摘要:

One hundred and twenty‐nine simultaneous measurements were carried out on seven patients, 67 at rest and 62 during the Valsalva manoeuvre, in order to compare impedance cardiography with the thermodilution method, during rapid changes in cardiac stroke volume and pulmonary blood volume.A coefficient of correlation of 0.86 was found following linear regression analysis of the whole material. Analysis of the individual patient showed that the mean coefficient of correlation was 0.94 (range 0.91–0.97), and that the slope of the regression lines was 0.41 to 1.82, and further that the mean intercept was 0.2 ml.It is concluded that impedance cardiography can be employed for measuring the relative intraindividual changes in cardiac stroke volume during the Valsalva manoeuvre, and it is suggested that it may be of use in other situations, such as during haemorrhage or continuous positive pressure ventilat

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1977.tb01231.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

In 26 unconscious patients with brain injuries, regional cerebral blood flow (rCBF) was measured with a 16‐channel Cerebrograph before and after acute reduction of Paco2The intra‐arterial133xenon washout technique was used, and CBF was calculated regionally as initial slope index or stochastic flow. The CO2reactivity was calculated as ΔIn CBF/ΔPaco2.In supratentorial cortical lesions, an acute fall in Paco2increased the homogeneity of the regional flow pattern (decrease in the standard deviation of the regional flow values), and reduced the number of focal hyperaemic regions (tissue peaks). The CO2reactivity in tissue peak regions was generally higher than in regions without tissue peaks. In severely injured patients with a poor outcome (dementia, vegetative survival or death), inverse steal reaction was accounted for in 11% of all regions, but only in 3% of the regions in patients who survived without dementia. Inverse steal reaction was most frequently seen during the first 3 days after the trauma. In repeated CBF studies, an increase in the CO2reactivity with time was observed after the acute trauma.In comparison with the CO2reactivity found in normocapnic awake subjects, this increase was higher than expected in several

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1977.tb01232.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

The study was undertaken in order to elucidate the suitability of four different types of general anaesthesia and of epidural block in short‐stay varicose vein surgery. Special consideration was given to recovery after anaesthesia. The series consisted of 230 female patients subjected to varicose vein surgery of one lower extremity. The patients' recovery after surgery was observed through tests measuring visual‐motor coordination and through questionnaires. The general anaesthesias used were halothane‐nitrous oxide‐oxygen anaesthesia with spontaneous respiration (Ha), relaxant‐dominated combined anaesthesia (Re), analgesic‐dominated combined anaesthesia (An), and analgesic‐dominated combined anaesthesia with hyperventilation (Hy).Of the general anaesthesias, halothane nitrous‐oxide inhalation anaesthesia gave the fastest recovery, although there were no major differences between it and analgesic‐dominated combined anaesthesia. In contrast, immediate recovery was prolonged after hyperventilation and after relaxant‐dominated anaesthesia. Epidural blockade provided a good alternative to

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1977.tb01233.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

A comparison was made between the adrenergic receptor responsein vitroin human adipose tissue obtained under halothane and neuroleptanaesthesia. In both groups the net release of glycerol was significantly stimulated (P<0.01) by the combined alpha‐ and beta‐adrenergic agonist, 1‐noradrenaline. In the halothane group, the lipolysis was further increased by the addition of phentolamine (an alpha‐adrenergic blocking agent). No such effect could be demonstrated in specimens from the fentanyl/droperidol group. This difference in response was most probably explained by the fact that droperidol had quite a long‐lasting alpha‐adrenergic blocking property, which totally obliterated the effect of another alpha‐adrenergic blocking agent.The findings stress the importance of using a standardized procedure, including the choice of anaesthetic agents, when human adipose tissue is sampled for metabolic studiesin vitro.The results also indicate the possibility of a difference in metabolic effectsin vivobetween the t

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1977.tb01234.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

A prolonged succinylcholine‐induced paralysis was observed in connection with a caesarean section in an otherwise healthy, 25‐year‐old female. Her serum pseudo‐cholinesterase was analysed and found to be pathologically low, displaying in addition an atypical dibucaine number. Ten individuals related to her were also studied as regards pseudocholinesterase in serum. She had two brothers, one displaying the same pattern as herself, while the other had a normal pattern. Both of the parents had ordinary dibucaine numbers, while the father had a slightly decreased pseudocholinesterase activity. Possible mechanisms underlying the disorder are di

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1977.tb01235.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

