摘要:

The stability over time and the effect of muscle temperature change were evaluated for the evoked compound EMG and for the mechanomyogram of the tibialis anterior muscle of 7 anaesthetized cats. Both EMG areas and amplitudes were recorded. During stimulation for 3 h with 0.1 Hz (one leg) and train‐of‐four (TOF) (the other leg), the EMG was stable while the mechanomyogram initially increased 35–50% in the first 7–8 min and then decreased 19–22% and 5–8% over the first and second 1.5‐h period, respectively. During subsequent mean muscle temperature reduction to 28.8°C (0.1 Hz) and 29.7°C (TOF) and rewarming, an inverse linear relationship was found between temperature and both the EMG and the mechanomyogram. During temperature reduction EMG increased about 6% (areas) and 2% (amplitudes) per °C. During rewarming, parameters decreased about 4.5% and 2% per °C, respectively (P<0.05 comparing EMG areas during cooling and rewarming). TOF ratio of the EMG was not affected by temperature. A very large interindividual variation was observed for the effect of temperature on the mechanomyogram with changes ranging up to 15% per °C for some cats. TOF ratio of the mechanomyogram was reduced from 1.02 to0.94 at lowest muscle temperature. It is concluded that the evoked EMG may be preferable to the mechanomyogram in cat experiments investigating the neuromus

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1992.tb03506.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

A randomized, double‐blind study was carried out on 193 ASA I–II surgical patients to assess the effect of aerosolized lidocaine on sore throat, hoarseness and cough in connection with tracheal intubation. The study group received aerosolized lidocaine 100 mg 2 min before tracheal intubation, using a spray. The control group received no spray. The patients underwent a standardized general anaesthesia. The patients were interviewed when leaving the recovery room and the next day in the ward. Specific questions were asked regarding sore throat, cough and hoarseness. There were no significant differences between the two groups, which suggests that topical anaesthesia of the mucosa of the upper airway is ineffective as a means of ameliorating airway complaints in connection with tracheal intubat

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1992.tb03507.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Combined high frequency ventilation (CHFV) with 8 mmHg (1.0 kPa) continuous positive airway pressure (CPAP) and without CPAP (CHFV0) were compared to each other, and to continuous positive pressure ventilation (CPPV) with 8 mmHg (1.0 kPa) CPAP in pigs with oleic acid induced lung injury. The respiratory rate was 15 min‐1and the high frequency (HF) rate 360 min‐1. Arterial carbon dioxide tension (Paco2) was adjusted to 5 kPa and 25% oxygen was used. After CHFV, CPAP was briefly discontinued to allow the establishment of CHFV0 in order to examine the cardiovascular and pulmonary effects of combined high frequency ventilation alone. Mean arterial oxygen tension (Pao2) was 15.8± 3.9 kPa during CPPV, 15.5 + 3.2 kPa during CHFV and 13.2 + 5.1 kPa during CHFV0 (ns). The peak airway pressure and the pericardiac pressure were lowest during CHFV0. CHFV provoked significant cardiovascular depression (mean arterial pressure, stroke index, left and right ventricle stroke work index). When compared to CPPV, a non‐significant trend towards improved cardiovascular function was found during CHFV0. With similar mean airway pressures (during CHFV0) or the same CPAP (during CHFV) as during CPPV, no further improvement in oxygenation due to HF waves was found. Airway pressure was the major factor causing alterations in cardiovascular function, not the ventilation tec

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1992.tb03508.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Omeprazole is a substituted benzimidazole that causes dose‐dependent intracellular inhibition of gastric acid secretion in humans. This double‐blind study examined the effect of omeprazole in decreasing gastric acidity and gastric residual volume in outpatient adults. Unpremedicated outpatients, ASA I–III, 18 years or older (n=17), were randomly assigned to receive omeprazole 80 mg, or placebo by mouth the night before scheduled elective outpatient surgery. The patients were fasted for 8 h prior to surgery. After the patient was anesthetized, an orogastric tube was inserted with proper placement verified by auscultation for gastric sounds. Gastric residual contents were withdrawn into a Luken's trap, and pH was then determined and gastric volume indexed to weight (ml ˙ kg‐1). Data were analyzed by at‐test, withP<0.05 considered statistically significant. Patient characteristics of both groups were similar. There was a statistically significant difference between the two groups for pH (P=0.02), but not between the two groups for gastric volume indexed to weigh

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1992.tb03509.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Twenty‐one patients were included in a randomized study to receive either 10 mg of 0.5% hyperbaric bupivacaine alone or combined with 0.05, 0.1, 0.2, 0.3, 0.4 or 0.5 mg ˙ kg‐1meperidine for spinal anaesthesia. Sensory blockade was assessed by pin prick, motor blockade by the Bromage scale, and postoperative analgesia by VAS scores and by the time before the first demand for analgesia. Spinal meperidine did not change the duration of sensory blockade, but induced a dose‐related increase in postoperative efficient analgesia. Spinal meperidine might be considered as a means to obtain postoperative analgesia in the hours immediately following s

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1992.tb03510.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Purpose: Acupuncture treatment of patients waiting for arthroplasty surgery.Methods: 29 patients with a total of 42 osteoarthritic knees were randomized to two groups. Group A was treated while Group B served as a no‐treatment control group. After 9 weeks Group B was treated too. Analgesic consumption, pain and objective measurements were registered. All objective measures were done by investigators who were “blinded” as to Group A&B. In the second part of the study 17 patients (26 knees) continued with treatments once a month. Registration of analgesic consumption, pain and objective measurements continued. Total study period 49 weeks.Results: Comparing Group A to B there was a significant reduction in pain, analgesic consumption and in most objective measures. In Group A + B combined there was an 80% subjective improvement, and a significantly increased knee range movement – an increase mainly in the worst knees. Results were significantly better in those who had not been ill for a long time. In the second part of the study, it was shown that it was possible to maintain the improvements.Conclusions: Acupuncture can ease the discomfort while waiting for an operation and perhaps even serve as an alternative to surgery. Seven patients have responded so well that at present they do not want an operation. (USD 9000 saved per ope

