Anesthesiology
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Comparative Study
Epidural sufentanil for postoperative analgesia after cesarean section.
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Comparative Study
Comparison of MAC and the rate of rise of alveolar concentration of sevoflurane with halothane and isoflurane in the dog.
The anesthetic requirements for sevoflurane, isoflurane, and halothane were determined in mongrel dogs. The MACs (minimum alveolar concentration) of sevoflurane, isoflurane, and halothane were 2.36 +/- 0.46% (n = 18), 1.39 +/- 0.25% (n = 10), and 0.89 +/- 0.20% (n = 12), respectively (mean +/- SD). ⋯ Thirty seconds after breathing a constant inspired concentration FA/FI was 0.75 for sevoflurane, which was 2.96 times higher than that with halothane (0.25 +/- 0.02) and 1.29 times higher than that with isoflurane (0.6 +/- 0.05). Induction with sevoflurane was smooth, with no struggling nor excessive salivation.
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The open ventriculocisternal perfusion method was used to determine the rate of cerebrospinal fluid (CSF) formation (Vf) and resistance to reabsorption of CSF (Ra) in halothane-anesthetized dogs with and without succinylcholine (n = 6) and with and without vecuronium (n = 6). Both Vf and Ra during the use of either muscle relaxant were not different than Vf and Ra when no muscle relaxant was used. Succinylcholine caused muscle fasciculations and raised CSF pressure transiently (increase of 5.5 +/- 1.0 cm H2O [mean +/- SD]), while vecuronium did not. ⋯ It is concluded that continuous infusion of succinylcholine or vecuronium do not affect Vf or Ra. When Vf and Ra are determined by the method of ventriculocisternal perfusion, immobilization of respiratory muscles improves both the reliability of Ra values and the usefulness of the CSF pressure waveform. If a muscle relaxant is used, either succinylcholine or vecuronium would be suitable for such studies.
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The anatomy of the lumbar epidural space was demonstrated in 40 patients by computed tomography (CT) examinations performed after epidural injection of noninonic radiographic contrast material into the sacral caudal canal via percutaneous catheter. Radiologic evaluation of the epidural space was performed to evaluate possible disc herniation or other pathologic encroachments on the epidural space. ⋯ Thirty-one of 40 patients demonstrated a greater amount of fatty tissue within the junctions of the posterior midline epidural connective tissue structures, producing a bulky triangular-shaped structure which might be an impediment to catheterization. The divisions of the anterior and posterior epidural spaces are seen to be more complex than previously described.