摘要:

Seventeen healthy children undergoing eye surgery in general anaesthesia were given morphine rectally for premedication. Six patients (Group I) were given morphine 0.15 mg·kg‐1in a propylene glycol solution also containing diazepam and hyoscine. Eleven patients (Group II) were given morphine 0.5 mg·kg‐1in a starch hydrogel preparation. The plasma concentrations of morphine (Groups I and II) and diazepam (Group I) were studied. After the lower dosage of morphine the plasma concentrations never exceeded 10 ng·ml‐1, whereas the mean peak plasma concentration was 25.3 ± 5.5 ng·ml‐1after the higher dosage. One child in each of Groups I and II needed postoperative analgesics. The simultaneous plasma concentration of morphine was then lower than 5 ng·ml‐1. Postoperative nausea occurred to about the same extent in both groups. It is suggested that morphine given rectally in a starch hydrogel may be an alternative to oral and parenteral routes of

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1985.tb02275.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

The present experiments were designed to study the effect of atracurium on the contractile responses produced by repetitive motor nerve stimulation and by depolarizing drugs in frog, chick and rat skeletal muscle‐nerve preparations, using electrophysiological and neurochemical techniques. The presynaptic effect of atracurium was assessed using train‐of‐four (2 Hz) and tetanic stimulation (50 Hz) in isolated chick and rat neuromuscular junctions. A further measure of the presynaptic effect of atracurium was examined by studying its effect on the uptake of labelled choline,3H‐methylcholine, in the control preparations. The effect of atracurium on postjunctional contractile responses of the chick isolated biventer cervicis skeletal muscle was studied using cholinergic drugs such as acetylcholine and tetraethylammonium. The results indicated that in addition to its postjunctional competitive and non‐depolarizing blocking effect, atracurium may have a prejunctional inhibitory action at the neuromuscular junction. Atracurium reduced all the contractile responses produced by both electrical and chemical st

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1985.tb02276.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

The effects of placental transfer of enflurane and halothane were studied in 81 women undergoing cesarean sections. All patients had rapid sequence induction using thiopental, succinylcholine, and endotracheal intubation. They were then randomly assigned to one of five groups: Group I (n = 16) received N2O and oxygen, Group II (n = 16) N2O, oxygen, and 0.25% halothane, Group III (n = 18) N2O, oxygen, and 0.5% halothane, Group IV (n = 18) N2O, oxygen, and 0.5% enflurane, Group V (n = 13) N2O, oxygen, and 1% enflurane. At delivery, blood was drawn from the maternal artery, umbilical vein and artery for measurement of the halogenated agents using gas chromatography. The neonates were evaluated by Apgar scores, umbilical artery and vein acid base status and the Early Neonatal Neurobehavioral Scores (ENNS) at 2 and 24 h of age. Blood loss and the incidence of maternal awareness were also determined. The umbilical vein to maternal vein ratio was approximately 0.5 and 0.6 for enflurane and halothane, respectively. The umbilical artery to umbilical vein ratio was 0.5 with both agents; higher inspired anesthetic concentrations produced higher blood levels. All neonates had Apgar scores of 8 or more at 5 min with the exception of one neonate in the N2O group. Maternal and neonatal acid base status, blood loss, and ENNS were not affected by the addition of the halogenated agents. Of the patients who had N2O alone, 12% had awareness versus none in the other groups. These data demonstrate that low dose halothane or enflurane decreases the incidence of maternal awareness and does not adversely affect the neonate.

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1985.tb02277.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

The plasma fluoride and bromide concentrations were studied in operating theatre personnel. When enflurane was used, the increase in plasma fluoride concentration could not be distinguished from normal individual variations, but the plasma bromide concentration increased significantly when halothane was used. Seven patients were exposed to enflurane in a concentration of 200 parts per million for 4 h. A significant increase in the plasma concentration of fluoride was observed. The peak concentrations of fluoride occurred during exposure and the increase lasted less than 12 h. The increase in fluoride concentration was larger at this trace concentration than reported after anaesthetic concentrations. Cerebrospinal fluid (CSF) fluoride concentration was also studied; a smaller and delayed increase was found in CSF compared to plasma.

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1985.tb02278.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

In a randomized cross‐over study on sedation in outpatient oral surgery, subcutaneous administration of morphine‐scopolamine was compared with rectal administration of diazepam. The mean dose of morphine was 0.13 mg kg‐1(range 0.13–0.24) and of diazepam 0.57 mg kg‐1(range 0.50–0.71). Apprehension, the determining factor for patients' preference for sedation method, the recovery from sedation and the postoperative course were studied. Both methods produced the desired effects. For diazepam, the effect was scored higher by the patient than the nurse observer and for morphine‐scopolamine the opposite was found. Postoperative pain and patients' preference for sedation did not differ between the methods and the determining factor for the patients' preference for sedation method was the experience of stronger tranquillization. Side‐effects such as prolonged recovery, nausea, dizziness, and dysphoria were frequent during the postoperative course after the morphine‐scopolamine sedation but were not seen during diazepam sedation. Thus, rectal administration of diazepam should be preferred to morphine and scopolamine for sedation in minor oral surgery performed under

