Anesthesia and analgesia
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Anesthesia and analgesia · Oct 1981
Postoperative hypothermia in adults: relationship of age, anesthesia, and shivering to rewarming.
Frequency, magnitude, and duration of hypothermia (core body temperature less than 36.0 C) in the recovery room (RR) were determined in 198 adults. In addition, the influence of age, anesthetic technique, and shivering on the rewarming process was assessed. Tympanic membrane temperatures were recorded on admission to the RR and every 15 minutes thereafter until discharge from the RR. ⋯ General anesthesia was associated with a significantly more rapid rate of increase in postoperative temperature and a shorter duration of hypothermia than was regional anesthesia. The incidence of shivering and the incidence of hypothermia were significantly related 30 and 45 minutes after admission to the RR. Duration of hypothermia varied with different operative procedures.
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Anesthesia and analgesia · Oct 1981
Failure of transcutaneous electrical stimulation to alleviate experimental tourniquet pain.
It has been proposed that transcutaneous electrical nerve stimulation (TENS) acts by stimulation of large nerve fibers which inhibits further propagation of nociceptive input conducted along smaller C-nerve fibers. We evaluated the effectiveness of TENS in alleviation of ischemic pain (C-fiber mediated) experimentally produced by the submaximal-effort tourniquet test. ⋯ Time from inflation of the tourniquet to onset of intolerable pain was noted together with a visual analog-derived intensity of pain for 10 subjects studied on three separate occasions. The results showed no statistically significant prolongation in the duration of ischemia tolerated nor reduction in the subjective intensity of pain during either single- or dual-channel stimulation in comparison to control levels.
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Anesthesia and analgesia · Sep 1981
Incidence of choledochoduodenal sphincter spasm during fentanyl-supplemented anesthesia.
One hundred patients were studied prospectively to assess the incidence of spasm of the choledochoduodenal sphincter during biliary tract surgery performed under a fentanyl-supplemented anesthetic technique. The incidence of failure of passage of contrast medium into the duodenum was 3%. In each of the three patients with cholangiographic evidence of sphincter spasm, contrast medium flowed freely into the duodenum after the intravenous administration of 2 mg of glucagon. It is concluded that spasm of the choledochoduodenal sphincter is an uncommon occurrence during fentanyl-supplemented anesthesia and that this method of anesthesia is suitable for biliary tract surgery.
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Anesthesia and analgesia · Aug 1981
Comparative StudyReversal of neuromuscular blockade: dose determination studies with atropine and glycopyrrolate given before or in a mixture with neostigmine.
Glycopyrrolate and atropine were studied in doses of 5, 10, or 15 microgram/kg and 10, 20, or 30 microgram/kg, respectively, given intravenously either before or in a mixture with neostigmine, 50 microgram/kg, at the time of reversal of neuromuscular block. When given first, both anticholinergic drugs produced a dose-related increase in heart rate; following the administration of neostigmine the heart rates decreased. When administered in a mixture with neostigmine, the 20- and 30-microgram/kg doses, but not the 10-microgram/kg dose of atropine were associated with an initial increase in heart rate. ⋯ The frequency of dysrhythmias was otherwise similar. It is recommended that anticholinergic drugs be administered in a mixture with neostigmine. Glycopyrrolate, administered in this way in a dose of 10 microgram/kg, is associated with stable heart rates.