 6 ineffective, the total effective rate being 98%.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
3/3. hypertension and peri-operative stroke.A 67-year-old adult male with borderline hypertension who had extracapsular cataract extraction under general anaesthesia is reported. There were marked fluctuations in his arterial blood pressure following induction of anaesthesia and during the recovery period. He developed a stroke in the immediate postoperative period but was fully recovered after 3 weeks. This case illustrates some of the potentially preventable factors that can predispose to stroke in undiagnosed or poorly controlled hypertensive patients. Such cases are commonly presented to anaesthetists in developing countries where the availability of monitoring equipments, anaesthetic drugs and agents is highly limited.- - - - - - - - - - ranking = 2keywords = anaesthesia (Clic here for more details about this article) |