ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1984.tb02148.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

The biochemical characteristics of skeletal muscle mitochondria of malignant hyperthermia (MH) susceptible Dutch Landrace pigs have been investigated before and during an MH attack, inducedin vivoby halothane plus succinylcholine. The muscle homogenates have a decreased capacity to synthesize ATP and creatine phosphate during the MH period. Muscle mitochondria prepared from susceptible pigs in an MH period consume less oxygen than do mitochondria isolated before the attack, or mitochondria from control pigs during the challenge. The oxidative phosphorylation is not uncoupled during the critical period. The production of CO2 indicates that thein vitromeasured capacity of the MH muscle mitochondria correctly reflects thein vivocondition during the MH attack. The restricted synthesis may be caused by a factor, finding expression in the mitochondria themselves, and obtained or activated during the MH attack.

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1984.tb02002.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Biceps femoris muscle biopsies of malignant hyperthermia susceptible (MH+) and non‐susceptible (MH‐) Dutch Landrace pigs were studied ultrastructurally, and exchangeable calcium was demonstrated, using the antimonate precipitation technique in combination with electron probe x‐ray microanalysis. Biopsies were taken before and during the administration of halothane‐plus‐succinylcholine and after dantrolene sodium treatment of the animals. MH+ muscle, taken before the MH triggering, showed a high proportion (about 35%) of cells with supercontraction. Both MH+ and MH‐muscle had broad but nearly identical ranges of cell diameter. Core‐like structures were occasionally present in muscle from MH+ pigs. Muscle mitochondria from the MH+ pigs accumulated large amounts of calcium in their matrix compartment during the halothane‐plus‐succinylcholine induced MH crisis. This calcium loading in the course of time caused swelling and structural damage to the mitochondria. Skeletal muscle mitochondria from MH+ pigs did not show such a reaction pattern on challenge with halothane and succinylcholine. It is concluded that in MH+ pigs the challenge brings about an increase in myoplasmic free calcium, which is predominantly due to calcium influx from the extracellular fluid. This rise in cytosolic calcium causes the mitochondria to accumulate the cation in an energy‐dependent way. These findings are discussed in relation to the diverging halothane and caffeine contraction responses of aerobic type I and anaerobic ty

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1984.tb02003.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

The effects of nitroglycerin (TNG) infusion during ventilation with F102 = 1.0 on central haemodynamics and the distribution of ventilation ‐ perfusion (V.A/Q.) were studied with the multiple inert gas elimination technique in eight patients after coronary bypass surgery. Administration of TNG resulted in a significant decrease in mean arterial pressure, and an increase in heart rate while cardiac output remained unchanged. Mean right atrial, pulmonary arterial and pulmonary wedge pressures all decreased. There was a significant reduction in PaO2from 50.5 to 32.7 kPa, while PaO2remained unchanged in a control group of eight patients. This was mainly due to an increase in shunt from 9.3 to 16.5% of cardiac output during TNG‐infusion. In the control group there was also an increase in shunt from 9.7 to 12.1 % of cardiac output with a simultaneous decrease of the same magnitude in perfusion of regions with low V.A/Q.(0.005‐0.1). This was not evident in the group receiving TNG. Twenty min after termination of TNG‐infusion the effects on central haemodynamics and gas exchange were not fully reversed. The mechanism behind the increase in inert gas shunt observed with infusion of TNG during oxygen breathing is probably a selective effect on vessels with remaining high vasomotor tone despite high alveolar oxygen

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1984.tb02004.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

The effect of intravenous procaine, 2 mg/kg/min, on the cardiovascular function of nine patients scheduled for cardiac valve replacement was studied under enflurane‐pancuronium anaesthesia. Procaine infusion was started after intubation during steady‐state anaesthesia, and continued until start of cardiopulmonary by‐pass. Systemic vascular resistance decreased steadily from 198.2±28.7 to 133.0±17.2 kPas/1 (P<0.05). A simultaneous decline in mean arterial pressure from 10.13±0.68 to 7.47±0.48 kPa was observed (P<0.01). Cardiac index, heart rate, central venous pressure, pulmonary arterial mean pressure and pulmonary capillary wedge pressure were all unaffected by procaine as well as by surgical stimulation. It is concluded that continuous procaine infusion as an adjuvant to general anaesthesia effectively abolishes the hypertensive and tachycardiac response to surgical stimulation. The limiting factor in the amount of infused procaine appears to be the hypotension caused by vasodilation, not myocardial depression or co

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1984.tb02005.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

