ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1982.tb01876.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

Cardiovascular homeostasis is dependent on the efficient performance of the effector organs, i.e. the vascular smooth muscle and the heart. Besides inherent activity and local control mechanisms, these effector organs are regulated by circulatory control centres within the central nervous system, which in turn receives information from receptors inside and outside the cardiovascular system. All these components of the circulatory systems, i.e. receptors, afferent and efferent pathways, control centres and effector organs, are possible sites for interactions by anaesthetics. Since different anaesthetics have different potencies and special predilections, there are a large variety of interaction patterns, as is discussed in the paper. Another way of evaluating circulatory effects of drugs used in anaesthesia is to analyse how these drugs may modify circulatory reflexes associated with surgery and trauma. For example, pain, hypoxia and/or hypovolaemia may evoke circulatory adjustments which correspond to and are functionally related to, from experimental physiology, well‐known reflex patterns such as the somatosympathetic reflex, the chemoreceptor reflex and the baroreceptor reflex. These reflex adjustments are liable to modification by anaesthetics, as exemplified in the paper. Due to the complexity of circulatory control and the varying effects of different anaesthetic agents, it is difficult to draw general conclusions. It can, however, be stated that most general anaesthetics depress cardiovascular reflexes in proportion to the depth of anaesthesia, and that suprabulbar centres are more easily depressed than bulbar ones. Opiates seem to have a specific inhibitory effect on circulatory adjustments induced by noxious stimuli. Transmission in efferent and afferent pathways is liable to modification by local anaesthetics, ganglionic blockers or α‐ and β‐receptor anta

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1982.tb01885.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

The endorphins constitute a large family of structurally but not generically related peptides. They act pharmacologically like narcotic analgesics. An intimate connection between endorphin fibers and pain pathways is present, for instance, at the spinal level and at the first synapse of primary afferent pain fibers. These fibers may contain the neuropeptide substance P. In acute pain, naloxone injection causes a significant increase in pain suffering. A patient with high preoperative endorphin levels in the cerebrospinal fluid will require less pethidine for adequate pain relief after major abdominal surgery. Pethidine administration reduces substance P levels in the cerebrospinal fluid. The data suggest that endorphins do have a protective role in acute pain conditions.

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1982.tb01839.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

The relationship between alcohol intake over the week preceding anesthesia and various anesthetic parameters was examined in 119 women scheduled for termination of pregnancy under thiopental‐nitrous oxide anesthesia. In terms of pure alcohol, the weekly intake was 1.0±1.09 ml·kg‐1(mean±s.d.), range 0–5.93. i.e. below average consumption in Denmark. Alcohol intake was negatively correlated with anesthetic sleeping time (P<0.01). Time and quality of anesthesia induction and frequency of anesthetic complications were not significantly correlated with the use of alcohol. Preanesthetic anxiety was not significantly correlated with any of the above data. Induction time and postoperative awareness were positively and sleeping time negatively correlated with age (P<0.05). The results indicate cross‐tolerance between alcohol and thiopental, even when the regular intake of the former is low, and increasing thiopental requirements with incr

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1982.tb01719.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1982.tb01877.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

Effects of the prolonged administration of isoflurane on haemodynamics were studied in 17 healthy volunteen under normocarbic conditions. The anaesthetic was administered for 90 min at a constant alveolar concentration. Cardiac index was unchanged in the presence of decreased stroke volume index and increased heart rate. The mean arterial pressure decreased with parallel reductions in total peripheral resistance. 1, eft ventricular work decreased. The left ventricular ejection time index increased marginally but significantly. Isoflurane caused no change in the pump performance of the heart but depressed the muscle performance.

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1982.tb01720.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

Neurophysiological measurement of pain is a research goal rather than a reality today. The gap may be narrowed by combining different techniques. Electrophysiological methods with stimulation and recording directly from the afferent pathway should contribute to a more specific and differentiated picture of the mode of action of analgesics, as a basis for development of new therapies. Such electrophysiological methods can be combined with behavioural studies, both in humans and in animal pain models.

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1982.tb01841.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

The effects were studied of 67 % nitrous oxide on the baroreceptor control of systemic haemodynamics in the dog. Nitrous oxide was added to end‐tidal halothane concentrations of about 0.9% (H2) together with halothane levels approximately 25 % above (H3) and below (H1) the H2 concentration. Baroreceptor function was assessed by brachiocephalic artery occlusion (BCO) or perfusion of the isolated carotid sinuses. In the intact animal, nitrous oxide significantly increased mean arterial pressure only at the H2 level (P<0.001). At the closed loop operating point of the carotid sinus reflex (CSR), for all halothane levels, nitrous oxide decreased cardiar output and stroke volume, increased systemic vascuIar resistance and central venous pressure with no effect upon mran arterial pressure. The operating point gain of the CSR was significantly depressed by nitrous oxide at the H1 and H3 levels (P<0.05). The Csroperating characteristics were significantly modified by N2O in a manner which depended upon the underlying concentration of halothan

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1982.tb01721.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

A prospective randomized study was performed in 91 patients scheduled for general surgery on 99 occasions. The patients were chronically (>3 months) treated with β‐receptor blockers because of ischaemic heart disease and/or hypertension and the β‐receptor blockade was either gradually withdrawn (n = 51) during 4 days preoperatively or continued until surgery (n=48). The effects on arterial blood pressure (BP), heart rate (HR) and rate‐pressure product (RPP) at rest and the incidence of chest pain during daily activities were registered. A withdrawal of the β‐receptor blockade was associated with increases of HR (in eight patients>30 beats min‐1) and RPP and in patients treated for hypertension there were also increases of systolic and diastolic BP (in five patients ≥30/15 mmHg). Patients who continued the β‐receptor blockade until surgery showed no changes. Nine out of 23 patients with a previous history of ischaemic heart disease had an increase of chest pain after withdrawal of the β‐receptor blockers, whereas none of the corresponding 25 patients who continued the therapy suffered from an increased chest pain. Due to the severity of symptoms after β‐receptor blocker withdrawal, surgery had to be postponed in 4 patients. The observations suggest that a 4‐day preoperative withdrawal of long‐term β‐receptor blockade is potentially hazardous in ischaemi

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1982.tb01886.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1982.tb01842.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY