Canadian journal of anaesthesia = Journal canadien d'anesthésie
-
The effects of diltiazem (1 microM) and nifedipine (1 microM) were examined separately on the in vitro halothane tests for malignant hyperthermia (MH) susceptibility. Eighteen patients with MH susceptibility were diagnosed as MH-susceptible (MHS) according to the protocol of the European MH Group. ⋯ Furthermore, in five of the ten MHS patients tested in the presence of diltiazem as well as in five of the eight MHS patients tested in the presence of nifedipine the halothane contracture test could be classified as negative. It is concluded that the presence of clinical concentrations of either diltiazem or nifedipine in the muscle bath affects the in vitro discrimination for MH susceptibility to halothane.
-
Location of the epidural space in epidural anaesthesia usually involves the measurement of loss of resistance using glass or plastic syringes. In the present study two varieties of glass syringe and one plastic type were evaluated to determine the resistive forces associated with plunger movement. ⋯ Each of these values was significantly lower (P less than 0.5) than those for plastic syringes fs = 2.22 X 10(-3) +/- 0.48 X 10(-3) N and fd = 1.46 X 10(-3) +/- 0.37 X 10(-3) N. It is concluded that glass syringes are favoured over plastic for locating the epidural space because frictional forces developed with glass syringes were significantly lower than with plastic.
-
Clinical Trial Controlled Clinical Trial
Clinical assessment of the muscular response to tetanic nerve stimulation.
The study was undertaken in order to determine clinical tactile evaluation of tetanic nerve stimulation (50 Hz, 5 sec) as a means of detecting fade and possible residual curarization. Forty-four patients were studied and 128 clinical evaluations by eight different observers were performed at various levels of neuromuscular blockade. Tetanic fade was detected reliably by clinical evaluation only when high degrees of fade (tetanic fade ratio of 0.3 or less) were detected with a force-displacement transducer. We conclude that the clinical tactile assessment of the response to tetanic stimulation is not accurate except at very high degrees of fade and that its usefulness in monitoring neuromuscular recovery is doubtful.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Continuous infusions of lumbar epidural fentanyl and intravenous fentanyl for post-thoracotomy pain relief. I: Analgesic and pharmacokinetic effects.
-
Clinical Trial Controlled Clinical Trial
Intravenous lidocaine does not attenuate the haemodynamic response of children to laryngoscopy and tracheal intubation.
The haemodynamic responses to laryngoscopy and intubation after induction of anaesthesia with thiopentone alone or in combination with 1.5 mg.kg-1 IV lidocaine were measured in 125 children age 2 to 12 yr to determine whether lidocaine administered one, two, three or four minutes before tracheal intubation attenuated the pressor response. Lidocaine did not attenuate the increases in heart rate and arterial blood pressure. ⋯ The increases in systolic and mean blood pressure were significantly affected by the age of the patient, P less than 0.05. Lidocaine is not a beneficial adjunct to induction of anaesthesia with thiopentone in healthy children for the purpose of attenuating the pressor response to intubation.