Premedication with temazepam in minor surgery

Fourteen patients received oral premedication of temazepam in soft gelatin capsules before minor surgery. The plasma concentrations of temazepam and its sedative, anxiolytic and amnesic effects were measured for 24 hours. Absorption was rapid and peak concentrations occurred 49 minutes after administration. Clinical effects were evident at 30 minutes and persisted for about 4 hours. The decline in plasma concentration was biexponential with a distribution half-life of 1.24 hours. The end of the distribution phase coincided approximately with the termination of its clinical effects. A relationship between plasma concentration and effect was observed; concentrations above 300 ng/ml produced measurable changes in tests of mental function. Patients had recovered fully from the effects of temazepam after 24 hours. This dose of temazepam is reliable and effective as premedication before surgery.     

Anestheasia in minor surgery

The analysis of anesthesiological accessories in carrying out some surgical interventions of short duration or painful manipulations on 652 patients has been performed. In 527 of them the intravenous narcosis was applied, therewith in 390 cases muscle relaxants were injected and artificial pulmonary ventilation was done without intubation of the trachea. In other patients mask narcosis or combined anesthesia were applied.     

Anesthesia in adrenal surgery

Although adequate preoperative readiness of patients with pheochromocytoma decreases the myocardial oxygen imbalance with which the anesthesiologist must deal, these patients remain a challenge, requiring attention to detail. Thorough knowledge of the pathophysiology and applicable pharmacology will aid in the selection of the most appropriate drugs for the task. Preoperative evaluation, adequate monitoring, protection against stimulating maneuvers, and prompt response to hemodynamic changes remain the hallmarks of good anesthetic care for these interesting patients.     

Anesthesia in transurethral surgery

Transurethral resection (TUR) is a surgical operation generally performed in elderly patients, afflicted with polymorbidity and a high risk for anaesthesia. We studied 1351 transurethral resections during the years 1974-1984: 840 of these procedures were done under regional block--spinal as well as epidural--and 511 in general anaesthesia. Results and complications were related to the applied technique of anaesthesia. Considering that especially the very old patients belong to the regional anaesthesia group where general anaesthesia is known to be dangerous, the results of this study confirm definitely that regional anaesthesia is at present the most appropriate technique for TUR surgery.