A double‐blind comparison of the pain‐relieving effect of piroxicam 5 and 10 mg, acetylsalicylic acid 648 mg and placebo was performed in 120 patients with moderate to severe pain on the morning after orthopedic surgery. The changes in pain intensity and pain relief during the 8 h following medication were recorded by a trained nurse observer. 67 % of the placebo‐treated patients needed rescue drugs compared to 41% of the acetylsalicylic acid, 43% of the piroxicam 5 mg, and 45% of the piroxicam 10 mg treated patients. One to three hours after ingestion of the test drug, the piroxicam and the acetylsalicylic acid groups had significantly improved verbal rating pain intensity scores compared to placebo. In the overall assessment of pain relief at the end of the observation period, the patients' own assessment was significantly superior for acetylsalicylic acid and piroxicam 10 mg compared with placebo. In the observer's assessment of overall pain relief, placebo was significantly inferior to the three other groups. Thus piroxicam 5 mg and 10 mg give relief of pain after orthopedic surgery similar to that given by acetylsalicylic acid 648 mg. The pain‐relieving effect of these drugs can be distinguished from placebo, but not from each other. They are not potent enough when pain is moderate to severe after orthopedic

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1984.tb02006.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

The effect was evaluated of a small “self‐taming” dose of suxamethonium (0.1 mg/kg) on fasciculations and postoperative muscle pain following a normal intubating dose of suxamethonium (1.0 mg/kg). Forty outpatients undergoing bronchoscopy were randomly allocated to pretreatment with either sodium chloride or suxamethonium 0.1 mg/kg. The pretreatment dose was followed in 60 s by suxamethonium 1.0 mg/kg. Visual rating and mechanical registration of muscle fasciculations were done separately. Muscle pain was found in 74 % and in 26% of the patients following pretreatment with sodium chloride and suxamethonium 0.1 mg/kg, respectively (P<0.01). No significant relationship was found between pain and muscle fasciculations. It is concluded that self‐taming with suxamethonium has a marked pain‐reducing effect; and this technique may be used as an alternative to pretreatment with a non‐depolarizi

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1984.tb02007.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Fourteen patients are described in whom repeated plasma exchange was performed as part of their treatment for Rh alloimmunisation during pregnancy. Despite administration of fresh frozen plasma at frequent intervals during therapy, serum cholinesterase activity was shown to be reduced to levels sufficient to put many of them at risk from suxamethonium sensitivity. It is recommended that if short‐acting muscle relaxants are intended to be used during the delivery of such patients, a careful investigation of cholinesterase status should be undertaken beforehan

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1984.tb02008.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

In 28 children undergoing adenoidectomy, plasma concentrations of catecholamines, ACTH and Cortisol were measured. Fourteen children were anaesthetized with halothane (seven non‐intubated, seven intubated) and 14 with enflurane (seven non‐intubated, seven intubated). During undisturbed anaesthesia, plasma catecholamines were significantly higher with halothane than with enflurane (P<0.05). Immediately after surgery, catecholamines were increased up to 300% in the halothane groups. In the enflurane groups, however, the catecholamine concentrations remained unchanged. This difference between the two agents, after surgery, was statistically significant (P<0.01 for intubated andP<0.001 for non‐intubated children). Fifteen minutes postoperatively no difference was found in plasma concentrations between the groups. In all four groups, plasma concentrations of ACTH and Cortisol increased similarly during the procedure. It was concluded that plasma catecholamines were higher during halothane than during enflurane anaesthesia in children undergoing adenoidectomy. This difference may be caused by a stimulating effect of halothane on the endogenous catecholamine release. This increased sympathomimetic response during halothane anaesthesia was correlated to the incidence of ventricular arrhythmias previously found with this agent during adenoide

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1984.tb02009.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

In 58 infants and children with body weights between 2.8 and 20.5 kg carbon dioxide production (V.co2ml min‐1) was measured during halothane anaesthesia for minor surgical procedures. In 22 cases measurements were made during both spontaneous and controlled ventilation during the same operation. A non‐rebreathing circuit was used. Expired ventilation volume was measured with a dry gas meter and expired gas collected during 3–5 min in a Douglas bag. The carbon dioxide fraction of exhaled gas was determined with a sampling Gould capnograph. A respiratory quotient (RQ) of 0.8 was used to calculate oxygen consumption (V.o2ml min1). During spontaneous breathing, regression analysis of the relationship between V.co2and kg and between V.o2and kg showed high intercepts while corresponding relations to kg revealed an almost direct proportionality. Thus, V.co2and V.o2ought to be related to body weight in kg in spontaneously breathing children. The mean value (±1 s.d.)for V.co2was 11.4 ±3.1 ml kg‐3/4and for V.o214.2 ±3.9 ml kg‐3/4. During controlled ventilation, the relationship between kg b. w. showed for V.co2as well as for V.o2an almost direct proportionality with a mean value (± 1 s.d.) for V.co2of 6.3± 1.6 ml min1kg‐1and for V.o2of 7.8±2.0 ml min kg. Prediction of V.o2for infants and children of this size could be based upon 14Xkg during halothane anaest

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1984.tb02010.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY