Anesthesia and analgesia
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Anesthesia and analgesia · Dec 1981
Delayed onset of epidural anesthesia in patients with back pain.
Onset and completeness of anesthesia were compared in 15 patients with back pain or sciatica and in 10 patients without back pain given lumbar epidural anesthesia with 20 to 25 ml of 1.5% mepivacaine, 80 mg of methylprednisolone, and 1:200,000 epinephrine. Sensory block was complete within 30 minutes in patients without back pain. Eleven of 15 (73%) patients with back pain had delayed onset of anesthesia ranging from 35 to 95 minutes. ⋯ Differences in time of onset between affected nerves and contralateral nerves were also significant (p less than 0.01). The nerve roots involved, as determined from the myelogram or the electromyogram, or those adjacent to them, were the roots with delayed onset of block. Any effect of the steroid on nerve blockade was ruled out as there was solid anesthesia in patients without back pain.
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Anesthesia and analgesia · Dec 1981
Effects of enflurane on release of insulin by pancreatic islets in vitro.
The effects of enflurane upon rate of insulin release from rat pancreatic islets were determined in vitro. A dose-related inhibitory effect of enflurane on glucose-stimulated insulin release was observed with almost complete inhibition being seen when the enflurane concentration in the gas phase was 3.21% (v/v), equivalent to 1.26 mM enflurane in the liquid phase. ⋯ To investigate further the metabolic integrity of islets, rates of islet incorporation of L-[4,5-3H] leucine were determined; these too were not significantly altered by concentrations of enflurane up to 1.26 mM. It is concluded that enflurane in the concentration range used clinically leads to a rapid, reversible inhibition of rat pancreatic islet insulin release, which is not attributable to interference with islet glucose metabolism or protein biosynthesis.