摘要:

Young, healthy outpatients (100) undergoing restorative dentistry and/or oral surgery under enfluranenitrous oxide‐oxygen anaesthesia were given 0.014 mg/kg of droperidol or a saline placebo i. v. in a doubleblind random fashion 5 min after induction of anaesthesia to prevent postoperative nausea and vomiting. Overall, less patients given droperidol were nauseated (18%) or vomited (7%) in comparison with patients given saline (27% and 11%, respectively). During the first postoperative hour, 4% of patients given droperidol were nauseated and 2% vomited, whereas 16% of patients given saline were nauseated and 6% vomited. Four patients given saline were not discharged from the clinic 1 h after anaesthesia owing to prolonged nausea and vomiting. The time elapsed until the patients were oriented as to time and place after cessation of enflurane and nitrous oxide administration was similar in both groups (mean±s. d., 13.5 ± 4.7 min). Thirty minutes after anaesthesia, the ability to walk on a straight line was significantly (P<0.001) worse in patients given droperidol as compared to patients given saline. After 60 min, only one patient given droperidol and four patients who received saline and vomited took side steps or were unable to walk. Psychomotor performance was significantly (P<0.05) better in a perceptual speed test both 30 and 60 min after anaesthesia in patients receiving saline as compared to those given droperidol. It is concluded that although droperidol is a less effective antiemetic after outpatient than after inpatient enflurane anaesthesia, small doses of droperidol may be used for outpatients prone to vomiting to prevent delayed discharge from the clinic due to prolonged vomit

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1985.tb02215.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

The haemodynamic effects of enflurane (1.7% and 3.4% expiratory concentrations) were investigated in sheep (n = 6) pretreated with an infusion of metoprolol (0.2 mg ˙ kg‐1˙ h‐1for 5 days) and in control animals (n = 6). Chloralose was used as basal anaesthetic. A 90 s apnoea period was included in the experiment to evaluate further the possible side‐effects of long‐term metoprolol treatment in combination with enflurane anaesthesia. MAC 1.0 for enflurane in the sheep was found at 1.45% end‐tidal concentration by separate measurements. Before enflurane administration, the only significant differences between the two groups of animals were a lower systemic vascular resistance and a higher stroke volume during metoprolol treatment. Enflurane abolished these discrepancies in a dose‐dependent fashion and similar cardiovascular depression was observed in both groups of animals at 3.4% expiratory concentration of enflurane. Metoprolol did not significantly affect the hypertensive response to apnoea during chloralose anaesthesia alone. At enflurane 1.7% expiratory concentration the apnoea response was small and only the metoprolol‐treated animals showed a significant increase in left ventricular end‐diastolic pressure. We conclude that 5 days of pretreatment with metoprolol in the sheep model does not significantly impair cardiovascular performance during enfl

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1985.tb02216.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

In previous studies increased plasma levels of vasoactive intestinal polypeptide (VIP), somatostatin and pancreatic polypeptide (PP) were demonstrated in a porcine endotoxin shock model. Unchanged levels of gastric inhibitory polypeptide (GIP) and secretin point to a specific shock reaction of peptide release and not to a diffuse mucosal leakage. A porcine model of cardiodepressive shock was developed to enable discrimination to be made between a general low‐flow state and endotoxin reaction. Infusion of the tricyclic antidepressive agent nortryptiline 15 mg/kg bodyweight resulted in a grave shock state. Increased plasma levels of somatostatin, PP and insulin were found. No increase in VIP levels could be demonstrated. Endotoxin given after nortryptiline administration resulted in the increase of VIP levels regularly seen during endotoxinaemia. VIP release during endotoxin shock is related to endotoxin and not to a general low flow stat

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1985.tb02217.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

Local anaesthetics of the amide type were studied in a modified rat infraorbital nerve block model, with which it was possible to determine varying degrees of sensory block. Of the agents investigated, 0.5% bupivacaine tended to give a longer duration of block than 2% prilocaine or 2% lidocaine, while 0.5% etidocaine had the shortest duration. The duration of prilocaine was prolonged by addition of adrenaline, 5 μg/ml, more than that of the other agents. Addition of dextrans of Mw40–110 × 103did not cause any prolongation of block induced by bupivacaine. When mixed with dextrans over a wide range of Mw(40–4900 × 103), prilocaine exhibited significant prolongations of its action by up to 200%. The extent of prolongation was dependent on the degree of block, the concentration of dextrans in the local anaesthetic solution, and the Mwof the dextran although in a less uniform way. An increase in the relative viscosity of the solutions might be a factor of importance for the prolonging effect of addition of dextran to local anaesthetics. Since a formulation providing analgesia of a long duration would be of clinical value, further studies on combinations of the comparatively low‐toxicity agent prilocaine and macromolecular substances are of

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1985.tb02218.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

The effects of adding various macromolecular substances to 2% prilocaine on duration of rat infraorbital nerve block were investigated. The tested substances consisted of dextrans with lipophilic or charged substituents as well as other neutral or highly charged macromolecules. Most of the adjuvants caused significant prolongations of sensory block. For substituted dextrans the duration of sensory block degree 3 amounted to between 120% (3% capryldextran II) and 350% (3% carboxymethyldextran) in comparison to prilocaine plain. The corresponding values for hydroxypropylstarch (3%) alginic acid (0.5%), β‐cyclodextrin (1.5%) and hyaluronic acid (0.25%) were about 170%, 285% and 380%, respectively. The results suggest that the increased duration of local analgesia by prilocaine is related to increased viscosity of the solution produced by the macromolecular compounds. The mechanism seems to be of a physical character, and hyaluronic acid seems to be worthy of further studi

