Anesthesia and analgesia
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Anesthesia and analgesia · Apr 1995
Effects of CAS 754, a new nitric oxide donor, on regional cerebral blood flow in focal cerebral ischemia.
Nitric oxide (NO) plays an important role in regulating regional cerebral blood flow (rCBF). This study was performed to compare the effects of the NO donor, CAS 754, a sydnonimine derivative, and sodium nitroprusside (SNP) on rCBF in ischemic and nonischemic brain regions. Twenty-eight rats were anesthetized with 1.4% isoflurane and were mechanically ventilated. ⋯ Phenylephrine infusion in the CAS 754-treated animals did not significantly affect the rCBF of the ischemic or nonischemic brain regions. In conclusion, our study demonstrated that CAS 754 was a more effective cerebral vasodilator than nitroprusside when administered systemically. In the ischemic cortex, neither CAS 754 nor nitroprusside improved rCBF Failure of CAS 754 to improve the rCBF of the ischemic cortex does not appear to be due to hypotension induced by CAS 754.
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Anesthesia and analgesia · Apr 1995
Randomized Controlled Trial Comparative Study Clinical TrialEffect of interpleural administration of bupivacaine or lidocaine on pain and morphine requirement after esophagectomy with thoracotomy: a randomized, double-blind and controlled study.
The purpose of the present study was to investigate the efficacy of interpleural (IP) analgesia with bupivacaine or lidocaine after esophageal surgery and to measure the plasma concentrations of bupivacaine and lidocaine after intermittent IP administrations. Two IP catheters were inserted percutaneously in the seventh intercostal space during operation. Patients in the bupivacaine group (Gr B) received 1 mg/kg of 0.5% bupivacaine with epinephrine 1:200000 in 20 mL of saline 0.9%, patients in the lidocaine group (Gr L) received 3 mg/kg of 2% lidocaine with epinephrine in 20 mL of saline 0.9%, and patients in the placebo group (Gr P) received 20 mL of saline 0.9% every 4 h during 2 days. ⋯ VAST scores were significantly lower in Gr B at 12, 16, 28, and 32 h when compared with Gr P and Gr L (P < 0.05). There was no statistical difference in mean VAST between Gr L and Gr P. Total consumption of morphine was lower in Gr B than in Gr P and Gr L (41.2 +/- 13 mg vs 66.1 +/- 21 mg in Gr P (P < 0.02) and 75.5 +/- 27 mg in Gr L (P < 0.01)), but were similar in Gr L when compared with Gr P.(ABSTRACT TRUNCATED AT 250 WORDS)
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Anesthesia and analgesia · Apr 1995
Comparative StudyA comparison of coronary hemodynamics during isoflurane and sevoflurane anesthesia in dogs.
We studied the effects of sevoflurane and isoflurane on coronary hemodynamics in relation to myocardial oxygen supply and demand. Dogs were anesthetized with pentobarbital and fentanyl and received isoflurane or sevoflurane. An electromagnetic flow probe and a pair of piezoelectric crystals were placed on the left circumflex coronary artery (CX) to measure CX flow and diameter. ⋯ The CX vascular resistance decreased significantly during isoflurane but not during sevoflurane. Moreover, the myocardial oxygen extraction ratio (Mo2exr) decreased at 0.75 and 1.5 MAC isoflurane and at 1.5 MAC sevoflurane, and the decrease in Mo2exr was significantly greater during isoflurane than during sevoflurane. The results suggest that sevoflurane is a less potent coronary arteriolar dilator than isoflurane, and that neither sevoflurane or isoflurane has a direct effect on the diameter of large coronary arteries.