Th.--Méd.--Paris, 1908-1909. / Paris, 1908-1909, tome 23, n ° 299.

Generell anestesi kan ges som inhalationsanestesi eller total intravenös anestesi (TIVA). En förutsägbar anestesi med snabbt uppvaknande och bibehållen vakenhet är en högt önskvärd egenskap oavsett anestesiform. Det råder en klinisk och vetenskaplig diskussion om vilken anestesiform som ger snabbast tidig postoperativ återhämtning. syftet med studien var att jämföra patienters tidiga postoperativa återhämtning efter inhalationsanestesi respektive efter total intravenös anestesi (TIVA). Metoden var en litteraturstudie baserad på 15 vetenskapliga artiklar. Dessa analyserades utifrån frågeställningen: Vilken anestesiform som ger den snabbaste tidiga postoperativa återhämtningen. Det framkom en indelning av resultatet i tre kategorier: snabbare tidig postoperativ återhämtning efter inhalationsanestesi, lika lång tid till återhämtning efter inhalationsanestesi som efter TIVA samt snabbare tidig postoperativ återhämtning efter TIVA. Resultatet visade att inhalationsanestesi gav snabbast tdiig postoperativ återhämtning. Anestesisjuksköterskans handhavande, planering och erfarenhet påverkar patientens uppvakande. därför skulle vidare forskning istället jämföra dessa båda anestesiformer på ett annat sätt. Tiden kunde istället mätas från det att anestesisjukskäterskan extuberat patienten och till payienten verkar adekvat orienterad för att erhålla ett mer jämförbart resultat. / General anesthesia includes both inhalations anesthesia and total intravenous anesthesia (TIVA). After any anesthetic technique a de sirable characteristics is a predictably rapid emergence and sustained alertness. There is a clinical and scientific debate about which anesthetic technique who gives the most rapid emergence in the early postoperative recovery. The aim of this study was to compare patients early postoperative recovery after inhalations anesthesia and after total intravenous anesthesia (TIVA). The methods are based on 15 research articles. They where analysized from the questionnaire: which anesthetic technique gives the most rapid emergence in the early postoperative recovery. The results showed that inhalations anesthesia gave the most rapid emergence in the earky postoperative recovery. The nurse anesthetist handling, planning and experience affect the patients awakening. Therefore further research instead could compare these anesthetic techniques in another way. The time after the nurse anesthetist has extubate the patient until the patient is adequate orientated, could be measured to find a more comparable result.

Allergic asthma is an inflammatory disease of the airways and is characterized by eosinophilic inflammation and increased airway reactivity. In the studies presented in this thesis, lung mechanics and measurements of airway reactivity were assessed in anaesthetized tracheostomized mice by using an animal ventilator (flexiVent®). A forced oscillation technique makes it possible to measure of both airway and tissue mechanics with a potential to distinguish between central and peripheral airways. The results of the experiments on lung mechanics imply that it is important to understand how altered lung mechanics can affect the airway physiology in order to assess the relevance of different animal models of asthma. We have investigated the effects of changing different components of the lung mechanical measurements, such as administering bronchoconstrictive agents via inhalation or intravenously and implementing deep inhalation in animals with airway inflammation. We have also investigated the relation between airway inflammation and oxidative stress. We found that the formation and time-course of F2-isoprostanes, a marker of oxidative stress, and tissue damage were associated with the degree of inflammation and with the degree of heterogeneous airway airflow. Finally we wished to investigate the hypothesis that nitric oxide (NO) may interact with glucocorticoid (GC) treatment because we see a potential for finding new strategies to increase the therapeutic effect in poor responders or patients resistant to GC treatment. NO plays a central role in physiological regulation of the airway function, and is involved in asthma. We found that the concomitant administration of NO and GC attenuated the airway reactivity more than either treatment alone. In conclusion, with the information presented in this thesis, we hope to contribute to the development of better experimental tools and to improved understanding of murine models of asthma for investigating and understanding the underlying pathophysiology of asthma.