Anesthesia and analgesia
-
Anesthesia and analgesia · Feb 1993
Randomized Controlled Trial Clinical TrialInfluence of different glucose-insulin-potassium regimes on glucose homeostasis and hormonal response in cardiac surgery patients .
Intravenous infusion of glucose/insulin in combination with potassium (GIK) is an often used technique to improve myocardial preservation in cardiac surgery. In a randomized study in 50 patients undergoing elective aortocoronary bypass grafting with good ventricular function, the influence on glucose homeostasis and hormonal response to four different glucose/insulin regimes were compared to an untreated control: 1) 50 g of glucose mixed with 100 U of human insulin (HI/100); 2) 50 g of glucose mixed with 100 U of bovine insulin (BI/100); 3) 50 g of glucose mixed with 50 U of human insulin (HI/50); and 4) 50 g of glucose mixed with 50 U of bovine insulin (BI/50) [corrected]. Glucose/insulin were given in combination with 70 mmol of potassium 40 min before beginning the operation. ⋯ Blood glucose levels showed no differences among all GIK groups (groups 1-4) but were significantly higher than in the control patients. The incidence of severely reduced (< 50 mg/dL) or elevated blood glucose level (> 300 mg/dL) did not differ between HI- and BI-treated patients but was significantly lower in the untreated control. Insulin plasma level increased significantly after infusion of GIK with higher levels in HI- than BI-treated patients (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
-
Anesthesia and analgesia · Feb 1993
Influence of age on awakening concentrations of sevoflurane and isoflurane.
We determined whether age, duration of anesthesia, gender, or type of surgery significantly influenced end-tidal concentrations on awakening from anesthesia with sevoflurane and isoflurane in 39 healthy ASA physical status I patients. Postoperatively, the end-tidal anesthetic concentration was maintained at a constant level at least for 15 min. If patients failed to open their eyes on request, the end-tidal concentration was decreased and again maintained at a constant level for 15 min. ⋯ The end-tidal concentrations on awakening from anesthesia were 0.62 +/- 0.02% (mean +/- SE) for sevoflurane and 0.41 +/- 0.02% for isoflurane. Awakening concentration of sevoflurane and isoflurane correlated significantly with age (P < 0.001), but not with duration of anesthesia, gender, or type of surgery. The authors conclude that awakening concentration decreases at the similar rate of decrease in minimum alveolar concentration (MAC) with increasing age; and therefore, the ratios to MAC are fairly constant, being 0.34 for both sevoflurane and isoflurane.