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1985.tb02279.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

The anxiety and pain‐relieving effect of paracetamol 10 mg/kg or a combination of aminophenazone 4 mg/kg and diazepam 0.2 mg/kg suppositories was studied in 82 children after tonsillectomy in a double‐blind study. Both suppositories were studied after halothane or enflurane anaesthesia. At 30 min after administration of coded suppositories, 88–90% of the children in various groups needed extra analgesics, and received pethidine 0.5 mg/kg i.v. Thereafter, the anxiety and pain relief was satisfactory in all groups. There was no significant difference between the effects caused by the drugs. No bleeding occurred from the operation site in any of the study groups. The results suggest that both paracetamol and a combination of aminophenazone and diazepam in the doses used here were weak analgesics for throat pain after tonsillectomy in children during the early postoperative p

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1985.tb02280.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

Haemodynamic stability and left ventricular function (LVF) during induction of anaesthesia and sternotomy were compared in three groups of patients with ischaemic heart disease, angiographically classified as having good, poor and depressed LVF. Anaesthesia was given with fentanyl‐droperidol and nitrous oxide. The groupwith good LVFshowed large variations in arterial pressure and heart rate between stimulated and unstimulated states with a reasonable preservation of LVF, expressed as stroke volume, through the whole observation period. The groupwith poor LVFshowed monotonously falling arterial pressure, and no heart rate response to tracheal intubation. These patients maintained remarkably stable stroke volumes in connection with low afterloads. After nitrous oxide, additional volume loading was required because of profound hypotension. The majority of the patients in the intermediate group, labelled “depressed LVF”, reacted to intubation and sternotomy with signs of left ventricular failure in connection with tachycardia and increased afterloads. The individual variations between patients with different degrees of left ventricular impairment were considerable, and these haemodynamic patterns need to be confirmed with a larger mat

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1985.tb02281.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

The courses of the hemodynamic and cardiometabolic effects of naloxone were evaluated in propoxyphene‐induced shock in eight pentobarbital‐anesthetized pigs. Circulatory shock was induced by an infusion of propoxyphene chloride 15 mg·min‐1i.v. At shock, i.e. MAP<60 mmHg and/or CI<2.0 l·min‐1·m‐2, naloxone was administered at 0.75, 1.5 and 3.0 mg·kg‐1with an interval between increments of 8 min. The propoxyphene infusion of 15 mg·min‐1was continued throughout the study. Following the injection of naloxone 0.75 mg·kg‐1, increases were observed (% of baseline value) in MAP (41%), i.e. deficit to baseline 59%, HR (66%), CI (67%) and SVI (108%), whereas MPAP and MPAOP were unchanged. dP/dt increased (34%). In the coronary circulation naloxone initiated the following changes: CSF increased (69%) as did MVo2(48%) with unchanged Mo2‐extraction, but CVR decreased further (36%). The maximum effects of naloxone were registered 2–3 min after 0.75 mg·kg‐1. Following 1.5 and 3.0 mg·kg‐1, no changes in hemodynamics were observed other than those caused by progre

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1985.tb02282.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

Three malignant hyperthermia susceptible (MHS) and three normal Danish landrace pigs were heated using a water‐heated mattress, warm blankets and warm intravenous saline during anaesthesia with barbiturate and 50% nitrous oxide in oxygen. The MHS pigs developed typical malignant hyperthermia (MH) at a rectal temperature of 41.0 ± 0.7°C, whereas the normal pigs tolerated heating to the same temperature without any ill effects. Haemodynamic and metabolic findings during MH were similar to those previously reported for anaesthetic‐induced MH in pigs. Heat intolerance may thus be one factor in the genesis

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1985.tb02283.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

The average dose of thiopental necessary for induction was 3.4 mg/kg body weight in seven patients on long‐term therapy with digoxin and a diuretic and 4.7 mg/kg body weight in seven matched control patients (P<0.05). The initial volumes of distribution (V1) did not differ significantly. The amounts of thiopental redistributed (removed from V1) during the induction were calculated as V1× k12× c1and V1× k13× c1, where k12and k13are the rate constants describing the drug transfer from V1to V2and V3and c1the computer‐calculated average thiopental concentration in V1during the initial 40 s of the induction period. There was no evidence of a lower amount being removed during the induction in the cardiac patients. The intravascular drug concentration at the time of sleep was expressed as the average of the arterial and the venous sleep concentrations. In the cardiac patients the average of that value was 20.1 μg/ml and in the control patients 30.2 μg/ml (P<0.05). It is concluded that the lower dose requirement in the cardiac patients was caused at least in part by a higher cerebral sensitivity to

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1985.tb02284.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY