P Pu ur rp po os se e: : Postoperative cognitive dysfunction (POCD) is evident in 26% of elderly patients seven days after major non-cardiac surgery. Despite the growing popularity of day surgery, the influence of anesthetic techniques on next day POCD has not been investigated. Therefore, we evaluated the incidence of POCD and changes in serum markers of neuronal damage (S-100ß protein and Neuron-Specific Enolase), 24 hr after single-agent propofol or sevoflurane anesthesia in elderly patients undergoing minor surgery.M Me et th ho od ds s: : Patients (n = 30, mean age 73, range 65-86 yr) coming for cystoscopy or hysteroscopy, were randomized, in an observer-blind design, to receive either single-agent propofol or sevoflurane anesthesia. Changes in neuropsychological tests (the Stroop test and the modified Word-Recall Test), 24 hr postoperatively were compared with age-matched control subjects (n = 15) using Z-score analysis. Changes in S-100ß protein and NeuronSpecific Enolase levels were also documented.R Re es su ul lt ts s: : POCD was present in 7/15 [47% (95% confidence interval (CI) 21 to 72%)] patients who received propofol and 7/15 [47% (95% CI 21 to 72%)] patients who received sevoflurane, compared with 1/15 [7% (95% CI 6 to 19%)] control patients, P = 0.03. S-100ß protein and Neuron-Specific Enolase levels were not significantly different in anesthetized patients postoperatively compared with preoperative values. C Co on nc cl lu us si io on n: : The incidence of POCD in elderly patients on the first day after minor surgery is higher than previously reported for seven days after major surgery, and is increased after both propofol and sevoflurane anesthesia, compared with age-matched controls. S-100ß protein and Neuron-Specific Enolase levels were unaffected by anesthetic technique. Objectif : Le dysfonctionnement cognitif postopératoire (DCPO) se manifeste chez 26 % des patients âgés, sept jours après une opéra-tion non cardiaque majeure. Nous avons évalué l'incidence de DCPO et les modifications des marqueurs sériques d'atteinte neuronale (protéine S-100ß et énolase neurospécifique), 24 h après une anesthésie à un seul médicament, le propofol ou le sévoflurane, chez des patients âgés qui ont subi une opération mineure. Méthode : Les patients (n = 30, moyenne de 73 ans, limites de 65-86 ans) opérés pour cystoscopie ou hystéroscopie, ont été randomisés à l'insu d'un observateur pour une anesthésie avec propofol ou sévoflurane. Les changements aux tests neuropsychologiques (test Stroop, test modifié de remémoration de mots) ont été notés 24 h après l'opération et comparés à ceux de sujets témoins appariés selon
Airway narrowing with increasing depth of propofol anesthesia results predominantly from a reduction in anteroposterior dimension, whereas CPAP acts primarily to increase the transverse dimension. Although airway caliber during deep propofol anesthesia and application of CPAP was similar to that during light propofol anesthesia, there were significant configurational differences.
Weaver syndrome is a rare disorder of unknown etiology characterized by skeletal overgrowth, distinctive craniofacial and digital abnormalities, and advanced bone age. The prime anesthetic problem reported in children with Weaver syndrome is difficulty with tracheal intubation, resulting in part from relative micrognathia, short neck, and an anterior and cephalad position of the larynx. In this report, the authors describe their experience with two children diagnosed with Weaver syndrome who presented for dental surgery. Contrary to previous reports, tracheal intubation was accomplished with relative ease, suggesting that difficulty in intubation in Weaver syndrome may be age-related, diminishing with advancing age and growth of the mandible, as has been reported for other micrognathic syndromes such as Pierre Robin sequence.
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