Anesthesia and analgesia
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Anesthesia and analgesia · Sep 1978
Epinephrine-induced arrhythmias during enflurane anesthesia in man: a nonlinear dose-response relationship and dose-dependent protection from lidocaine.
Forty-eight patients undergoing transsphenoidal pituitary surgery under enflurane anesthesia received submucosal injections of 1:150,000 or 1:200,000 epinephrine in saline, 0.5% lidocaine, or 1.0% lidocaine. The threshold doses for ventricular irritability, defined as 3 or more premature ventricular contractions during or in the 3 to 5 minutes following injection, were 1.3 microgram/kg with saline, 2.5 microgram/kg with 0.5% lidocaine, and 4.9 microgram/kg with 1.0% lidocaine. There was no consistent relationship between epinephrine dose and occurrence of ventricular irritability within or among groups. The data show a protective effect of lidocaine against epinephrine-induced ventricular irritability during enflurane anesthesia and suggest a qualitative as well as quantitative difference between enflurane and other volatile anesthetics in their interaction with epinephrine.
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Anesthesia and analgesia · Sep 1978
Comparative StudyRacial mydriatic response to belladonna premedication.
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Anesthesia and analgesia · Sep 1978
Comparative StudyTracheal pathology following short-term intubation with low- and high-pressure endotracheal tube cuffs.
Histologic sections of dog tracheas were taken from 20 dogs anesthetized and intubated for 5 to 7 hours with high-pressure, low-volume Shiley or low-pressure, high-volume Lanz endo-tracheal tubes. Microscopic examination and measurement showed that while the high-pressure, low-volume cuff produced deeper average mucosal erosion, the large-volume, low-pressure cuff resulted in significantly greater lengths of tracheal mucosa-cuff erosion. ⋯ Grooves in the mucosa were seen in 50% of the high-volume-cuff trachea sections but none of the low-volume-cuff tracheal sections. These findings demonstrate that low-pressure, high-volume endotracheal tube cuffs produce different but significant tracheal damage after short-term intubation when compared to high-pressure, low-volume cuffs.