摘要:

Ischemic ventricular dysrhythmias were produced in 40 of 47 anesthetized mongrel dogs by high ligation of the left anterior descending coronary artery. Dysrhythmias were treated with a single iv bolus of 20, 40, 80, or 120 mg of lidocaine (L) in order to determine the dose at which approximately 50% of animals had an antidysrhythmic response. Cardiac output and regional myocardial blood flow (RMBF) were measured by using radionuclide labeled microspheres. Lidocaine concentration ([L]) was measured from samples of arterial and venous blood and normal and ischemic myocardium. All dogs treated with 40, 80, or 120 mg of L had an antidysrhythmic effect. However, with 20 mg of L the dysrhythmia persisted in 12 and resolved in 14. With 20 mg of L, ischemic myocardial [L] was greater in dogs with an antidysrhythmic effect than in those with persistent dysrhythmias (1.14 ± 0.12vs. 0.76 ± 0.04 μg · g−1), but no difference was seen for arterial, venous, and normal myocardial [L]. Ischemic RMBF was higher in the dogs that had an antidysrhythmic effect than in those that did not, 9.8 ± 1.5versus, 6.9 ± 1.3% of normal. With 20 mg of L, [L] in ischemic myocardium correlated well with ischemic RMBF. The antidysrhythmic response to L had a threshold at a tissue concentration of greater than or equal to 1.0 μg · g−1(chisquare = 8.55,P< 0.005). For this model, the [L] in ischemic myocardium during acute ischemia correlates with the antidysrhythmic response to L, while the concentration in normal myocardium or blood does not.

ISSN:0003-3022    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

The disposition ofd-tubocurarine (dTc) was assessed when a bolus and infusion dosage regimen was used to obtain relaxation during major orthopedic surgery on the spine. Renal clearance ofdTc was 0.63 ± 0.23 ml · min−1· kg−1and was correlated with creatinine clearance. Total plasma clearance of 1.21 ± 0.40 ml · min−1· kg−1was lower than that found in many previous studies, and the predetermined continuousdTc infusion produced an apparent plateau in plasma concentrations of 1.8 ± 0.3 μg · ml−1. Despite the operative blood loss, these concentrations were greater than anticipated and were associated with a more intense neuromuscular blockade than the infusion was designed to produce. Autologous blood transfusion was used to reduce the reliance on homologous donor blood, and the erythrocytes from the 2.2 ± 1.2 1 of blood loss during the procedure were reinfused after intra-operative salvage, washing, and centrifugation. With 80 ± 23 mgdTc administered, 1.4 ± 0.8% was recovered from the fluid discarded after centrifugation. These results indicate that even massive intraoperative blood loss will not entail a significant reduction in the amount ofdTc present in the body.

ISSN:0003-3022    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

The effects of fentanyl and sufentanil with and without N2O on left ventricular myocardium supplied by a critically narrowed and a normal coronary artery were studied in 16 dogs. Regional ventricular function was measured by recording ventricular segment length with the use of ultrasonic length detectors in the left anterior descending (LAD) and the left circumflex (LC) coronary artery territories before and during critical stenosis of the LAD. Critical stenosis was documented by the absence of a hyperemic response following a 10-s total occlusion of the LAD. Hemodynamic variables (aortic flow and pressure, left ventricular pressure, heart rate, and coronary blood flow) were measured and the first derivative of left ventricular pressure (LVdP/dt) and coronary perfusion pressure derived. Eight dogs received fentanyl 100 μg · kg−1followed by an infusion of 1 μg · kg−1· min−1while ventilated with O2:N2(1:2), and eight dogs received sufentanil 30 μg · kg−1with an infusion of 0.3 μg · kg−1· min−1. Replacement of N2with N2O produced evidence of mild systolic myocardial depression but no dysfunction in either group. After application of the critical constriction, the addition of N2O rapidly produced evidence of dysfunction with significant postsystolic shortening only in the LAD territory. This was not accompanied by hypotension or a decrease in coronary flow and was not always reversible. Higher infusion rates of either narcotic (fentanyl 2 μg · kg−1· min−1, 4 μg · kg−1· min−1; sufentanil 0.6 μg · kg−1· min−1, 1.2 μg · kg−1· min−1) in the absence of N2O did not produce dysfunction but had no protective effect when N2O was added. These data suggest that the addition of N2O to a narcotic base anesthetic can produce clinically unapparent regional myocardial ischemia, which may be an important factor in the etiology of perioperative myocardial infarction.

ISSN:0003-3022    

出版商:OVID    

年代:1985

数据来源: OVID

ISSN:0003-3022    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Antimicrobial activity of bupivacaine and morphine against 10 micrabial strains was studied with an agar dilution method. The strains tested were Escherichia coli (ATCC 25922),Pseudomonas aeruginosa, ATCC 27853),Staphylococcus aureus(ATCC 25923), and one of each of the clinical isolates of Staphylococcus epidermidis (a multiresistant strain),Staphylococcus epidermidis, a sensitive strain),Streptococcus pneumoniae, Streptococcus pyogenes(A),Streptococcus faecalis, Bacillus cereus, andCandida albicans. The antimicrobial effect of bupivacaine was tested at concentrations of 0.5, 1.25, 2.5, and 5 mg/ml (0.05% 0.125%, 0.25%, and 0.5%). Bupivacaine at a concentration of 2.5 mg/ml inhibited the growth of the sensitiveS. epidermidisstrain,S. pyogenes, andS. pneumoniae, and all of the others exceptP. aeruginosaat a concentration of 5 mg/ml. Morphine 0.2 and 2 mg/ml (0.02 and 0.2%) did not inhibit any of the strains.

ISSN:0003-3022    

出版商:OVID    

年代:1985

数据来源: OVID

ISSN:0003-3022    

出版商:OVID    

年代:1985

数据来源: OVID

ISSN:0003-3022    

出版商:OVID    

年代:1985

数据来源: OVID

ISSN:0003-3022    

出版商:OVID    

年代:1985

数据来源: OVID

ISSN:0003-3022    

出版商:OVID    

年代:1985

数据来源: OVID

ISSN:0003-3022    

出版商:OVID    

年代:1985

数据来源: OVID