摘要:

Although preoxygenation has been extensively studied, to our knowledge this is the first study addressing its optimal length in children, who form a high risk group for developing hypoxaemia during induction of anaesthesia. Recommended preoxygenation times in children range between 1 and 4 min, but whether one of these times maintains arterial oxygen saturation (Sao2) at an adequate level for a longer time period is unknown. This study was performed on 11 healthy children, randomly distributed into either Group 1 (1 min of preoxygenation, n = 6) or Group 2 (3 min of preoxygenation, n = 5). Sao2was measured by pulse oximetry. While the patients were breathing room air, Sao2was similar in both groups (97%) and rose to 100% after preoxygenation in all patients. After intravenous induction of anaesthesia and muscle relaxation, all patients became apnoeic. The time taken for the Sao2to decrease to 90% was measured. In Group 1 this occurred in 91 s, whereas Group 2 required 144 s. Thus, a 3‐min rather than a 1‐min period of preoxygenation would appear to maintain Sao2at a safe level for a longer time in child

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1992.tb03433.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Twenty‐four female patients undergoing sterilization through a minor lower laparotomy received, in a double‐blind, randomized study, either lidocaine spray 200 mg or placebo in the surgical wound. Postoperative pain intensity was evaluated on a verbal and a visual analogue scale and wound tenderness with an algometer. During mobilisation from the supine to the sitting position, VAS‐score was lower (P0.05). No significant differences were found in VAS‐scores at rest or during cough, or in verbal scale ratings during rest, cough or mobilisation, and postoperative consumption of morphine was similar in the two groups. Pressure pain thresholds were higher (P<0.05) 2 h postoperatively in the lidocaine group, but not 4, 6 and 8 h postoperatively. In conclusion, topically applied lidocaine aerosol in the surgical wound leads to very short and clinically insignificant relief of postoperati

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1992.tb03434.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

In vitromuscle contracture tests for malignant hyperthermia screening are routinely performed using standardized protocols. In the present studyon‐linemonitoring of halothane concentrations in the gas phase was demonstrated to be an improved test standard. The kinetics of halothane concentration and their effect onin vitromuscle contracture tests were evaluated in two test baths, I and II, which contained 3 and 18 ml Krebs‐Ringer solution, respectively. The equilibration kinetics for halothane was significantly faster in bath I (t1/2= 8.2 s) compared with bath II (t1/2= 25.6 s). Twenty‐one pairs of muscle bundles from 21 potentially malignant hyperthermia susceptible patients were investigated, each test bath receiving one bundle from each pair. The variance of muscle contractures was significantly increased in test bath I compared with test bath II. However, there was no influence on malignant hyperthermia diagnosis, suggesting that, within the ranges of t1/2= 8.2 s‐25.6 s, the test bath volumes need not be stand

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1992.tb03435.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Serum levels of cortisol, dehydroepiandrosterone (DHA) and its sulfate (DHAS), 4‐androstene‐3,17‐dione (A‐4), 17‐alfa‐hydroxy‐progesterone (17 OHP), testosterone (T, only in males), unconjugated (E1) and total estrone (tE1>85% estrone sulfate) were studied in six male and two female patients before, during and up to 30 days after aortic graft surgery. All steroids except 17 OHP decreased following induction of anesthesia but, except for testosterone, rose again during surgery to preoperative levels or slightly above. Extremely high peak values for El and tE1 and a less pronounced peak for cortisol were noted on postoperative day 2; after that, the levels of these steroids returned to normal. The levels of 17‐OHP, DHA and DHAS decreased after surgery and were below preoperative values from postoperative day 4 to day 16 or (DHAS) day 30. In males, 17 OHP showed a pronounced peak 30 min after initiation of surgery, but decreased after that to below preoperative values. Testosterone levels decreased further during surgery and remained very low until postoperative day 16. Major surgical trauma has a rapid, profound and long‐lasting effect on gonadal activity, as judged from decreased testosterone levels, while the effect on adrenal steroids is less pronounced. Adrenal Δ4 and Δ5‐steroids showed different patterns in the postoperative period, indicating differences in their regulation. The highly elevated estrogen levels on postoperative day 2 probably reflect either transiently elevated peripheral aromatization or decreased estrogen metabolism rather than increased levels of substrate steroids (A‐4).The biological significance of this r

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1992.tb03436.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Seventeen male patients delivered a sperm sample before and 80–90 days after halothane anaesthesia, acting as their own control. The sample was tested according to WHO criteria. There was no difference before and after anaesthesia. We conclude that halothane used in normal anaesthetic concentration in combination with nitrous oxide during arthroscopic knee surgery had no certain effect on the quality of sper

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1992.tb03437.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

The effects of sedative‐hypnotic doses of propofol on respiratory drive and pattern have not yet been extensively described. Repeated small boluses of propofol (0.6–0.3 mg ?˙ k‐1) were administered to ten ASA I patients undergoing carpal tunnel release using regional anaesthesia. Airway pressure, capnography and pneumotachography were continuously recorded. With respect to basal values, no significant variations of respiratory rate, minute volume, tidal volume, inspiratory and expiratory time, total expiratory cycle, Ti/Ttot, TV/Ti, P0.1, Etco2and blood gas analysis were observed. Low doses of propofol, to maintain conscious sedation or light sleep, have not been shown to cause respiratory depr

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1992.tb03438.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

The hemodynamic effects of separate and combined intravenous administration of the vasopressin (AVP) V1‐receptor antagonist SK&F 100273 (10 μg/kg) and the angiotensin I converting enzyme inhibitor captopril (20 mg+ 1 mg/h) were studied in 12 sheep during stable halothane anesthesia (1.5% end‐tidal conc.). The separate blockade of either V1‐receptors or angiotensin II (ANG II) synthesis induced a small (7–10%), but significant, fall in mean systemic arterial pressure (MSAP), whereas the combined treatment caused a 30% reduction in blood pressure. The changes in systemic vascular resistance paralleled those of the MSAP. Consequently, the cardiac output was largely unaffected by the interference with AVP effects and/or ANG II synthesis. The halothane anesthesia effectively increased the plasma levels of AVP and ANG II, and plasma renin activity without any relation to changes in MSAP. When either the AVP effects or ANG II synthesis were blocked separately, there was a slight tendency for a compensatory increase of the unimpeded hormonal system. It is concluded that halothane anesthesia increases the plasma levels of AVP and ANG II in sheep, and that the maintenance of the arterial pressure is dependent on the concurrent vasopressor effects of the two hormones in this s

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1992.tb03439.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Desbutylbupivacaine, a major metabolite of bupivacaine, is known to accumulate during long‐term continuous infusion blocks in man. Its acute toxicity in comparison with that of bupivacaine has not been studied. In a lightly anaesthetized rat model, bupivacaine (2 mg/kg/min, N = 10) or desbutylbupivacaine (4 mg/kg/min, N = 10) was infused i.v. until asystole. Arterial blood pressure, ECG and EEG were continuously recorded. The mean doses of bupivacaine producing cardiac toxicity, i.e. arrhythmia (12.4 mg/kg) and asystole (24.0 mg/kg), were approximately half of those of desbutylbupivacaine. Seizure activity on the EEG was observed in only one of the desbutylbupivacaine‐infused rats while all rats receiving bupivacaine developed seizures (mean dose 5.2 mg/kg). Desbutylbupivacaine infusion caused a decrease in arterial blood pressure greater than that resulting from bupivacaine infusion. When desbutylbupivacaine 0.67 mg/kg/min was coinfused with bupivacaine 2 mg/kg/min, the cardiovascular toxicity of bupivacaine was clearly potentiated. The EEG parameters were affected in a similar fashion as when bupivacaine alone was infused. In this rat model, desbutylbupivacaine was about half as toxic as bupivacaine judged by cardiac parameters, and clearly less toxic to the central nervous system than bupivaca

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1992.tb03440.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

In 20 patients undergoing surgery for cerebral aneurysms, hypotension was induced with either gradual (over 5 min) or sudden increase of inspiratory concentration of isoflurane from 0.5% to 3%. Both modes elicited the same speed of induction of deliberate hypotension and similar decreases of cerebral arteriovenous difference of oxygen (AVDo2). The overall median values of mean arterial blood pressure decreased from 75.5 (range 64–90) mmHg (10 (8.5–12.0) kPa) to 55 (40–66) mmHg (7.3 (5.3–8.8) kPa) and the overall AVDo2decreased from 6.75 ml/100 ml (3.8–9.4 ml/100 ml) to 5.85 ml/100 ml (2.6–8.1 ml/100 ml) within 10 min. It is concluded that irrespective of gradual or sudden increase of isoflurane concentration, cerebral blood flow is in surplus of metabolism and a favourable oxygen demand/supply ratio is maintained during induction of deliberate hypotension by isoflurane be

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1992.tb03441.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Clinical studies have indicated that a low dos of the dopamine DP‐receptor antagonistdroperidol given epidurally potentiate the antinociceptive effect of epidural morphine. The present study was conducted in order to evaluate this drug interaction in a rat model. Rats were given morphine and droperidol intrathecally in several combinations of doses. It was found that droperidol had no antinociceptive effect by itself, nor in combination with morphine. It was also shown that droperidol and morphine exert no histopathologicaleffects on the rat spinal cord. This discrepancy between clinical Endings and experimental pain studies suggests different modes of action of droperidol in the two situation

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1992.tb03442.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY