ISSN:1155-5645    

DOI:10.1046/j.1460-9592.1996.d01-19.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

ISSN:1155-5645    

DOI:10.1046/j.1460-9592.1996.d01-3.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

The oral cavity offers a simple, painless way of drug administration. For this reason, we used oral transmucosal ketamine (5–6 mg·kg−1) for premedication in 15 children and compared it with intranasal ketamine (5–6 mg·kg−1), placebo and intramuscular ketamine (5–6 mg·kg−1). Oral transmucosal ketamine (OTK) provided effective sedation, facilitated i.v. line insertion and was accepted with pleasure by the patients (as lollipops). The lollipops produced a slight increase in gastric volumes but did not affect gastric pH. In conclusion OTK has been shown to be an effective, harmless preoperative medication in paedi

ISSN:1155-5645    

DOI:10.1046/j.1460-9592.1996.d01-9.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

The effective concentrations of mivacurium induced neuromuscular block were studied in the phrenic nerve‐hemidiaphragm preparations of forty male Sprague‐Dawley rats in four groups according to body weight, 10 g, 25 g, 100 g, and 200 g. Mivacurium was added to the Krebs» solution to obtain an initial concentration of 0.275 μg·ml−1(2.5×10−7mole·litre−1). Thereafter, the concentration of mivacurium was increased in increments to obtain more than 90% neuromuscular twitch inhibition at 0.1 Hz. Data were analysed by probit and logistic models. The two statistical techniques yielded very similar results, almost identical values of EC50and EC95. There were significant decreases in the effective concentrations of mivacurium needed to depress the twitch response in neonatal rats (10 g) compared to older rats. No significant differences were observed between 25, 100 and 200 g rats. We conclude that the neonatal neuromuscular junctions of rats show increased sensitivity to mivacurium related to pharmacod

ISSN:1155-5645    

DOI:10.1046/j.1460-9592.1996.d01-137.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

Cisatracurium, 51W89, is one of the ten stereoisomers of Tracrium®which, unlike atracurium, has been reported to have a lack of histamine mediated cardiovascular effects at doses as high as 8×ED95in adults. We compared the time‐course of neuromuscular effects of 80 μg·kg−1or 100 μg·kg−1cisatracurium during N2O‐O2‐halothane or N2O‐O2‐opioid anaesthesia, respectively, in 32 children 2–12 years old. Neuromuscular function was monitored by evoked adductor pollicis EMG. Even‐numbered patients (n=16) were allowed to obtain full spontaneous recovery of neuromuscular function and odd‐numbered patients (n=16) received neostigmine 45 μg·kg−1together with glycopyrrolate at the time of 25% EMG recovery. Data are expressed as median with 10th to 90th percentile range. Cisatracurium had an onset time (time from administration to maximal effect) of 2.2 (1.7–3.8) or 2.3 (1.8–4.9) min, a clinical duration (time to 25% EMG recovery) of 34 (22–40) or 27 (24–33) min, and a spontaneous 25–75% recovery time (time from 25 to 75% EMG recovery) of 11 (9–13) or 11 (7–12) min during halothane or balanced anaesthesia, respectively (NS). Train‐of‐four ratio recovered to 0.70 in 2.5 (1.8–3.0) or 3.2 (2.1–4.3) min following neostigmine during halothane or balanced anaesthesia, respectively (NS). Changes in blood pressure or heart rate following cisatracurium were negligible. We regard cisatracurium as a safe and promising intermediate duration muscle relaxant the effec

ISSN:1155-5645    

DOI:10.1046/j.1460-9592.1996.d01-8.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

Patients with epilepsy on long term antiepileptic drug (AED) therapy deserve special consideration not only concerning seizure control but also the effect on anaesthetic metabolism and hepatorenal functions. In the present study, we examined the effects of sevoflurane anaesthesia on plasma inorganic fluoride (F−) level and hepatorenal function in patients with and without AED therapy. Twenty‐two patients (12 with AEDs=AED group, and ten without AEDs=control group=C group), ASA I, who were free of hepatorenal disease, received approximately 2–3 h sevoflurane anaesthesia. Plasma F−analysis was performed at the stages of: 1) induction of anaesthesia, 2) conclusion of anaesthesia, 3) 15 h after the conclusion of anaesthesia, using an ion‐selective electrode calibrated with a standard solution of sodium fluoride. Pre‐ and postoperative hepatic (aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, total bilirubin) and renal (blood urea nitrogen, creatinine) function was tested. There were no significant differences between the two groups in the average age (AED group=9.4 and control group=10.1 y.o.), body weight, duration of anesthesia, and MAC hours (2.6 and 2.4). The mean peak F−levels were 15.5 and 13.6 μM, in AED and C groups (not significant), respectively. No patient exhibited F− values greater than 50 μM, the hypothetical nephrotoxic threshold. The patients showed no abnormal values either in hepatic or renal function tests postoperatively. These results suggest approximately 2–3 h sevoflurane anaesthesia to be safe in pat

