摘要:

In order to detect the incidence of myocardial ischemia during the perioperative period and to determine during which situation it ocurred, continuous monitoring of the electrocardiogram by the Holter method was used in 51 patients with coronary artery disease who were undergoing a vascular surgical procedure. Clinical parameters measured preoperatively were evaluated as predictors of the occurrence of myocardial ischemia during the perioperative period. Twenty of 51 patients demonstrated 36 episodes of myocardial ischemia, which started in 11 cases during induction. Fourteen of 16 patients with disabling angina pectoris (Class III and IV) developed myocardial ischemia, whereas only six patients out of 35 with Class II or less or no angina experienced preoperative ischemic episodes (P<0.001). All the patients without or with only mild angina who experienced perioperative ischemia showed ST‐T abnormalities at the preoperative resting electrocardiogram. Our data suggest that the risk of intraoperative myocardial ischemia can be predicted during the preoperative period by the degree of disability exhibited by patients with coronary artery diseas

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1982.tb01768.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

The memory performance of 60 female patients, scheduled for either local or general anaesthesia and extraction of senile cataract, was investigated. Six subtests of the Wechsler Memory Scale and four items of memory tests according to Luria were performed. One week postoperatively there was a diminution in the performance of the Wechsler Memory Scale and Luria tests. Comparison of the pre‐ and postoperative diminutions between the local and general anaesthesia groups was statistically significant only in the Luria tests. According to this study general anaesthesia does not affect memory function more profoundly than local anaesthesia supplemented with tranquillizing and/or analgesic drugs in this respect, the advantages of general anaesthesia should be utilized, at least in patients without clearcut contraindication

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1982.tb01769.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

Pharmacokinetic studies on atropine were performed in 52 patients under general or spinal anaesthesia. Age had a clinically significant effect on the kinetics of this alkaloid in children under 2 years of age and in the elderly a prolonged elimination was found. This might explain, partly at least, the higher sensitivity of these age groups to the effects of atropine. Age had no effect on the serum protein binding of this alkaloid. Atropine was found in human CSF after a single i.m. administration, but not after a single i.v. administration. During anaesthesia alter i.v. atropine administration, a diminished cardiovascular response was found in the elderly in comparison with healthy adult patients. This indicates changes also at the cholinergic receptor sites in the elderly.

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1982.tb01770.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

Monocyte functions have been investigated in 18 patients undergoing total hip arthroplasty performed under either general anaesthesia or epidural anaesthesia. Serum cortisol increased significantly both per‐ and postoperatively in the general anaesthesia group compared to minor changes in the epidural group. The spreading of monocytes on plastic surfaces possibly reflects the phagocytic capacity of the cells. This spreading index of monocytes derived from patients operated under epidural anaesthesia and cultured in medium containing autologous serum showed a significant increase per‐ and postoperatively compared to the spreading index of monocytes from patients operated under general anaesthesia. This difference increased with increasing culture time. The ability of monocytes to induce lysis in malignant cells was reduced to 45% peroperatively in monocytes derived from patients operated under general anaesthesia and cultured in medium containing autologous serum. In the epidural group the lysis was nearly unchanged from the preoperative value, making the difference between the groups highly significant (P<0.01). On the first postoperative day, the difference between the groups was less pronounced. The differences in spreading index and cytolytic capacity were not seen when the monocytes were cultured in medium with pooled AB‐serum, thus indicating a serum factor responsible for the monocyte depression when the patients were operated under general anaest

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1982.tb01771.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

An anaesthetic technique using high‐dose fentanyl for coronary artery surgery is described. Fentanyl 160 or 70 μg kg‐1was used as the sole anaesthetic agent, and patients were ventilated with air/O2(fentanyl 70 μg kg‐1) or N2O/O2(fentanyl 60 μg kg‐1). Cardiovascular data from 30 patients are presented. Fentanyl caused no significant cardiovascular depression. The only statistically significant changes in cardiovascular parameters were seen in the patients who received fentanyl 60 μg kg‐1. Five minutes after skin incision there was an increase in peripheral resistance. Diastolic pressure was increased following sternotomy. Problems associated with this technique of anaesthesia are a 50% incidence of hypertension following sternotomy (requiring treatment with sodium nitroprusside) and prolonged respiratory depression. The lack of cardiovascular depression produced by fentanyl and the ability of fentanyl to reduce hormonal and metabolic responses to surgery make it a satisfactory technique for cardia

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1982.tb01772.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