Small doses of nondepolarizing relaxants are often recommended as prior medication to suxamethonium in order to avoid or attenuate the side effects elicited by the latter drug. After D‐tubocurarine (0.05 mg/kg b.w. and 0.075 mg/kg b.w.) in unmedicated volunteers, a dose‐dependent recession of the monocular near point of accommodation was recorded. This recession, which parallelled the decrease in grip strength, was 4 cm and 9 cm, respectively. The same doses evoked an exophoria of 14 and 17 prism diopters, respectively.Intraocular pressure was significantly lowered by D‐tubocurarine 0.05 mg/kg b.w., from 2.01 kPa (15.1 mmHg) to 1.64 kPa (12.3 mmHg), and by pancuronium 0.015 mg/kg b.w. from 1.90 kPa (14.3 mmHg) to 1.44 kPa (10.8 mmHg). The decreases lasted for 7 min. Gallamine 0.3 mg/kg b.w. also decreased intraocular pressure, but to a lesser degree, and with statistical significance only during the fourth minute after administration.Relaxation of extraocular muscles may change the slightly ovoid shape of the eyeball into a more spherical one, thereby inducing a fall in intraocular pressure and a recession of the near point of accommod

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1977.tb01236.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

One hundred patients, who were in pain during the immediate postoperative period after upper abdominal operations, were included in this double‐blind, between‐patient, two‐dose study. During N2O‐O2‐halothane‐relaxant anaesthesia no analgesics were given. The patients received 0.07 mg/kg or 0.14 mg/kg of nalbuphine or 0.3 mg/kg or 0.6 mg/kg of pentazocine by intravenous injection. Pain and side effects were assessed for 4 h after administration of the test drug, or until the pain returned to the pre‐injection level, when a conventional analgesic was given. The onset of pain relief was similar and the peak effect occurred about half an hour after the injection after both drugs. On a milligram basis, nalbuphine seemed to be about three times as potent as pentazocine. The duration of action seemed to be slightly longer after nalbuphine, but 2 1/2 h after the injection the pain had returned to preinjection level in 2/3 of the patients, even after the higher doses of both drugs. Except for sleepiness, there were few side effects and they were similar after both drugs. No psychotomimetic effects

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1977.tb01237.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

Pre‐ and peroperative determination of glomerular filtration rate (GFR) was performed in nine patients operated during light halothane anaesthesia (group A) and in nine patients operated during epidural analgesia in combination with light halothane anaesthesia (group B). In group A, the mean GFR decreased insignificantly by 7% and the mean arterial blood pressure increased significantly by 10%. In group B, the mean GFR decreased significantly by 19% and the mean arterial blood pressure decreased significantly by 15%. It is suggested that the difference in change in GFR between the two groups was caused by differences in mean arterial blood pressur

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1977.tb01238.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

A recently described injection formulation for diazepam, consisting of an oil emulsion where the drug is dissolved in the oil phase, has been found to give a lessened degree of side reactions than commercially available preparations. This emulsion formulation was compared to Valium® inj. as premedication in patients undergoing operation for hernia or varices under epidural anaesthesia.The effects, measured as the degree of drowsiness according to an arbitrary scale, were found to be equal for the two formulations. Neither was there any difference in blood concentrations in the two application groups, respectively, between the preparations used. The propylene glycol content of Valium inj. is said to cause a delayed release of the drug from the injection site after i.m. application, and this is briefly discussed, as well as the possibility of administering the diazepam emulsion continuously, diluted with Intralipid, without the risk of precipitation

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1977.tb01239.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

The organisation and initial experiences of a Danish Cholinesterase Research Unit are presented.The primary aim of the research unit is to provide a service for determining genotypes and activity of serum cholinesterase (acylcholine‐acyl‐hydrolase E.C. 3.1.1.8.) in patients suspected of having abnormal serum cholinesterase. Centralization of these investigations and use of a standard methodology have permitted the setting up of a central card index of families in Denmark with inherited abnormal serum cholinesterase.During the first 3 years, a total of 967 individuals have been genotyped. Two hundred patients were referred to the centre following an episode of prolonged apnoea after suxamethonium. In addition, 723 relatives of these 200 patients have been investigated, and 513 warning cards have been issued. Forty‐four individuals were genotyped for reasons not related to prolonged apnoea.Genetic variations of serum cholinesterase were identified with differential inhibition techniques using dibucaine, sodium fluoride, sodium chloride, succinyldicholine, and urea as inhibitors. It was found that no single inhibitor was able to differentiate between all known genotypes of locus E1. Inhibition of serum cholinesterase by urea, used together with the conventional dibucaine inhibition, gave results which compared favourably with the results obtained with the classical combination of dibucaine and fluoride inhibition. The results indicated that, at least in differentiation of rarer genotypes, urea inhibition may give valuable information not obtainable using fluoride inhibition.The difficulties in deciding which patients should be issued with warning cards are discussed. It is pointed out that only through close cooperation with the local anaesthetists involved will it be possible to elucidate the connection between the rarer genotypes and suxamethonium sensit

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1977.tb01240.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY