摘要:

The effects of two structurally similar butyrophenones (droperidol and haloperidol) and ketamine were evaluated in anin vitrosystem to determine their potential for eliciting or exacerbating an episode of malignant hyperthermia. Muscle strips from patients referred for diagnostic testing for malignant hyperthermia and muscle strips from the rat diaphragm were exposed to droperidol, haloperidol, or ketamine prior to challenge with halothane, succinylcholine or caffeine. If any agent augmented the contracture response to the malignant hyperthermia triggering or diagnostic agents, then the agent was considered unsafe for use in malignant hyperthermia susceptible patients. Droperidol 10 μmol/1 and ketamine 100 μmol/l did not induce contractures in human or rat skeletal muscle when added alone, nor did they augment halothane, succinylcholine or caffeine contractures. These agents appear to be safe for use in patients susceptible to malignant hyperthermia. In contrast, haloperidol 10 μmol/1 augmented the response to succinylcholine about 1.5–fold and may be contraindicated in MH suscepti

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1989.tb02887.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Calcium channel blockers and halogenated inhalation anesthetics reduce hypoxic pulmonary vasoconstriction (HPV) when administered separately to isolated rat lungs. This study was undertaken to investigate the effect of combining the calcium channel blocker verapamil with halothane or isoflurane. HPV was elicited in three groups of experiments. First, we studied the effect of halothane 1.3 MAC and varying concentrations of verapamil. Halothane reduced HPV as a mean by 34.7%, and a dose–dependent reduction was seen with verapamil. The depressant effect of the combination of halothane and verapamil was significantly greater than when the drugs were administered alone. We further investigated in separate groups the effects of varying concentrations of halothane and isoflurane, administered both separately and in combination with a constant dose of verapamil (1.02 nmol). Both anesthetics depressed HPV in a dose–dependent fashion. Verapamil reduced HPV as a mean by 34.2% and 39.3% in the halothane and isoflurane groups, respectively. The inhibition caused by combining verapamil with an anesthetic was significantly greater than when administered separately. We conclude that verapamil in combination with halothane or isoflurane has an additive dampening effect on

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1989.tb02888.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

The cerebral and systemic effects of hypotension induced by adenosine (0.61 0.07 mg–kg‐1–min‐1) were studied in eight pigs anesthetized with droperidol, phenoperidine and nitrous oxide. Mean arterial blood pressure (MABP) was reduced by 58%, from 17.2 kPa (128 mmHg) to 6.9 kPa (53 mmHg) during a 30–min period. The hypotension was caused by a decrease in systemic vascular resistance (58%) while the cardiac output was unaffected. Cerebral blood flow (CBF), as determined by microsphere distribution, and the cerebral metabolic rate for oxygen (CMRo2) remained unchanged. Cerebral vascular resistance decreased by 61%. There were no signs of cerebral lactate release. After discontinuation of adenosine infusion, the MABP returned to control levels within 5 min. Thirty minutes later the CBF was increased by approximately 60%, in comparison to the control, while the CMRo2was unchanged. It is concluded that adenosine–induced hypotension in pigs is associated with preserved CBF and CMRo2, whereas cerebral hyperperfusion is present in the early post–hypot

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1989.tb02889.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Fade in the train–of–four (TOF) responses during onset of neuromuscular block was studied following administration of atracurium (225 or 450 μg/kg), vecuronium (40 or 80 μg/kg), pancuronium (60 or 120 μg/kg) and tubocurarine (450 μg/kg). TOF ratios were measured at approximate heights of T, (first response in the TOF) of 75, 50 and 25%. Fade in TOF increased as the height of T1decreased, with maximum fade being observed at T1of 25%. The greatest difference between relaxants was observed at T, of 25%, vecuronium showing the least fade and pancuronium, atracurium and tubocurarine showing increasing fade, in that order. The difference between atracurium and tubocurarine or between vecuronium and pancuronium was not significant, but the degree of TOF fade was significantly greater with atracurium and tubocurarine in comparison to vecuronium or panc

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1989.tb02890.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

The acute hemodynamic effects of pericardial closure were studied in 30 patients with normal left ventricular function, who were undergoing coronary artery bypass surgery. Closure of the pericardium resulted in decreases in arterial blood pressure (P<0.01), cardiac index (P<0.001), mean right atrial (P<0.001), mean pulmonary artery (P<0.001) and pulmonary capillary wedge pressure (P<0.001). The observed hemodynamic changes are probably caused by a change in the ventricular pressure–volume relationship

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1989.tb02891.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