Vagal reflexes are generally recognized as a possible cause of cardiac arrest during anaesthesia. Studies were performed to determine whether hypoxia, respiratory acidosis or deep halothane anaesthesia modify the cardiovascular effect of vagal stimulation (VS) in dogs. The animals were anaesthetized with intravenous urethane and chloralose, and paralysed with metocurine. Normal temperature and arterial blood gas variables were maintained and supramaximal VS was applied to the distal end of both vagus nerves for 5 min. No differences were found in any of the variables measured among the time periods when VS was repeated five times in six control dogs receiving urethane‐chloralose basal narcosis only to determine the effects of time. VS resulted in 15 ± 3 s (mean ± s.e. mean) of asystole. Heart rate, cardiac output (CO) and mean arterial pressure (MAP) were still significantly decreased (p<0.001) and central venous pressure, right atrial pressure. pulmonary capillary wedge pressure (PCW), systemic (SVR) and pulmonary vascular resistance significantly increased (p<0.01 ‐P<0.001) at the end of stimulation when compared to values before VS in all 24 dogs. Neither hypoxia [Pao25.3 kPa (40 mmHg)] nor respiratory acidosis [pH 7.00, Paco210.6 kPa (80 mm Hg)] modified these effects of VS. VS during halothane anaesthesia (1.6% end‐tidal concentration) resulted in further significant decreases (P<0.05 ‐P<0.001) in CO, MAP, mean pulmonary arterial pressure. PCW and SVR when compared to VS under basal narcosis. VS under halothane anaesthesia combined with hypoxia or respiratory acidosis did not decrease the cardiovascular parameters as much as VS under halothane Anaesthesia alone. VS alone, or in combination with hypoxia or respiratory acidosis, failed to cause persistent

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1982.tb01773.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

We have constructed an oxygen‐consuming model lung based on pure combustion of hydrogen. Besides consuming oxygen the model produces water vapour, and carbon dioxide is delivered to the lung, thus mimicking carbon dioxide production. Oxygen consumption and carbon dioxide production can be set at desired values. The model lung can be used for investigations on and evaluation of all types of anaesthesia circuits. Results in a circle system with carbon dioxide absorption show that FIO2is related to the fresh gas flow. The end tidal CO2level is correlated to the alveolar ventilation and cannot be used for predicting FIO

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1982.tb01774.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

The effects of nitroprusside‐induced hypotension on cerebral blood flow and cerebral oxygen consumption were investigated in nine patients scheduled for cerebral arterial aneurysm surgery. Anesthesia was maintained with nitrous oxide/oxygen and fentanyl; muscle relaxation was achieved with pancuronium; Paco2was maintained at 4.79‐5.32 kPa. Mean arterial pressure was reduced to 50 mm Hg by nitroprusside infusion after opening of the dura. Measurements were recorded and blood samples were taken 15 min before induction of hypotension, during stable hypotension and 15 min after termination of nitroprusside infusion. Measurements included: cerebral blood flow, using the argon‐washin technique, cardiac output (thermodilution), mean arterial pressure and heart rate. Cerebral blood flow averaged 56 ± 6 ml/min. 100 g before hypotension. Nitroprusside produced hypotension but did not significantly alter cerebral blood flow (61 ± 7 ml/min · 100 g). Cerebral blood flow remained virtually at preinfusion values upon cessation of infusion (53 ± 6 ml/min · 100 g). Cerebral oxygen uptake averaged 3 ± 0.2 ml/min · 100 g before hypotension and did not change significantly during hypotension (3.3 ± 0.3 ml/min · 100 g) and after termination of hypotension (2.7 ± 0.3 ml/min · 100 g). In two patients nitroprusside produced a 17 and 20% increase, respectively, in cerebral blood flow with no change in cerebral oxygen consumption, together with a marked increase in cardiac outpu

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1982.tb01775.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

In 44 boys undergoing day case circumcision, analgesia was provided with either buprenorphine 3 μg/kg intramuscularly or 0.25% bupivacaine 0.5 ml/kg by caudal injection. Both methods provided good analgesia; the frequency of side effects was less with caudal analgesia; and restoration to normal activity 24 h after operation was greater than with buprenorphine

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1982.tb01776.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

The effect of the adenine nucleotides on procaine‐induced conduction block in rats was investigatedin vivoandin vitro.Both adenine and cyclic nucleotides significantly shortened the duration of sciatic nerve Mucks in rats without affecting the frequency, degree of block or time of onset. Adenosine 5′ triphosphate (ATP) and N‐6, O2dibutyryl 3′:5′‐monophosphate (db‐cyclic AMP) were most effective. In isolated sciatic nerve preparations. the adenine nucleotides (ATP, adenosine 5′diphosphate (ADP), adenosine 5′monophosphate (AMP)) rapidly reversed procaine‐induced depression of the action potential. These results suggest that local anesthetic effects may be mediated through interference with the physiological functions

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1982.tb01777.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY