Anesthesia and analgesia
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Anesthesia and analgesia · Dec 1981
Effects of enflurane on release of insulin by pancreatic islets in vitro.
The effects of enflurane upon rate of insulin release from rat pancreatic islets were determined in vitro. A dose-related inhibitory effect of enflurane on glucose-stimulated insulin release was observed with almost complete inhibition being seen when the enflurane concentration in the gas phase was 3.21% (v/v), equivalent to 1.26 mM enflurane in the liquid phase. ⋯ To investigate further the metabolic integrity of islets, rates of islet incorporation of L-[4,5-3H] leucine were determined; these too were not significantly altered by concentrations of enflurane up to 1.26 mM. It is concluded that enflurane in the concentration range used clinically leads to a rapid, reversible inhibition of rat pancreatic islet insulin release, which is not attributable to interference with islet glucose metabolism or protein biosynthesis.
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Dosage of pancuronium required to produce 90% neuromuscular blockade, time of onset of action of pancuronium and changes in heart rate and arterial pressure were evaluated in 30 children with congenital cardiovascular disease during intravenous anesthesia. Neuromuscular blockade was measured using train-of-four stimulation (2 Hz for 2 seconds) and twitch count. The 90% blockade was defined as being one twitch felt on the stretched abducted thumb. ⋯ There were no significant changes in heart rate or arterial pressure. In one case bigeminy during intubation was seen. No children had tachycardia after pancuronium.
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Anesthesia and analgesia · Nov 1981
Randomized Controlled Trial Clinical TrialIsobaric tetracaine spinal anesthesia and the lithotomy position.
The extent and pattern of anesthesia produced by hyperbaric and by isobaric 0.5% tetracaine spinal anesthesia were compared in this blind-observer, randomized study of 103 spinal anesthetics performed in 98 patients having genitourinary surgery in the lithotomy position. Pinprick stimulation showed no significant differences in maximum segmental sensory levels, times to maximum level, or duration of anesthesia for isobaric as compared to hyperbaric tetracaine. No parameters were significantly altered by barbotage of isobaric tetracaine solutions. With injections given to patients in the sitting position and with patients subsequently maintained in a horizontal lithotomy position before being put in the lithotomy position, the addition of dextrose to tetracaine solutions injected at room temperature into the subarachnoid space does not significantly alter the cephalad spread of spinal anesthesia.
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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.