Journal of anesthesia
-
Journal of anesthesia · Sep 1995
Leukocytosis after fluid loading and induction of epidural anesthesia.
The present study shows that leukocytosis occurs from fluid loading and from the small amounts of adrenaline given epidurally. Five healthy volunteers received an intravenous infusion of 25 ml·kg-1 b.w. of Ringer's acetate solution over 15, 30, 45, and 80 min, and epidural anesthesia (EDA) was induced in 25 urology patients using mepivacaine 2% with or without adrenaline 1∶200 000. In the volunteers, we found that the total leukocyte count increased by up to 33% within 1 h after rapid volume loading. ⋯ In the patients, the leukocyte count increased by 32% during the onset of EDA when mepivacaine with adrenaline was used. This increase was accounted for by lymphocytes. Our results suggest that caution is needed when interpreting the importance of a raised leukocyte count in samples taken in association with fluid loading and also when EDA is induced by a local anesthestic solution that contains adrenaline.
-
Journal of anesthesia · Sep 1995
Pendelluft is not the major contributor to respiratory insufficiency in dogs with flail chest: a mathematical analysis.
"Pendelluft", or out-of-phase movement of the airway gas between the intact and flait-chest-side lungs has long been believed to be the major contributor to respiratory dysfunction in patients with flail chest. However, conflicting findings have also been reported mainly from animal studies. The aim of this study was to provide a mathematical projection on this classical problem. ⋯ A mathematical model implementing flail chest was fitted toZRS. The fitted results were used in simulating the mechanical behavior of a respiratory system with flail chest during spontaneous breathing. Our results suggest that the paradoxical movement of breathing between the flail segment and the intact chest wall does not create substantial pendelluft and that alveolar hypoventilation is created by the wasting movement of the flail segment which interferes with effective thoracic expansion.