Anesthesia and analgesia
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Anesthesia and analgesia · Sep 1994
Randomized Controlled Trial Clinical TrialEffects of end-tidal gas monitoring and flow rates on hemodynamic stability and recovery profiles.
This study was designed to evaluate the impact of routine end-tidal anesthetic gas monitoring on the intraoperative hemodynamic stability and early recovery profile in 253 consenting ASA physical status I-III patients undergoing elective otolaryngologic procedures with isoflurane or enflurane anesthesia. Patients were randomly assigned to one of six treatment groups: Group I, monitored high-flow isoflurane; Group II, unmonitored high-flow isoflurane; Group III, monitored low-flow isoflurane; Group IV, unmonitored low-flow isoflurane; Group V, monitored low-flow enflurane; or Group VI, unmonitored low-flow enflurane. After a standardized induction sequence, anesthesia was maintained by administering variable concentrations of isoflurane or enflurane in an air/oxygen mixture at two different total gas flow rates (0.7 L/min or 3.5 L/min, respectively). ⋯ Intraoperative hemodynamic stability was assessed in each patient and reported as the average error from the preincisional (baseline) MAP, average absolute error from the baseline MAP, coefficients of variation for HR, systolic, diastolic, and MAP values, and ET anesthetic concentrations. Recovery times from discontinuation of the volatile drug until awakening, following commands, and postanesthesia care unit (PACU) discharge were recorded. The six study groups had similar intraoperative MAP and HR values, coefficients of variation, and numbers of episodes of hypertension, hypotension, tachycardia, and bradycardia.(ABSTRACT TRUNCATED AT 250 WORDS)
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Anesthesia and analgesia · Sep 1994
Comparative StudyThe partition coefficient as a predictor of local anesthetic potency for spinal anesthesia: evaluation of five local anesthetics in a mouse model.
Local anesthetic partition coefficients correlate with drug potencies in vitro, but in vivo data have not always complimented in vitro results. Despite extensive studies on intrathecal anesthetic action, whether there is correlation between the partition coefficient and local anesthetic potency has not been addressed. Mice (n = 150) were randomly allocated into 15 groups. ⋯ ED50 showed high correlation (R = 0.978) with partition coefficients of local anesthetics. This study implies that the partition coefficient is a predictor of intrathecal local anesthetic potency. We suggest that the mouse model is reliable for evaluation of intrathecal local anesthetic action.
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Anesthesia and analgesia · Sep 1994
Randomized Controlled Trial Comparative Study Clinical TrialPancuronium or vecuronium for treatment of shivering after cardiac surgery.
This randomized double-blind study compared the hemodynamic and metabolic effects of pancuronium and vecuronium during treatment of shivering after cardiac surgery with hypothermic cardiopulmonary bypass. Thirty sedated and pain-free patients who shivered after cardiac surgery were treated with pancuronium (n = 15) or vecuronium (n = 15) 0.08 mg/kg. Baseline values of heart rate (HR), mean arterial pressure, arterial and venous blood gases, total body oxygen consumption indexed to body surface area (VO2-I), and pressure work index (PWI, an estimate of myocardial oxygen consumption) were measured on arrival in the intensive care unit, at onset of shivering, and repeatedly for 2 h after treatment. ⋯ The disproportionate relationship between VO2-I and PWI after treatment with muscle relaxants indicates that increased VO2-I does not contribute significantly to the hemodynamic disturbances associated with shivering. These disturbances are more likely the results of increased adrenergic activity related to pain and recovery from anesthesia. Shivering and its associated hemodynamic disturbances appear to be concomitant but independent signs of awakening.