Acta anaesthesiologica Scandinavica
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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.
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Forty healthy, young volunteers received intravenously, in a double-blind and random fashion, 7.5 or 15 micrograms/kg of alfentanil, 1.5 or 3 micrograms/kg of fentanyl, or saline. The ventilatory response to CO2 was measured before and at 4, 20, 30, 50, 80, and 120 min post-treatment. Mental and psychomotor functions were measured before and at 10, 40, 100, 130, and 180 min post-treatment. ⋯ High-dose fentanyl caused more intense and prolonged mental effects than other treatments. Neither drug affected learning or recall, although high-dose fentanyl impaired motor activity. Nausea and vomiting rates were similar between high-dose alfentanil and low-dose fentanyl.
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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
Perivascular axillary block IV: blockade following 40, 50 or 60 ml of mepivacaine 1% with adrenaline.
Perivascular axillary blockade was performed on 90 patients with the aid of a catheter technique. The patients were randomly allocated to receive either 40, 50 or 60 ml of 1% mepivacaine with adrenaline 1:200,000. Blood concentrations of mepivacaine were measured up to 90 min after injection in seven, eight and ten of the patients from the three groups. ⋯ None of the 90 patients showed any signs of systemic toxic reactions. The mean peak values of blood concentrations were 0.5-1.0 microgram/ml higher in the groups given 50 ml and 60 ml than in the group given 40 ml. On the basis of the present and two previous investigations on the dose response in perivascular axillary blockade, a dose of 50 ml 1% mepivacaine with adrenaline or another equivalent drug with vasoconstrictor is recommended.