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1992.tb03511.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Forty elderly patients, scheduled for orthopaedic surgery of the hip or knee were studied. Twenty patients received a single‐dose spinal anaesthesia with 3 ml of plain 0.5% bupivacaine (SDSA group). Twenty patients received continuous spinal anaesthesia using a 32‐ or 22‐gauge catheter. A bolus of 1.0 ml of plain 0.5% bupivacaine was given to ten patients and 0.5 ml to another ten, continued by an infusion at a rate of 2 ml/h. The spread of analgesia and haemodynamic changes (central venous pressure, arterial pressures, need for sympathomimetic medication) were registered. The mean dose of bupivacaine was 2.9 ml (range 1.5–5 ml) in the CSA group (3.0 ml in the SDSA group). Eight patients in the CSA group needed medication for pain during surgery compared to five patients in the SDSA group (n.s.). The median level of pinprick analgesia at 60 min was T11 in the CSA and T6.5 in the SDSA group (P<0.01). The mean maximum decreases in CVP and MAP were quite similar in the CSA and SDSA group (2.1 vs 2.8 mmHg (0.3 vs 0.4 kPa) and 17 vs 21 mmHg (2.3 vs 2.8 kPa), respectively) (n.s.). Six patients in the SDSA group and four patients in the CSA group needed sympathomimetic medication. It is concluded that titration of bupivacaine for spinal anaesthesia caused only minor haemodynamic changes which were similar to those after single‐dose spinal bu

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1992.tb03512.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Fifty unpremedicated patients scheduled for outpatient restorative dentistry and/or oral surgery lasting 2 to 4 h were anaesthetized with either propofol infusion or isoflurane inhalation. Before induction of anaesthesia with propofol (2.5 mg ˙ kg‐1), all patients were given 75 mg of diclofenac and 0.01mg ˙ kg‐1vecuronium intravenously. Intubation was facilitated with suxamethonium (1.5 mg ˙ kg‐1) and anaesthesia was maintained in random order either with propofol infusion (12 mg ˙ kg‐1˙ h‐1for the first 20 min, 9 mg ˙ kg‐1˙ h‐1for the next 20 min, and 6 mg ˙ kg‐1˙ h‐1for the rest of the anaesthesia) or with isoflurane (inspired concentration 1–2.5%), both with nitrous oxide and oxygen (30%). The patients breathed spontaneously using a non‐rebreathing circuit. Patients given propofol infusion became re‐orientated faster (11.0 ± 5.5 min vs. 16.5 ± 7.5 min;P<0.01) and at 30 min walked along a straight line better (P<0.01). At 60 min, none of the propofol patients displayed an unsteady gait, whereas 11 of the 25 isoflurane patients did (P<0.001). None of the patients receiving propofol had emesis at the clinic, compared with 10 of the 25 patients receiving isoflurane (P<0.001). The overall incidence of emesis was 2 of 25 and 14 of 25 in the propofol and isoflurance groups, respectively (P<0.01). Patients receiving propofol were discharged home earlier than patients receiving isoflurane (80 ± 14 min and 102 ± 32 min, respectively;P<0.01). It is concluded that propofol allows early discharge of pa

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1992.tb03513.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

In this double‐blind trial, we observed the effect of intermittent wound infiltration with local anaesthetic plus continuous coeliac plexus blockade on postoperative pain relief, pulmonary function, the neuroendocrine and acute phase protein response following upper abdominal surgery. In Group A (n = 10) patients received bupivacaine intermittently into the wound and continuously into the coeliac plexus following an initial bolus. A total of 862.5 mg of bupivacaine was used over 12 h with no observed toxicity. Group B (n = 10) received equal volumes of saline. Although pain relief was poor in both groups, the bupivacaine group used less morphine postoperatively and had lower pain scores than the saline group 4 h after operation (P<0.05). Pulmonary function was significantly reduced in both groups with no statistical difference between the two. Significant reductions in serum glucose and cortisol were achieved (P<0.05), suggesting that afferent neural blockade was partially effective in attenuating the neuroendocrine response. However, the postoperative rise in interleukin‐6 was not affected by this technique. It is concluded that total afferent neural blockade cannot be achieved with peripheral wound and coeliac plexus administration of relatively large doses of local anaesthetic during upper abdominal surg

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1992.tb03514.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Quantitative measurements of coordination ability and performance speed were carried out on 76 female day‐case patients undergoing minor gynaecological operations. The women were assigned at random to the anaesthetic agent used, propofol 2.5 mg/kg or thiopentone 4 mg/kg. Spacing control, timing control and performance speed were recorded using a newly developed computerized coordination ability test system. The patients were tested once before the operation and 0.5, 1 and 2 h after awakening. Postoperatively the initial impairment and the subsequent regression towards preoperative test results were very similar whether the anaesthetic agent was propofol or thiopentone. Although the test apparatus was able to detect even minor differences, no postoperative test showed statistically significant differences between the two groups. We find it reasonable to conclude that there is no difference in recovery of coordination ability following propofol‐ or thiopentone‐induced anaest

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1992.tb03515.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY