Anesthesia and analgesia
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Anesthesia and analgesia · Apr 1986
Clinical Trial Controlled Clinical TrialSuccinylcholine pretreatment with magnesium sulfate.
The effect of pretreatment with 60 mg/kg magnesium sulfate on the neuromuscular blockade and consequent potassium release produced by 1.5 mg/kg succinylcholine in ten normal patients was compared with ten saline pretreated control patients. Magnesium had no significant effect on the characteristics of the paralysis. ⋯ No patient in the magnesium group had an increase in serum potassium (mean change -0.05 +/- 0.02 mmol/L). The difference between the groups was statistically significant (P less than 0.01).
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Anesthesia and analgesia · Apr 1986
Randomized Controlled Trial Comparative Study Clinical TrialProlongation of lidocaine spinal anesthesia with epinephrine and phenylephrine.
The effect of vasoconstrictors on the duration of lidocaine spinal anesthesia is controversial. We conducted a double-blind study of 28 neurologically normal ASA Class I or II patients to determine the effect of vasoconstrictors (epinephrine and phenylephrine) on the duration of lidocaine spinal anesthesia. The patients were randomized into three groups. ⋯ Time for regression by two sensory dermatomes were significantly prolonged in both Groups 2 and 3, 102.9 +/- 18.1 and 105.7 +/- 33.1 min, respectively, compared to 78.1 +/- 12.6 min in Group 1. Times for regression to T-12 was also significantly prolonged in both Groups 2 and 3, 153.7 +/- 27.6 and 156.8 +/- 26.7 min, respectively, compared to 117.71 +/- 10.0 min in Group 1. In the doses used in the present study, both epinephrine and phenylephrine significantly prolong the duration of lidocaine spinal anesthesia.
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Anesthesia and analgesia · Apr 1986
Resuscitation from bupivacaine-induced cardiovascular toxicity during partial inferior vena cava occlusion.
The hemodynamic effects and ability to resuscitate animals experiencing bupivacaine cardiovascular toxicity after partial inferior vena cava occlusion were investigated in anesthetized dogs (n = 12). Partial occlusion of the inferior vena cava resulted in a 12% decrease in mean arterial pressure, a 62% decrease in cardiac output, a 66% decrease in stroke volume, and a 135% increase in systemic vascular resistance. ⋯ Significantly increased amounts of epinephrine and NaHCO3 were required to resuscitate the animals with caval occlusion. We conclude that partial inferior vena cava occlusion can significantly alter the ability to resuscitate animals experiencing bupivacaine cardiovascular toxicity.
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Anesthesia and analgesia · Apr 1986
Cardiovascular responses and lidocaine absorption in fiberoptic-assisted awake intubation.
Local anesthetic toxicity and cardiovascular stress during fiberoptic-assisted awake tracheal intubation were assessed prospectively in 20 patients with airway management problems. Cardiovascular responses, dose of lidocaine, its systemic absorption, and patient comfort were measured. A standardized topical anesthesia protocol of 4% lidocaine aerosol, topical 2% lidocaine viscous gel, and direct perbronchoscopic laryngeal application was used. ⋯ Patient comfort assessment showed that nine patients had no discomfort, whereas 11 had minimal discomfort. Supplementary sedation used was minimal (fentanyl, 1.4 +/- 0.6 micrograms/kg, and diazepam, 1.9 +/- 1.8 mg). This method of producing topical anesthesia for awake tracheal intubation is recommended as a safe, easy, and comfortable method of managing patients with airway difficulties.
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Anesthesia and analgesia · Apr 1986
The effects of atracurium besylate (Tracrium) on intracranial pressure and cerebral perfusion pressure.
Twenty-five patients with expansive pathologic brain lesions, who were anesthetized with thiopental, nitrous oxide in oxygen, and fentanyl, and who were mechanically ventilated to ensure normocarbia, received atracurium besylate 0.6 mg/kg, intravenously. Intracranial pressure, mean arterial pressure, central venous pressure, heart rate, and end-tidal CO2 were simultaneously recorded for 5 min before and for 10 min after administration of the muscle relaxant. No statistically significant changes were observed after administration of atracurium besylate. These results suggest that atracurium besylate may be used for muscle relaxation during neurosurgical operations, despite its potential for histamine release and excitement of the central nervous system.