ISSN:1155-5645    

DOI:10.1046/j.1460-9592.1996.d01-7.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

Intermittent oxygen jet ventilation at an inspiratory:expiratory ratio of 1:3 was used to ventilate 15 children undergoing rigid Storz bronchoscopy for removal of inhaled foreign body. Oxygenation of the patient was continuously monitored by pulse oximetry. In all childrenSpO2was above 95% when the bronchoscope was above the carina. When the bronchoscope was introduced into one of the bronchi,SpO2decreased to 70–85% in five children. Delivery of a continuous flow of oxygen via a T‐piece attached to the side‐arm of the bronchoscope increased theSpO2>95% in the five children. Oxygen jet ventilation during bronchoscopy is based on the Venturi principle; the oxygen jet will entrain room air from the side arm of the bronchoscope which functions as an entrainment orifice. This will decrease theFIO2. TheFIO2can be increased by flowing oxygen continuously via the T‐piece attached to the side arm of the bronc

ISSN:1155-5645    

DOI:10.1046/j.1460-9592.1996.d01-12.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

Our objective was to establish the safety and effectiveness of a loading dose of midazolam for postoperative sedation of children recovering from open heart surgery; a prospective randomized placebo‐controlled double‐blind study was done with subjects randomized to three groups according to loading dose. I=0.08 mg·kg−1; II=0.04 mg·kg−1; and III=0.00 mg·kg−1(placebo). An open label continuous midazolam infusion protocol followed. Haemodynamic parameters were monitored. The study was discontinued following an adverse event involving the 23rd subject. When data for all 23 subjects were combined, there was a mean decrease of 10% in blood pressure (BP) 30 min after the loading dose (P<0.001). Heart rate change was less significant. Clinicians identified four hypotensive episodes as temporally associated with the midazolam load, two each in Groups I (0.08 mg·kg−1) and III (placebo). One subject in Group I (the 23rd) became hypotensive within five min of receiving the loading dose, had a difficult clinical course and died four weeks postoperatively. We cannot conclude that the loading dose of midazolam had any systematic haemodynamic effect in our study population. Although the clinical course of the 23rd subject suggests a subset of more susceptible children (those who receive opioid analgesia with midazolam, are volume‐restricted, and/or undergo more complex forms of surgical correction), many critical care patients are inherently physiologically unstable, and concluding clinically that blood pressure fluctuation is drug related

ISSN:1155-5645    

DOI:10.1046/j.1460-9592.1996.d01-6.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

Methylxanthines are used to treat or prevent respiratory failure (apnoea) in premature infants both perinatally and perioperatively. Heart rate variability (HRV) is being increasingly used to measure autonomic function. In this study various indices of HRV were compared pre‐ and postmethylxanthine dosing in 22 infants (aged 24–36 weeks). HRV significantly increased postdosing, particularly in the high frequency (HF) band (P=0.001 by ANOVA). This increase was more pronounced in the sickest infants. This pattern of increased HRV and %HF is the same that occurs with normal maturation. This suggests that methylxanthine may stimulate and normalize autonomic funct

ISSN:1155-5645    

DOI:10.1046/j.1460-9592.1996.d01-10.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

We studied the haemodynamic and cardiovascular effects of epidural anaesthesia with plain bupivacaine 0.75 ml·kg−1in 13 unpremedicated ASA 1 children using measurements of heart rate, blood pressure and M‐mode echocardiography. Under general anaesthesia, M‐mode echocardiographic evaluation of left ventricular function in each patient was performed at four points (after general anaesthesia, point A; 5 min, 10 min and 25 min after epidural anaesthesia, point B; point C; and point D, respectively). Results were compared between point A and B, A and C, A and D, B and C, B and D, C and D. HR decreased significantly at 10 min (point C) and 25 min (point D) and MBP decreased at 5 min (point B) and 10 min (point D) compared to point A. No other M‐mode cardiographic indices were changed at any point. Epidural anaesthesia using 0.25% bupivacaine 0.75 ml·kg−1did not affect LV function in you

ISSN:1155-5645    

DOI:10.1046/j.1460-9592.1996.d01-11.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY