MARKED HYPOXEMIA AFTER GASTROPLASTY DUE TO DlSORDERS OF BREATHING IN RUM SLEEP

Knill, R. L.; Moote, C A; Rose, Elizabeth; Skinner, Marilyn I.

doi:10.1097/00000542-198709001-00552

Cited by 10 publications

(12 citation statements)

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“…If propofol anaesthesia is associated with dreams, this phenomenon may even be positive. Opioid and to some extent also other anaesthetics are claimed to induce an unphysiological sleep pattern with the risk of a REhl rebound phenomenon ( 19,20). This increased frequency of REM sleep for some nights after general anaesthesia has been proposed to be associated with changes in breathing and arterial oxygen desaturation and hypothetically creates a risk for myocardial ischaemia (21,22).…”

Section: Discussionmentioning

confidence: 99%

Recall of music: a comparison between anaesthesia with propofol and isoflurane

Oddby-Muhrbeck

Jakobsson

1993

Acta Anaesthesiol Scand

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Sixty patients undergoing laparoscopy were randomly assigned to receive total intravenous anaesthesia with propofol or inhalation anaesthesia with isoflurane. Patients in these two groups were also randomly assigned to three subgroups listening to soft music, hard rock music or no music at all. Twenty-four hours after surgery all patients were interviewed and asked if they had heard music during the operation. A tape with seven different pieces of music was also played for the patients. The music they heard during surgery was one of these. No patient had any memories or experiences from the operation. Four patients had dreams, three from the total intravenous anaesthesia group and one from the inhalation anaesthesia group. Twelve patients believed they had heard music, ten from the total intravenous anaesthesia group and two from the inhalation anaesthesia group (P < 0.05). Two patients, one from each group, picked the right melody. In conclusion, there was no difference between the two groups with respect to recall during anaesthesia. Patients in the TIVA group were significantly more inclined to state that they had been exposed to music.

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Section: Discussionmentioning

confidence: 99%

Recall of music: a comparison between anaesthesia with propofol and isoflurane

Oddby-Muhrbeck

Jakobsson

1993

Acta Anaesthesiol Scand

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“…Hypoxaemia is a common phenomenon following major surgery [2]. The pathogenesis of constant postoperative hypoxaemia is reduction in functional residual capacity leading to increased shunting of blood through the lungs [7], whereas sudden oxygen desaturation in the late postoperative period may be caused by an effect of opioids on ventilatory pattern [8] or disturbed postoperative sleep pattern [9]. We cannot exclude the possibility that cardiac effects could initiate changes in Sa^, but consider it less likely.…”

Section: Discussionmentioning

confidence: 99%

Late Postoperative Episodic and Constant Hypoxaemia and Associated Ecg Abnormalities

Rosenberg

Rasmussen

Jessen

et al. 1990

British Journal of Anaesthesia

113

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Twenty-two patients without cardiopulmonary disease and undergoing elective major abdominal surgery were monitored continuously with a Holter tape recorder and a pulse oximeter on one night before operation and the first two nights after operation (23:00 to 07:00), without oxygen therapy. Mean heart rate increased 16 beat min-1 (P less than 0.001) and mean oxygen saturation (SaO2) decreased 2.6% (P less than 0.001) after operation. Episodic oxygen desaturation to less than 80% occurred in four patients before operation, but in 13 patients after operation (P less than 0.05). ECG abnormalities were observed in 10 patients before operation and in 16 patients after operation (ns). Individual maximum ST depression was more pronounced after than before operation (P less than 0.05). Episodic desaturation was related closely to tachycardia in six patients before operation and one patient after operation; before operation to atrioventricular block in one patient, and after operation to ST depression in two patients. Mean SaO2 on the second night after operation correlated with total dose of opioid for pain relief (rs = -0.48; P less than 0.05), and postoperative decrease in SaO2 correlated with postoperative increase in heart rate (rs = -0.43; P less than 0.05). No patient had postoperative cardiac complications indicating treatment.

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“…Postoperative sleep disturbances in patients undergoing non-cardiac surgery have been described after major abdominal surgery [1][2][3][4][5] and herniorrhaphy. 2 6 The investigators found a marked reduction in SWS during the first 1-4 postoperative nights, 1-4 6 and in a previous study from our group, SWS was absent in all 10 patients on the first night after major abdominal surgery.…”

Section: Discussionmentioning

confidence: 99%

“…However, we have shown previously that when monitoring surgical patients for 2 nights before operation and with the same monitoring equipment and experimental set-up, a first night effect was not present. 3 After major surgery, REM sleep is usually absent on the first and sometimes the second and third postoperative nights, [1][2][3][4][5][6] followed by an increased duration of REM sleep and density (rebound) during the subsequent 2-4 nights. 1 3 5 6 In a previous study, performed after major abdominal surgery, there was a significant decrease from a median of 17% to 5% in the proportion of REM sleep on the first night after operation.…”

Section: Discussionmentioning

confidence: 99%

“…Sleep disturbances have been described after major abdominal surgery [1][2][3][4][5] and herniorrhaphy 2 6 ; the disturbances include decreases in total sleep time, proportion of rapid eye movement (REM) sleep and slow wave sleep (SWS). These changes are most pronounced on the first and second postoperative nights [1][2][3][4][5][6] , with a subsequent rebound on the following nights. 1 3 5 6 The magnitude of surgery (the surgical stress response), the surroundings (noise, nursing procedures, etc.…”

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confidence: 99%

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Sleep after laparoscopic cholecystectomy

Rosenberg-Adamsen¹,

Skarbye²,

Wildschiødtz³

et al. 1996

British Journal of Anaesthesia

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The sleep pattern and oxygenation of 10 patients undergoing laparoscopic cholecystectomy were studied on the night before operation and the first night after operation. Operations were performed during general anaesthesia and postoperative analgesia was achieved without the administration of opioids. There were no significant changes in the total time awake or the number of arousals on the postoperative night compared with the night before operation. During the postoperative night, we found a decrease (P = 0.02) in slow wave sleep (SWS) with a corresponding increase in stage 2 sleep (P = 0.01). SWS was absent in four of the patients after operation, whereas in six patients it was within the normal range (5-20% of the night). The proportion of rapid eye movement (REM) sleep was not significantly changed after operation. There were no changes in arterial oxygen saturation on the postoperative compared with the preoperative night. Comparison of our results with previous studies on SWS and REM sleep disturbances after open laparotomy, suggests that the magnitude of surgery or administration of opioids, or both, may be important factors in the development of postoperative sleep disturbances.

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MARKED HYPOXEMIA AFTER GASTROPLASTY DUE TO DlSORDERS OF BREATHING IN RUM SLEEP

Cited by 10 publications

References 0 publications

Recall of music: a comparison between anaesthesia with propofol and isoflurane

Recall of music: a comparison between anaesthesia with propofol and isoflurane

Late Postoperative Episodic and Constant Hypoxaemia and Associated Ecg Abnormalities

Sleep after laparoscopic cholecystectomy

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