ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1986.tb02508.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

The purpose of this experimental study was to compare two methods of pulmonary blood flow manipulation during one‐lung ventilation (OLV), either reducing pulmonary blood flow to the non‐ventilated lung by inflation of a pulmonary artery catheter balloon (PAB) or by infusion of prostaglandin F2α(PGF2α). Seven anaesthetized dogs were intubated with a Kottmeier endobronchial tube and ventilated with 66% O2. Systemic and pulmonary pressures and blood gases, cardiac output and airway pressure were measured, and the venous admixture (Qsp/Q) was calculated. During two‐lung ventilation (TLV) Pao2was 43.6 1.9 kPa (mean s. d.) and (Qsp/Q) was 11 3%. OLV reduced Pao2to 12.1 1.6 kPa (P0.001) and increased Qsp/Q to 40 4% (P0.001). Mean pulmonary artery pressure and airway pressure increased. PAB inflation caused an increase in Paosb>2to 19.9 2.9 kPa (P0.02) and a decrease in Qsp/Q to 27 6% (P0.001). PGF2αinfusion (1.2 μg kg‐1min‐1) into the pulmonary artery of the non‐ventilated lung increased Pao2to 22.4 3.3 kPa (P0.001) and decreased Qsp/Q to 254 (P0.001). PGF2αinfusion resulted in a small increase in mean systemic and pulmonary artery pressures. During the infusion of 1.2 μg kg‐1min‐1of PGF2αno signs of bronchoconstriction were observed. PAB inflation and PGF2αinfusion were equally effective in improving oxygenation and reducing venous admixture during OLV. PGF2αinfusion is proposed as a practical and safe alternative to PAB inflation when application of PEEP or oxygen to the non‐ventilated lung during OLV is

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1986.tb02355.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

Four Danish landrace pigs susceptible to MH were challenged with halothane and suxamethonium on six occasions after pretreatment with the serotonin‐S2antagonist ketanserin 0.4 mg/kg (three animals) or 4 mg/kg (three animals). The animals developed typical MH on all occasions despite the pretreatment. Dantrolene remains the only specific drug for prevention and treatment of M

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1986.tb02356.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

Thirty‐seven patients undergoing elective abdominal surgery (excluding gastric operations) received either ranitidine 300 mg or placebo orally at 10 p. m. in the evening preceding surgery in a double‐blind randomised study. The mean time interval between this oral premedication and induction of anaesthesia was 12 h. When compared to placebo, ranitidine decreased significantly (P<0.05) the amount of gastric juice, and none of the ranitidine‐treated patients had an increased risk of acid pulmonary aspiration (pH below 2.5 and volume over 25 ml), while four patients in the control group had an increased risk (21%). The mean ranitidine blood level was 237 ng/ml at the time of induction of anaesthesia. It is concluded that in elective abdominal surgery ranitidine included in the premedication is likely to decrease the risk for acid pulmonary aspir

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1986.tb02357.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

The pressure in the proximal axillary vein (AVP) was compared with central venous pressure (CVP) in eight patients during and after elective abdominal surgery. Both pressures were recorded from soft, elastic, polyurethane catheters inserted in the basilic or cephalic veins (“half‐way” catheters), punctured at the fossa cubiti (AVP), and via the right jugular vein (CVP). The AVP and CVP were recorded simultaneously using hydrostatic, conventional disposable venous pressure measurement sets. The measurements were performed during intermittent positive pressure ventilation with positive end‐expiratory pressure from 0 to 7.5 cmH2O (0‐0.74 kPa), as well as during spontaneous breathing. During both controlled and spontaneous respiration, small mean differences (0.2‐1.0 cmH2O) (0.02‐0.1 kPa), and a highly significant (P<0.001) positive correlation between CVP‐ and AVP‐values were found. An increase of 1 cmH2O (0.10 kPa) in the CVP was associated with an increment of practically identical order (0.99‐1.04 cmH2O) (0.10‐0.11 kPa) in the AVP. The results suggest that monitoring of the AVP by a basilic “half‐way” catheter produces diagnostic information similar to that from the measurement of the CVP from subclavian, external or internal jugular, as well as “long‐way” brachial catheter, with no risk of the major mechanical complications which accompan

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1986.tb02358.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

