Anesthesia and analgesia
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Anesthesia and analgesia · Apr 1994
Randomized Controlled Trial Clinical TrialVisual estimation of train-of-four responses at the orbicularis oculi and posttetanic count at the adductor pollicis during intense neuromuscular block.
Posttetanic count (PTC) predicts the time to return of train-of-four (TOF) responses at the adductor pollicis (AP) muscle. The duration of neuromuscular block at the orbicularis oculi (OO) is shorter than at the AP. The aim of this study was to assess whether TOF at the OO can predict, as accurately as PTC does, the time to return of TOF at the AP. ⋯ Times from injection to the first response to PTC (PTC1), to the reappearance of the first response of TOF at the OO (T1OO), and to the reappearance of the first response of TOF at the AP (T1AP) were recorded. After pancuronium and atracurium, PTC1 and T1OO recovered before T1AP (P < 0.001). In all patients, PTC1 recovered earlier than T1OO (P < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
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Anesthesia and analgesia · Apr 1994
Comparative StudyStructure-selective anesthetic action of steroids: anesthetic potency and effects on lipid and protein.
Alphaxalone was a clinically used steroid anesthetic. Its analog delta 16-alphaxalone is nonanesthetic. The only difference between the two is the presence of a double bond at the hydrophobic end of the delta 16-alphaxalone molecule. ⋯ These values translate into 3.5 mmol/L for alphaxalone and 0.15 mol/L for delta 16-alphaxalone, when expressed by the concentration in the peptide. The change from alpha-helix to beta-sheet is accompanied by dehydration of the surface of poly(L-lysine). The steroids decreased the phase-transition temperature of DPPC membrane.(ABSTRACT TRUNCATED AT 250 WORDS)
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Anesthesia and analgesia · Apr 1994
Comparative StudyRheologic effects of plasma substitutes used for preoperative hemodilution.
This study was designed to compare the influence of various plasma substitutes, administered for preoperative hemodilution, on blood rheology. We studied 40 patients, ASA grade I, who underwent elective facial reconstructive surgery and received 4% albumin (n = 10), 3.5% dextran 40 (n = 10), gelatin (n = 10), or hydroxyethyl starch (HES) (n = 10). Ten patients, undergoing the same surgical procedure without hemodilution, were chosen as controls. ⋯ In contrast, at a low shear rate and at 40% corrected hematocrit, the blood viscosity decreased in the albumin (15.9 +/- 1.9 to 13.1 +/- 2.1 mPa.s; P < 0.01) and the dextran 40 (16.9 +/- 2.9 to 12.8 +/- 2.5 mPa.s; P < 0.01) groups and was unchanged in the gelatin and the HES groups. Erythrocyte aggregation (measured with primary aggregation time) was markedly decreased in the albumin (3.27 +/- 1.74 to 7.03 +/- 2.95 s; P < 0.01) and in the dextran 40 (2.72 +/- 0.58 to 6.24 +/- 2.55 s; P < 0.001) groups, unchanged with HES, and increased with gelatin (2.41 +/- 0.90 to 1.55 +/- 0.33 s). These findings suggest that albumin and dextran 40 may be the plasma substitutes of choice for preoperative hemodilution when this technique aims to improve rheologic conditions.