Anesthetic management of patients with dilated cardiomyopathy (DCM) is a challenge to the anesthesiologist, due to poor left systolic function, ventricular enlargement, risk of malignant arrhythmias and sudden cardiac death. Therefore, preoperative assessment and appropriate anesthetic management are important in patients with DCM. This review describes the preoperative evaluation and anesthesi...

INTRAOPERATIVE monitoring of the electroencephalcgram (EEG) is commonly used for detection of cerebral ischemia during carotid endarterectomy. Although realtime interpretation of analog EEG recordings may be considered the “gold standard” for ischemia detection, various signal-processing techniques have been used to ease the interpretation of intraoperative EEG. Several reviews of various EEGpr...

Introduction In October 1996 the Food and Drug Administration approved the use of a new monitoring device of anesthetic effect that integrates various electroencephalogram (EEG) descriptors into a single dimensionless, empirically calibrated number, the Bispectral Index (BIS, Aspect Medical Systems, Natick, MA).1 The BIS monitor is the latest innovation in the quest for a reliable monitoring de...

STUDY DESIGN A prospective randomized controlled trial. OBJECTIVE The purpose of this study was to prospectively compare the efficacy of neurophysiological monitoring during general anesthesia with either a total intravenous technique or with the volatile anesthetic agent, desflurane. SUMMARY OF BACKGROUND DATA A total intravenous anesthetic technique is generally chosen when neurophysiolog...

In Part II of a continuing series on neuroanesthesia, the author discusses the many variables in managing anesthesia for neuroradiologic procedures, encompassing pneumoencephalography, angiography, myelography, and computerized axial tomography (CA T scans). From the discovery of the X-ray to the introduction of computed tomography, the one basic and most important requirement for obtaining a s...

The anesthetic management of pheochromocytoma is complicated and challenging. However, preoperative pharmacologic preparation has greatly improved perioperative outcome, and modern anesthetic drugs combined with advanced monitoring contribute to intraoperative stability. There is great regional and international variation in which intraoperative anesthetic technique is employed and there are li...

Within the framework of the Trilateral Initiative, technical challenges have arisen due to the potential of the International Atomic Energy Agency (IAEA) monitoring fissile material with classified characteristics, as well as the IAEA using facilityor host country-supplied monitoring equipment. In monitoring material with classified characteristics, it is recognized that the host country needs ...

Major technical and pharmacological achievements in recent years have greatly influenced the practice of anesthesia. Clinical signs related to the main aspects of anesthesia, i.e., hypnosis, analgesia, and muscular relaxation, are increasingly obtainable from variables supplied by the monitoring equipment. It is not known, however, to what extent more indirect, patient-associated clinical signs...