摘要:

Dobutamine, a recently introduced derivative of dopamine, is reported to retain inotropic properties with less pronounced chronotropic and arrhythmogenic effects than isoproterenol. The drug was evaluated in two doses, 5 μg/kg/min and 10 μg/kg/ min, in two groups of ten patients each, during emergence from cardiopulmonary bypass. A third group of five patients was studied similarly with isoproterenol, 0.02 μg/kg/min. Cardiac index increased 16 and 28 per cent with the two doses of dobutamine, respectively, and 9 per cent with isoproterenol. Heart rate, in contrast, increased 6 and 15 per cent with dobutamine (not significant) and 44 per cent with isoproterenol (significant). Dobutamine seemed to be associated with fewer arrhythmias than isoproterenol. It is concluded that dobutamine, 5–10 μg/kg/min, is suitable for use during emergence from cardiopulmonary bypass and may possess advantages over isoproterenol.

ISSN:0003-3022    

出版商:OVID    

年代:1976

数据来源: OVID

摘要:

Effects of long-term inhalation of 100 per cent oxygen on the microbial flora of the rat larynx, trachea, and large intestine were studied. Rats were kept 14 days in an atmosphere of 100 per cent oxygen after being conditioned to high oxygen concentrations by exposure to three cycles of 100 per cent oxygen (two days) alternating with 40 per cent oxygen (two days). Controls were kept under similar conditions in normal atmosphere. Rats were sacrificed, and at necropsy laryngotracheal swabs and fecal material from the large intestine were obtained and cultured for bacteria and fungi.Streptobacillus moniliformis, the predominant microorganism in the upper tracheas of controls, was not isolated from the oxygen-treated rats. Alpha-hemolytic streptococcus andStaphylococcus albuswere present in control rats, but were found less frequently in rats exposed to oxygen.PseudomonasandProteus, infrequently isolated from controls, were predominant and sometimes the only microorganisms isolated from oxygen-treated rats. The data indicate that prolonged exposure of the rat to 100 per cent oxygen shifts the microbial flora in the upper respiratory tract from mainly gram-positive to mainly gram-negative bacteria. In contrast, there was no significant difference between the microbial flora in large intestines of control and oxygen-treated rats. The possibility that similar changes may occur in man should be considered when prolonged oxygen therapy is contemplated.

ISSN:0003-3022    

出版商:OVID    

年代:1976

数据来源: OVID

摘要:

Either fentanyl or Innovar (fentanyl, 0.05 mg/ml, and droperidol 2.5 mg/ml) was administered to supplement nitrous oxide anesthesia for operations on 29 patients. Both fentanyl and Innovar depressed the slope of the rebreathing CO2response curve during operation to 42 per cent ± 6 (mean of all intraoperative values, ± SE) of the awake control value. Following the last injection of drug but with continuation of operation, the slope increased such that it was 77 percent r S of control on the patients' arrival in the recovery room. The slope continued to increase to a peak of 103 per cent ± 5 of control. Soon thereafter respiratory depression recurred, as indicated by a decline in the slope to 55 per cent ± 5 of control, with a subsequent gradual return to 85 per cent ± 8 of control 230 minutes after the last injection. This biphasic response occurred in 90 per cent (26 of 29) of the patients treated either with fentanyl alone or with Innovar. Full recovery appeared to be more rapid with Innovar than with fentanyl alone. Droperidol did not augment and may have attenuated fentanyl-induced respiratory depression.

ISSN:0003-3022    

出版商:OVID    

年代:1976

数据来源: OVID

ISSN:0003-3022    

出版商:OVID    

年代:1976

数据来源: OVID

摘要:

In ten patients anesthetized with halothane and nitrous oxide,d-tubocurarine or pancuronium was infused continuously for 80 minutes to produce a constant 90 per cent depression of twitch tension. For the first 30-minute period, 8.2 ± 0.32 and 1.09 ± 0.06 (mean ± SE) mg/m2ofd-tubocurarine or pancuronium, respectively, were required, and for the last 30-minute period (50 to 80 minutes of infusion) 2.1 ± 10.10 and 0.41 ± 0.02 mg/m3were required, giving potency ratios of 8.2/1.1,i.e., 7.4, and 2.1/0.41,i.e., 5.1. The difference in potency ratios in the first and last 30-minute periods implies that potency values determined by single-injection techniques inadequately describe the relative requirements for sustained paralysis. The mean ratios between that amount of relaxant representing tissue uptake and that amount representing metabolism and renal excretion during the first 30 minutes were 3.06 ± 0.28 ford-tubocurarine and 1.63 ± 0.19 for pancuronium. The significantly higher ratio ford-tubocurarine implies that its tissue uptake relative to metabolism and renal excretion is greater than that for pancuronium. The higher ratio ford-tubocurarine may be partly explained by its greater binding to plasma and tissue proteins.

