Journal of anesthesia
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Journal of anesthesia · Sep 1994
The effect of pH adjustment of 1% lidocaine on the onset of sensory and motor blockade of epidural anesthesia in nonpregnant gynecological patients.
Using a double-blind randominzed study protocol, we examined the distribution of sensory blockade and the quality of motor blockade after epidural anesthesia with 1% lidocaine with or without bicarbonate in nonpregnant gynecological patients. Alkalinization significantly decreased the time to onset of sensory blockade. However, there were no statistically significant differences between the low-pH and high-pH groups with respect to motor blockade or the distribution of sensory blockade. We conclude that pH-adjusted 1% lidocaine offers the advantage of a more rapid onset of sensory blockade, while motor blockade and the distribution of anesthesia are unaffected by pH change in epidural anesthesia.
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Journal of anesthesia · Sep 1994
Flecainide is effective against premature supraventricular and ventricular contractions during general anesthesia.
The effect of intravenously administered flecainide on premature supraventricular (PSCs) and ventricular contractions (PVCs) which developed under general anesthesia was evaluated. Flecainide was infused intravenously at a rate of 0.2 mg/kg/min until the efficacy of this drug appeared or for 10 min; thus, the maximum dose was determined to be 2 mg/kg. Flecainide was administered to 10 patients who experienced more than 5 supraventricular and/or ventricular contractions/min for a period of more than 5 min (PVCs, 4 patients; PSCs, 6 patients). ⋯ This dose of flecainide did not affect the heart rate and QRS interval, but caused a transient decrease in systolic blood pressure from 127±6 mmHg (SE) to 114±6 mmHg, a 14% increase in the PQ interval, and a 6.3% increase in the QT interval. These results suggest that flecainide is a promising drug for the treatment of PSCs and PVCs which develop during general anesthesia. Transient hypotension and cardiac conduction disturbances immediately after injection may occur when flecainide is used intravenously.
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Journal of anesthesia · Sep 1994
The pharmacodynamics of rocuronium in pediatric patients anesthetized with halothane.
The aim of this study was to determine the neuromuscular blocking potency of rocuronium (ORG 9426) in 4-to 14-year old children anesthetized with halothane. After induction of anesthesia, the ulnar nerve was stimulated with electrical impulses of 0.2 ms duration every 12 s and the force of contraction of the thumb (P) was continuously recorded. Doses of 0.12, 0.16, 0.20, and 0.24 mg·kg(-1) rocuronium were administered, in a randomized fashion, to 4 groups of 12 patients each. ⋯ When at termination of anesthesia T4/T1 ratios were lower than 0.75, the residual neuromuscular block could be antagonized with 0.5 mg·kg(-1) edrophonium in 2 min. Rocuronium, 0.3 mg·kg(-1) caused a 13.5% increase of heart rate but had no effect on blood pressure. In conclusion, in 4 to 14-year-old children, rocuronium appears to have a more rapid onset and shorter duration of action than other steroid-type muscle relaxants.