To determine whether cerebral blood flow (CBF) changed with time under isoflurane anaesthesia, as has been reported for halothane, CBF and cerebral metabolic rate for oxygen (CMRo2) were studied in five dogs under prolonged isoflurane anaesthesia. CBF was measured with a modified sagittal sinus technique and CMRo2was calculated as the product of CBF and the arteriovenous O2difference. Maintaining this experimental dog model with 1 % isoflurane in oxygen and nitrogen for 3 h in five dogs and for 4 h in three dogs did not cause any significant changes in CMRo2or CBF. Cerebral metabolite levels were consistent with earlier reports from short–time studies and the EEG recordings showed a continuous sleep pattern with no pathological changes. It is concluded that there is no change in CBF or CMRo2in our modified sagittal outflow model during 3–4 h of 1 % isoflurane anaesthe

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1989.tb02892.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

In order to evaluate the effect of isosorbide dinitrate (ISDN), administered as a bolus intravenous injection, on the circulatory response to tracheal intubation, mean arterial pressure (MAP), and heart rate (HR) in response to laryngoscopy for 30 s followed by tracheal intubation were compared in patients not receiving ISDN (control) and receiving 40 μg/kg or 80 μg/kg of ISDN 45 s before starting laryngoscopy. Each group consisted of 10 patients undergoing elective surgery. Forty–five seconds after starting laryngoscopy, MAP was significantly (P<0.01) lower in patients receiving 80 μg/kg ISDN than in those receiving no or 40 μg/kg ISDN. HR increased to a similar extent in the three groups. These results indicate that a bolus injection of ISDN (80 μg/kg) is a simple, practical and highly effective means of attenuating the hypertensive response to direct laryngoscopy and tracheal intu

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1989.tb02893.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

In a randomized, double–blind study, 131 consecutive patients, subjected to elective upper laparotomy, were prophylactically given the recommended dose of N–acetylcysteine (NAC) (Mucomyst, ASTRA) (200 mg × 3) or placebo against postoperative pulmonary complications. The effect was evaluated by lung function tests (VC and FEV1), arterial blood gas analyses and chest x–ray. No benefit could be demonstrated, either to postoperative pulmonary function or in the frequency of atelectasis in the recommended dose. However, no patients with preoperative bronchopulmonary disease demanding treatment with bronchodilatators were included in the study. A positive effect of NAC in this category of patients could not be ex

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1989.tb02894.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Cannulae made of polytetrafluoroethylene (PTFE: n = 11), thermoplastic polyether–urethane (TPEU: n = 11), and a new test material, polyamide–ether–elastomer (XLON: n = 10) were inserted into the veins of the dorsum of the hand in 32 healthy volunteers (10 women and 22 men), 21–50 years old. The cannulae were intended to be left in place for 5 days. No infusion was given and the dressings were not exchanged. The resulting thrombophlebitis, defined as two or more of the symptoms pain, redness, oedema and hardness, was estimated on a scale which took into account the incidence, location, intensity, and duration of the symptoms. Except for one volunteer in the XLON group, all the volunteers developed thrombophlebitis, generally observed on the third day of cannulation, and being more frequent and intense over the cannulae (P<0.001) and at the tip (P<0.01) than at the insertion sites. Pain and oedema were, on the whole, the most frequent and severe symptoms during the period of indwelling. After withdrawal, hardness was the most intense, and together with pain, the most long–lasting (up to 10 days) symptom. The differences between the materials in thrombophlebitis incidence and intensity were statistically significant only when each symptom was analysed separately. Thus, the PTFE cannulae caused more pain and hardness (probably because of greater platelet adhesion and a relatively greater stiffness), while the TPEU and XLON cannulae produced more periphlebitis (redness and oedema), probably because of potentially irritant and antigenic substances leaking from them (polyurethane oligomers and polyamide/polyethyleneglycol o

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1989.tb02895.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

This study was undertaken in surgical patients in order to evaluate the effects of intravenous verapamil on the circulatory responses to laryngoscopy and tracheal intubation. Laryngoscopy for tracheal intubation was initiated 1 min after thiamylal 5 mg·kg‐1and succinylcholine 1.5 mg·kg‐1in the control group (n = 21). The verapamil group (n = 23) received intravenous verapamil 0.1 mg·kg‐1immediately after thiamylal–succinylcholine administration. The resulting changes in mean arterial pressure (MAP) and heart rate (HR) were continuously measured. Compared with the control group, MAP increased less in response to laryngoscopy and tracheal intubation (56 ± 13% versus 25 ± 15% above baselines,P<0.01) and returned toward baseline sooner in patients receiving verapamil. For hypertensive patients, MAP increases from baseline after intubation were 18 ± 9% in the verapamil group, and 53 ± 14% in the control group, respectively (P<0.001). Increases in HR response to laryngoscopy for intubation were comparable in both groups. We conclude that intravenous verapamil is effective in reducing pressor responses during endotracheal intubation, especially in hyperte

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1989.tb02896.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY