Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Feb 1984
In vivo induced malignant hyperthermia in pigs. I. Physiological and biochemical changes and the influence of dantrolene sodium.
The effects of an induced malignant hyperthermia (MH) crisis have been studied in the intact pig. Both physiological and biochemical changes in skeletal muscle were studied. MH was induced with 3% halothane plus a bolus injection of succinylcholine. ⋯ The earliest physiological change during an induced MH crisis in our study was the rapid increase of the end-tidal CO2. Within 5 min after MH induction, end-tidal CO2 was doubled. It is concluded that the monitoring of the end-tidal CO2 is essential to diagnose MH at a very early stage.
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Acta Anaesthesiol Scand · Feb 1984
Caudal anaesthesia for upper abdominal surgery in infants and children: a simple calculation of the volume of local anaesthetic.
Where the use of non-depolarizing muscle relaxants and antagonists is undesirable in infants and children undergoing abdominal surgery, caudal anaesthesia is frequently adopted, combined with light general anaesthesia. A simple calculation has been derived to determine the volume of local anaesthetic needed to obtain a higher effective anaesthetic level (up to T4-5) for upper abdominal operations using caudal anaesthesia. ⋯ A similar relationship was also demonstrated radiographically in 16 cadavers by studying the spread of radio-opaque solution in the epidural space introduced by the caudal technique. From both statistical studies, a simple formula to determine the required volume of local anaesthetic for upper abdominal surgery was derived: V = D-13, where V is the volume of local anaesthetic in ml and D is the distance from C7 to the sacral hiatus in cm.
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Acta Anaesthesiol Scand · Feb 1984
Comparative StudyComparison of some postanaesthetic effects of atropine and glycopyrrolate with particular emphasis on urinary problems.
Two hundred and two patients undergoing elective surgery were given either atropine (98 patients) or glycopyrrolate (104 patients) for intravenous premedication and as an adjunct to reversal of neuromuscular block by neostigmine in a double-blind study. The dose ratio of atropine and glycopyrrolate was 2.5:1. After reversal, both drugs induced an initial increase and a subsequent decrease in heart rate. ⋯ Nausea and vomiting were equally common after both drugs. There were no differences between the drugs in the occurrence of postoperative micturition difficulties, the total rate of this complication being 18%. It is concluded that factors other than the choice of anticholinergic drug may be blamed for postoperative micturition difficulties.
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Acta Anaesthesiol Scand · Feb 1984
Metabolic correlates in infants and children during anaesthesia and surgery.
In 58 infants and children with body weights between 2.8 and 20.5 kg carbon dioxide production (VCO2 ml min-1) was measured during halothane anaesthesia for minor surgical procedures. In 22 cases measurements were made during both spontaneous and controlled ventilation during the same operation. A non-rebreathing circuit was used. ⋯ The mean value (+/- 1 s.d.) for VCO2 was 11.4 +/- 3.1 ml kg-3/4 and for VO2 14.2 +/- 3.9 ml kg-3/4. During controlled ventilation, the relationship between kg b.w. showed for VCO2 as well as for VO2 an almost direct proportionality with a mean value (+/- 1 s.d.) for VCO2 of 6.3 +/- 1.6 ml min-1 kg-1 and for VO2 of 7.8 +/- 2.0 ml min-1 kg-1. Prediction of VO2 for infants and children of this size could be based upon 14 X kg3/4 during halothane anaesthesia and surgery.
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Acta Anaesthesiol Scand · Feb 1984
Comparative StudyCatecholamine and endocrine response in children during halothane and enflurane anaesthesia for adenoidectomy.
In 28 children undergoing adenoidectomy, plasma concentrations of catecholamines, ACTH and cortisol were measured. Fourteen children were anaesthetized with halothane (seven non-intubated, seven intubated) and 14 with enflurane (seven non-intubated, seven intubated). During undisturbed anaesthesia, plasma catecholamines were significantly higher with halothane than with enflurane (P less than 0.05). ⋯ It was concluded that plasma catecholamines were higher during halothane than during enflurane anaesthesia in children undergoing adenoidectomy. This difference may be caused by a stimulating effect of halothane on the endogenous catecholamine release. This increased sympathomimetic response during halothane anaesthesia was correlated to the incidence of ventricular arrhythmias previously found with this agent during adenoidectomy.