Journal of anesthesia
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Journal of anesthesia · Mar 1989
Effects of anesthetic and related agents on calcium-induced calcium release from sarcoplasmic reticulum isolated from rabbit skeletal muscle.
We have investigated the effects of anesthetic and related agents on Ca(2+)-induced Ca2+ release (CICR) in heavy sarcoplasmic reticulum isolated from rabbit skeletal muscle. The purpose of this study is to elucidate their possible role as triggering agents in malignant hyperthermia (MH). ⋯ It is unlikely that lidocaine is a potent facilitator of CICR at any concentrations. We conclude that procaine, lidocaine, non-depolarizing muscle relaxants and opiate can be used safely for MH susceptible patients and that ketamine and succinylcholine are not recommended.
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Journal of anesthesia · Mar 1989
A new closed-system using partially frozen injectate for thermodilution cardiac output determinations.
The FI (partially frozen injectate) system, a new closed-system devised by the authors for thermodilution cardiac output determinations, has two major features: 1) it needs no ice-filled receptacle to keep injectate cold because it uses partially frozen injectate, and 2) it can go without monitoring the injectate temperatures during the whole process of cardiac output determinations. The author evaluated the accuracy and reproducibility of cardiac output determinations with the FI system in 10 critically ill patients, as compared with another closed-system (which is commercially available) and the standard open method. ⋯ Even when no monitoring of injectate temperatures was made, the predicated error in the calculated cardiac output resulted as low as 2% with the FI system. The mean cardiac output values were not statistically different between the FI system and the other two systems.
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To determine whether there is any systemic relationship between the distance from the skin to the epidural space and physical constitution, the distance from the skin to the epidural space was measured in 1007 epidural punctures. The distance from the skin to the epidural space in male was greater than that in female ( P < 0.001). However, the analysis of the distance from the skin to the epidural space of the selected patients who had both a weight of 50-60 kg and a height of 1.5-1.7 m indicated no statistical difference between male and female. ⋯ The correlation between the distance from the skin to the epidural space and height was less striking. Ninety-five percent of the patients who received epidural puncture at the thoraco-cervical area (C7-T2) had a distance to the epidural space of 4.0-6.9 cm; 87% at the lower-thoracic area (T8-T10), 4.0-6.9 cm; 93% at the thoraco-lumbar area (T12-L2), 3.0-4.9 cm; 85% at the mid-lumbar area (L2-L4), 3.0-4.9 cm. These results may be useful for young anesthesiologists to master epidural block safely and efficiently.
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Journal of anesthesia · Sep 1988
Effects of halothane and calcium entry blockers on atrioventricular conduction-a comparative study of verapamil, diltiazem, and nifedipine.
The effects of halothane on AV nodal function were evaluated in dogs with verapamil, diltiazem, or nifedipine during atrial pacing using the technique of His-bundle electrocardiography. Fifty-one mongrel dogs were divided into six groups. Anesthesia was induced with ketamine 100 mg im. and thiamylal 25 mg/kg iv. ⋯ There were more prolongations of these variables after iv administration of verapamil (SCL; 617 +/- 35, AH; 118 +/- 7, FRP of the AV node; 311 +/- 4) and diltiazem (SCL; 554 +/- 19, AH; 118 +/- 12, FRP of the AV node; 283 +/- 12) but no prolongations after nifedipine (SCL; 533 +/- 19, AH; 99 +/- 8, FRP of the AV node; 272 +/- 9). Comparing effects of calcium entry blockers with and without halothane in groups I and II, III and IV, or V and VI, there were additive depressing effects of halothane with either verapamil or diltiazem on AV nodal function. And there is a difference between the effects of nifedipine on SCL with and without halothane.
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Journal of anesthesia · Mar 1988
The effect of verapamil on halothane-epinephrine or digitalis-induced ventricular dysrhythmias in dogs.
The effect of verapamil on ventricular dysrhythmias was evaluated using two canine models. In one model, ventricular dysrhythmias were induced by 1% halothane-epinephrine (1.5 approximately 30 micro g/kg/min.) in 20 dogs (Group I). In the other model, ventricular dysrhythmias were induced by digoxin (0.1 approximately 0.2 mg/kg) in 27 dogs (Group II). ⋯ Lidocaine was ineffective in the remaining 4 of group I, whereas effective in the remaining 17, including those given lidocaine alone of group II. From these findings, it was inferred that Ca(2+) dependent abnormal automaticity and/or re-entry may be more closely related to the genesis of halothane-epinephrine-induced ventricular dysrhythmias refractory to lidocaine, whereas triggered activity may be more closely related to that of digitalis-induced ventricular dysrhythmias. In conclusion, verapamil was more effective against halothane-epinephrine-induced ventricular dysrhythmias than against digitalis-induced ventricular dysrhythmias.