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1985.tb02219.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

The effects of addition of hyaluronic acid (sodium hyaluronate, Healon®) to different local anaesthetics of the amide type on the duration of sensory or motor blocks following various regional anaesthetic procedures were studied in animal experiments. In the rat infra‐orbital nerve block model, the addition of 0.1‐0.5% hyaluronic acid (HA) to 2% prilocaine increased the duration of sensory block of varying degrees in a dosedependent way by up to 500% of values obtained with plain prilocaine. The duration of degree 5 blocks produced by 0.5% etidocaine and 0.5% bupivacaine was also significantly prolonged when 0.4% HA was included to 206% and 282% of control, respectively, while blocks induced by 2% lidocaine were prolonged to 123% of control. The duration of motor block following spinal anaesthesia in the mouse was prolonged in a dose‐dependent way when HA was added to prilocaine, bupivacaine and etidocaine. For solutions containing 0.4% HA, prolongations to 254%, 166% and 134% of control, respectively, were obtained. A concomitant increase of latency to onset of block and failure rate occurred with increasing concentrations of HA. The duration of corneal anaesthesia in the rabbit increased by 57% and 44% when 0.3% HA was added to prilocaine and bupivacaine, respectively. The duration of infiltration anaesthesia was not affected by the addition of HA to the local anaesthetic solutions. Addition of HA had no effect on the onset, depth and duration of prilocaine‐induced block of the nervous transmissionin vitro. The duration of infra‐orbital nerve block and spinal anaesthesia shows a significant relation to the relative viscosity of the local anaestheti

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1985.tb02220.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

The vascular response in autoperfused small intestine was studied in ten cats during basal chloralose anaesthesia and controlled ventilation with either air, nitrous oxide/oxygen (70/30) or 0.7% end‐tidal concentration of isoflurane + nitrous oxide/oxygen (70/30). Intestinal blood flow was measured by the optical drop recording technique, and intestinal perfusion pressure was kept constant at either 100, 75 or 50 mmHg (13.30, 9.98 or 6.65 kPa). At perfusion pressures of 100 and 75 mmHg (13.30 and 9.98 kPa), intestinal blood flow was significantly increased and intestinal vascular resistance decreased during isoflurane + nitrous oxide/oxygen anaesthesia, compared with nitrous oxide/oxygen or air. According to the equation of closed loop gain (Gf), autoregulation was active in the pressure range 100‐75 mmHg (13.30‐9.98 kPa). In the pressure range 75‐50 mmHg (9.98‐6.65 kPa), the autoregulatory capacity was attenuated during air or nitrous oxide/oxygen and absent during isoflurane + nitrous oxide/oxygen. The vasodilator responses and the autoregulatory pattern were not changed by post‐ganglionic intestinal denervation. The intestinal vasodilator effect of isoflurane was further investigated in the denervated intestine, perfused at systemic arterial pressure by local intra‐arterial administration of isoflurane dissolved in a fat emulsion. A dosedependent vasodilator response was he

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1985.tb02221.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

A new method for calculating total respiratory system compliance is described, based on simple modelling of a ventilator‐respiratory system circuit that assumes linear characteristics of the circuit parameters compliances and resistances. The method requires only that flow measurement be conducted continuously to obtain compliance, if the internal compliance of the circuit is known beforehand. Model experiments showed that the compliance of a child test lung, calculated from the flow recording, differed at most by 10% from the compliance obtained by separate measurements of pressure and volume under static conditions, over a wide range of respiratory flows and airway resistance

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1985.tb02222.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

We investigated the effect of unilateral or bilateral positive end‐expiratory pressure (PEEP) on pulmonary perfusion in 12 dogs with a hydrochloric acid aspiration injury of the left lung. The lungs were ventilated separately and PEEP was applied to the left lung at 10 cm H2O (1.0 kPa) in six and at 15 cmH2O (1.5 kPa) in six others. Measurements of the right and left pulmonary arterial blood flows (QRand QL.) and venous admixture were made before, during and after PEEP. After this study, 5 and 10 cmH2O (0.5 and 1.0 kPa) PEEP were applied to both lungs in six dogs and measurements were repeated. Following the application of PEEP to the left lung, a significant decrease in QJ. and increase in QRwere observed. However, the application of PEEP to both lungs was followed by significant decreases in both QJand QR. The cardiac output decreased slightly during unilateral PEEP and markedly during bilateral PEEP. The venous admixture decreased significantly during PEEP in all the groups. These findings indicate that selective PEEP causes a transfer of pulmonary blood flow from the injured lung to the normal lung, improving ventilation‐perfusion inequality, and improves gas exchange without impeding oxygen deliv

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1985.tb02223.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

The intubating conditions, time to complete block and duration of clinical relaxation were observed in a group of 101 elderly patients (aged over 65 years) following pancuronium 0.1 mg kg‐1, vecuronium 0.1 mg kg‐1or atracurium 0.5 mg kg‐1. The intubating conditions in the three groups were similar when assessed at 2 min following relaxant administration. The time to complete block was shortest with vecuronium (4.3 min) in comparison to atracurium (5.0 min) and pancuronium (6.0 min), but the differences were not statistically significant. The duration of clinical relaxation, however, was significantly shorter with vecuronium (37 min) and atracurium (35 min) in comparison to pancuronium (99

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1985.tb02224.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY