Influences of alcohol upon performance and performance awareness

The effects of alcohol and performance feedback on reaction time, judgments of response speed, and awareness of performance were examined with 15 male subjects. It was suggested that the dose of alcohol which impaired performance would also reduce the awareness of the impairment. In response to extrafoveal visual signals, a series of RTs and response-speed judgments were recorded over three experimental sessions which differed in target blood alcohol concentration, i.e., placebo, .05, .10. The spurious performance feedback presented to five subjects in each of three groups represented either fast, average, or slow RTs. Data support the hypothesis that alcohol impairs both performance and performance awareness. In all groups alcohol significantly increased RTs and significantly impaired the accuracy of response speed judgments. The measures of awareness, i.e., correlations between RTs and response speed judgments, showed that alcohol and spurious feedback significantly impaired performance awareness.

Awareness and dreams during general anaesthesia for Caesarian section a study of incidence

One hundred Nigerian patients presenting for emergency caesarian section were interviewed within the first 24 hours post-operatively. The purpose was to determine the incidence of awareness and dreams. The standard anaesthetic technique consisted of atropine 0.6 mg and thiopentone 250 mg given intravenously at the time of induction, suxamethonium bromide 40 mg intravenously to facilitate tracheal intubation and nitrous oxide/oxygen/pancuronium for maintenance. The incidence of awareness was 4% while the incidence of dreaming was 17%. Most (94%) of the patients said they dreamed only occasionally at home and of these, 15% claimed they dreamed more frequently when pregnant than when not pregnant.

Effect of morphine-diazepam on signs of anesthesia, awareness, and dreams of patients under N2O for cesarean section

Morphine (0.2 mg/kg) and diazepam (0.1 mg/kg) were injected IV after delivery of the fetus in 68 parturients undergoing cesarean section (CS). General anesthesia was with thiamylal-N2O-O2 (4:2) and muscle relaxant. Twenty-four to 36 hours postoperatively, 1 patient had recall, 1 had unpleasant dreams, and 2 had pleasant dreams. The incidence of recall and unpleasant dreams was 3.8 percent in elective CS and 0 percent in emergency cesareans. Morphine-diazepam combination caused anterograde and retrograde amnesia. During the cesarean, movement of patient, size of pupils, or changes in blood pressure were not indicative of awareness or dreams. During anesthesia, 33 percent O2 produced adequate oxygenation of mother and fetus.

A further study of general anaesthesia for Caesarean section

Methoxyflurane or trichloroethylene in concentrations of 0.2% or 0.1% used in anaesthesia for Caesarean section were compared. There were no differences in the acid-base state or the clinical condition of the infant at delivery, or in the incidence of maternal complications, which could be related to the choice of volatile agent. Either volatile agent in the 0.2% concentration was associated with an overall incidence of maternal awareness and unpleasant dreams of 2.5%, compared with 4.9% when the 0.1% concentration was used. The incidence of maternal nausea and vomiting was less in the 0.2% series. There was an apparent relationship between the induction-delivery interval and (a) the degree of neonatal acidosis and (b) the Apgar-minus-colour scores at one minute ((A-C)1). The correlation between those indices of increasing foetal depression and increasing length of the uterine incision-delivery interval was highly significant. There was no systematic relationship between the one-minute score for "colour" and the umbilical artery PO2.

[Elaboration and standardization of a series of psychometric tests for old people (author's transl)]

We had previously elaborated a series of psychometric tests for old people. The aim of this test series is to assess the effects of brain-stimulating drugs (vasodilatating drugs). A factorial analysis was then carried out which enables us to reduce the number of tests, on the one hand, and to indicate the most fundamental fields of activity in old people, on the other hand. Four factors were distinguished. They assess respectively: watchfulness, memory, fluidity, and precision in the task undertaken. These four factors are strongly correlated. This implies the presence of a general factor, close in kind to the first factor. Watchfulness, attention and concentration are, in fact, necessary but insufficient conditions for the performance of all cognitive activities. A total of 7 tests among the most representative of each factor were retained. They are described in detail: test conditions, instructions, scoring and standardization.

On awakening paralyzed during surgery. A syndrome of traumatic neurosis

We have observed several cases of a traumatic neurotic syndrome in patients who awakened from light anesthesia while still unable to move. The subsequent symptoms of anxiety and irritability, preoccupation with death, and repetitive nightmares should lead the physician to suspect the condition even though the patient is reluctant to talk about it. A direct explanation of the situation often serves as a dramatic cure.

Awareness, dreams, and hallucinations associated with general anesthesia

This incidence of mental aberrations (awareness, dreams, and hallucinations) in 490 adult patients undergoing a variety of surgical procedures was investigated. The total incidence of mental aberrations reported was 11 percent (awareness 1 percent, halluncinations 2 percent, dreams 8 percent). No statistically significant correlation was found between the incidence of unusual mental reactions and the anesthetic agents employed, the age or sex of the patients, or the duration or type of surgical prcedure.

A return to trichloroethylene for obstetric anaesthesia

A study of 405 patients revealed that the substitution of 0.1% trichloroethylene for 0.1% methoxyflurane in a previously established technique of anaesthesia led to no remarkable changes in the incidence of postoperative nausea, vomiting or headache. There was, however, an increase in the incidence of awareness from 3.5% to 5.1%. There was no significant difference in the Apgar scores (totals or individual components) or in the materno-foetal acid-base gradients at delivery between the Group A elective Caesarean section patients in the two series. In view of these findings, and of the relative freedom from toxicity and the inexpensiveness of trichloroethylene, a more general re-introduction of the drug into anaesthetic practice is advocated. The study also served to demonstrate that, using the technique described, the duration of the interval from induction of anaesthesia to the initial incision into the myometrium was, at least up to 30 min, of no significant import to the well-being of the infant, but that the time elapsing between uterine incision and complete delivery was directly and significantly associated with neonatal asphyxia and clinically-apparent depression of the infant.