ISSN:0003-3022    

出版商:OVID    

年代:1976

数据来源: OVID

ISSN:0003-3022    

出版商:OVID    

年代:1976

数据来源: OVID

摘要:

A survey or hospitals with anesthesia residency training programs was undertaken to determine the frequency and types of complications encountered with the use of bulk supplies of oxygen and nitrous oxide. Of the responding hospitals, 98 per cent dispense oxygen from a central source and 80 per cent dispense nitrous oxide from a central source. Nearly a third of the hospitals responding reported the occurrence of serious or potentially serious accidents related to their bulk gas delivery systems. In three instances accidents resulted in patient deaths. More than half of the reported incidents were decreases in oxygen pipeline pressure, often resulting in insufficient delivery of oxygen for clinical use. Most complications related to pipeline accidents could have been prevented by observance of National Fire Protection Association regulations. Anesthesiologists should be familiar with these regulations and should understand the designs of gas delivery systems in their institutions.

ISSN:0003-3022    

出版商:OVID    

年代:1976

数据来源: OVID

摘要:

Respiratory resistance significantly increased from 5.0 to 8.0 cm H2O/l/sec in anesthetized patients who were given ultrasonically nebulized water for 20 minutes via an endotracheal tube. Intravenous administration of lidocaine failed to reverse the provoked increase in resistance. In another group, respiratory resistance significantly increased from 5.8 to 7.5 cm H2O/l/sec in response to nebulized water despite prior and concurrent intravenous administration of lidocaine. In a third group, initial respiratory resistance was 5.6 cm H2O/l/sec and did not increase during a 20-minute challenge with intratracheally administered ultrasonically nebulized 2 per cent lidocaine. In a final group, resistance was increased from 5.0 to 6.9 cm H2O/l/sec with nebulized water. When challenge was continued with nebulized 2 per cent lidocaine, resistance remained elevated for about 10–12 minutes. It then decreased and returned to its initial control value at about 17 minutes, despite continuing lidocaine aerosol administration.Lidocaine, when administered intratracheally as an aerosol, both prevented and reversed provoked increases in respiratory resistance. Intravenously administered lidocaine was ineffective. Intratracheal administration of ultrasonically nebulized lidocaine might be another useful technique for management of bronchoconstriction in anesthetized patients.

ISSN:0003-3022    

出版商:OVID    

年代:1976

数据来源: OVID

摘要:

Low concentrations of ethanol (17 mM) inhibited development of spontaneous mechanical activity (vasomotion) in isolated rat portal veins. Low concentrations of ethanol potentiated, however, contractions induced by epinephrine, but not those induced by angiotensin or potassium. Higher concentrations of ethanol, such as those associated with surgical anesthesia (100–170 mM), resulted in almost complete suppression of spontaneous contractile responses. These higher concentrations of ethanol: a) attenuate contractions induced by epinephrine, angiotensin, and potassium (K+); b) cause noncompetitive displacement of the dose-response curves of these vasoactive compounds; c) attenuate calcium (Ca++)-induced contractions of K+-depolarized portal veins; d) relax drug-induced, as well as Ca++-induced, contractions of portal veins. The profound depressant actions of ethanol are not mimicked by alpha-adrenergic, histaminergic, cholinergic, or serotonergic blocking drugs, nor are they attributable to actions on β-adrenergic receptors. The direct vasodepressant actions of ethanol on isolated venous smooth muscle may play a significant role in alcohol-induced peripheral vasodilatation seen in man and animals.

ISSN:0003-3022    

出版商:OVID    

年代:1976

数据来源: OVID

ISSN:0003-3022    

出版商:OVID    

年代:1976

数据来源: OVID