European journal of anaesthesiology
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The time profile of the neuromuscular block produced by a single bolus administration of vecuronium was simulated by a new model for the access of the relaxant to the receptors on the motor end plates. The receptors were assumed to be kinetically a part of the interstitial space of the muscle. ⋯ The model describes well the time lag needed to reach the peak submaximal block, its magnitude, as well as the time course of recovery from the maximal block. The limits of the model, evident in less than optimal simulation of the neuromuscular block by two doses of vecuronium in rapid succession, were attributed to the inadequate description of the vecuronium concentrations in plasma immediately after the bolus injection.
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Randomized Controlled Trial Clinical Trial
Thiopentone, thiopentone/ketamine, and ketamine for induction of anaesthesia in caesarean section.
Seventy-five healthy patients were randomly allocated to receive thiopentone, thiopentone/ketamine or ketamine for induction of anaesthesia for elective Caesarean section. Thiopentone resulted in the most pronounced and ketamine in the smallest drop in blood pressure, while the combination induced only moderate haemodynamic changes. ⋯ The muscle tone of neonates in the thiopentone group was more reduced than in neonates in the other two groups. Infants delivered after uterine incision-to-delivery intervals exceeding 3 min more often had Apgar scores < 7 than those delivered in less than 3 min.
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Auditory continuous reaction time was studied in three treatment groups. Twenty opioid naive patients received intramuscular morphine 0.15 mg kg-1 bodyweight for premedication. Thirty-one cancer patients were treated with oral opioids, 180 mg morphine per 24 h (median). ⋯ The reaction time was measured using 152 auditory signals and summarized as 10%, 50% and 90% percentiles. Analysing reaction time distributions, the opioid naive patients showed the greatest difference to the control group in the shortest reaction times while chronic opioid users showed the greatest difference for the longest reaction times. There seems to be a qualitative difference in reaction time distribution, between opioid naive individuals treated with single dose morphine and cancer patients in long-term treatment.