Anesthesia and analgesia
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Anesthesia and analgesia · Oct 1987
Bunegin-Albin catheter improves air retrieval and resuscitation from lethal venous air embolism in dogs.
Three types of catheters, the single-orifice Sorenson CVP kit catheter, the right atrial (RA) port of an American Edwards 7F Swan-Ganz catheter, and the Cook Bunegin-Albin multi-orifice CVP catheter were evaluated for their ability to retrieve venous air emboli and effect on the success rate of resuscitation from venous air emboli. The catheters were inserted in anesthetized dogs in the prone position. Swan-Ganz catheters were positioned with the RA port just above the junction of the superior vena cava (SVC) and the RA, single-orifice Sorensen catheters with the orifice tip located either just above the SVC-RA junction or in the mid-RA, and Bunegin-Albin multiorifice catheters with the proximal orifice just above the SVC-RA junction and the distal orifice near the mid-RA. ⋯ The amounts of air retrieved and the incidence of successful resuscitation were compared. Significantly greater percentages of injected venous air were retrieved with the Bunegin-Albin catheter (60 +/- 7%) than with the Sorenson catheter in the SVC (16 +/- 6%), with the Sorenson catheter in the mid-RA (10 +/- 3%) or with the Swan-Ganz RA port (4 +/- 1%). Resuscitation was significantly more often successful with the Bunegin-Albin catheter (six of nine dogs) than with either Sorenson catheter (zero of seven in both groups) or the Swan-Ganz RA port (one of seven).(ABSTRACT TRUNCATED AT 250 WORDS)
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Anesthesia and analgesia · Oct 1987
End-tidal PCO2 measurements sampled at the distal and proximal ends of the endotracheal tube in infants and children.
To determine whether the site of gas sampling affects end-tidal gas measurements in pediatric patients, end-tidal PCO2 was measured continuously from the distal and proximal ends of the endotracheal tube in 60 infants and children ventilated with an Air-Shields Ventimeter and a partial rebreathing circuit. These data were compared with simultaneous arterial PCO2 measurements. ⋯ In infants and children weighing less than 12 kg, however, only distal end-tidal PCO2 measurements approximated arterial PCO2 measurements. It is concluded that in infants and children weighing less than 12 kg, accurate end-tidal measurements can be obtained only from the distal end of the endotracheal tube.
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Anesthesia and analgesia · Oct 1987
Comparative StudyRates of awakening from anesthesia with I-653, halothane, isoflurane, and sevoflurane: a test of the effect of anesthetic concentration and duration in rats.
The low blood solubility of two new inhaled anesthetics, I-653 (human blood/gas partition coefficient, 0.42) and sevoflurane (0.69), suggested that awakening from these agents should be more rapid than awakening from currently available anesthetics such as isoflurane (1.4) and halothane (2.5). This prediction proved valid in a study of these four agents in rats given 0.4, 0.8, 1.2, or 1.6 MAC for 2.0 hr or 1.6 MAC for 0.5 or 1.0 hr. At a given dose and duration, awakening was most rapid with the least soluble agent and longest with the most soluble agent. For example, recovery of muscle coordination at 1.2 MAC administered for 2 hr required 4.7 +/- 3.0 min (mean +/- SD) with I-653, 14.2 +/- 8.1 min with sevoflurane, 23.2 +/- 7.6 min with isoflurane, and 47.2 +/- 4.7 min with halothane.
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Anesthesia and analgesia · Oct 1987
The effects of age, epinephrine, and operative site on duration of caudal analgesia in pediatric patients.
The effects of age, operative site (penoscrotal or inguinal), and the addition of epinephrine 1:200,000 to bupivacaine on duration of postoperative analgesia after caudal block were prospectively and blindly evaluated in 341 children aged 13 months to 17 yrs. At the conclusion of the surgical procedures under halothane/N2O/O2 anesthetics (n = 419), caudal blocks were performed with 0.5 ml/kg of either 0.25% bupivacaine or 0.25% bupivacaine with 1:200,000 epinephrine injected at a rate of 0.5 ml/sec. ⋯ There were no major complications. The authors conclude that duration of analgesia is significantly influenced by age, operative site, and the addition of epinephrine 1:200,000 to bupivacaine.