Axillary perivascular injection of 50 ml blue‐stained gelatine was made in 20 cadavers, and a total dissection of the axilla was performed. The distribution of injected gelatine and the contact between nerves and gelatine were examined on cross‐sections of the neurovascular bundle. The spread of gelatine was characterized by: 1) restriction of gelatine to the neurovascular bundle, 2) an upper border of the gelatine which was constantly found to be proximal to the coracoid process, and 3) bulging of the gelatine towards the medial part of the axillary space. Cross‐sections of the neurovascular bundle showed the nerves and vessels to be located in the periphery of the gelatine and in close contact with the lateral wall of the axillary space. The median and the ulnar nerves were in all dissections found to be in direct contact with the gelatine, whereas the radial, the musculocutaneous, and the axillary nerves did not always have direct contact with the gelatine. Abduction of the arm to 90 brings the stretched neurovascular bundle close to the lateral wall of the axilla and this compromises perivascular circumferential spread of the injected gelatine. On the basis of the present investigation, it is hypothesized that insufficient circumferential spread is the cause of incomplete axillary blockades, and the perivascular injection of local anaesthetic should consequently be made with the arm along the side of the

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1986.tb02359.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

The effect of intranasally administered nitroglycerin (NTG) on the cardiovascular response to laryngoscopy and intubation was studied. Thirty patients scheduled to undergo coronary artery by‐pass surgery under thiopentone, enflurane and pancuronium anaesthesia were randomly divided into three groups. Group I received lignocaine 1.5 mg/kg i. v. prior to laryngoscopy and intubation (control group). Group II received lignocaine 1.5 mg/kg i. v. and in addition 2 mg nitroglycerin (NTG) was given intranasally. Group III received only 2 mg NTG intranasally. In Group I laryngoscopy and intubation caused a significant increase in mean arterial pressure (MAP) (P<0.01), heart rate (HR) (P<0.01) and rate pressure product (RPP) (P<0.01) compared to preoxygenation values. In Group II and III MAP and RPP remained unchanged, whereas HR increased (P<0.01 andP<0.01 respectively). It can be concluded that intranasally administered NTG effectively attenuates the pressor response to laryngoscopy and intubation in patients presenting for coronary artery by‐pass surgery and that it is a more effective and convenient method than intravenous lignoca

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1986.tb02360.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

The hemodynamic effects of vecuronium 0.2 mg/kg were investigated in 11 patients with coronary artery disease. Vecuronium, at a dose double the ED90, produced 90% neuromuscular block in a mean time of 163 7 s, and was not associated with any significant hemodynamic changes. The results suggest that vecuronium can safely be used in cardiac patients.

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1986.tb02361.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

The effects of the new intravenous anaesthetic drugs alfentanil (50 μg/kg) and atracurium (0.5 mg/kg) on per‐ and post‐operative function in out‐patients clinics were compared with fentanyl (5 μg/kg) and pancuronium (0.07 mg/kg). Sixty‐two healthy female patients submitted for out‐patient sterilization by laparoscopy participated in the study. Thirty patients receiving alfentanil and atracurium (the AA‐group) had significantly less pain during analgetic injection, less coughing during intubation, and faster and more pronounced muscle relaxation during induction of anaesthesia, compared with 32 patients receiving fentanyl and pancuronium (the FP‐group). The AA‐group had less adrenocortical stress‐response judged by systolic blood pressure and pulse rate during anaesthesia. Reversal of anaesthesia and neuromuscular blockade were performed without differences in awakening parameters between the two groups. The AA‐group had a significantly better score on P‐deletion test 45 min after reversal of anaesthesia, a better street fitness score in the afternoon after the procedure and a better day‐life function score at home in the evening. There was no difference between the groups in postoperative complaints and in function a

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1986.tb02362.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

Five different dosage schemes for alfentanil administration supplemented with thiopentone, pancuronium and N2O/O2have been studied in 25 patients undergoing elective cholecystectomy. Six patients in the high dosage group experienced stiff chest during induction and five patients developed respiratory arrest on the recovery ward. The effects of the different schedules in blocking the surgical stress response have been elucidated by serial measurements of serum cortisol and glucose, heart rate and systolic blood pressure. There were no significant changes in serum cortisol, heart rate and blood pressure during anaesthesia and surgery in any group. All patients showed a significant increase in serum cortisol 2 h postoperatively. There was significant elevation of serum glucose after 1 h of surgery in two groups (maintenance dose 1 μg/kg/min of alfentanil) and in all groups except one (maintenance dose 3.0 μg/kg/min) 2 h postoperatively. High dosage of alfentanil resulted in frequent stiff chest during induction and respiratory arrest postoperatively. High dosage did not seem to give any additional benefits in blocking the surgical stress response in this type of surger

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1986.tb02363.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY