Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jul 1985
Comparative StudyEdrophonium and neostigmine for reversal of the neuromuscular blocking effect of vecuronium.
The effect of edrophonium for reversal of the non-depolarizing neuromuscular blockade produced by a continuous infusion of vecuronium was compared to that of neostigmine in 20 adult patients during neurolept anaesthesia. When antagonism was attempted at 10% twitch height recovery, reversal time to a train-of-four ratio of 0.7 was significantly shorter following neostigmine 0.04 mg/kg than after edrophonium 0.75 mg/kg (9.8 min and 18.7 min, respectively) but the same after edrophonium 1.5 mg/kg (10.3 min). There was no statistically significant difference in reversal time between neostigmine 0.04 mg/kg given at 10% twitch height and edrophonium 0.75 mg/kg given at 25% twitch height recovery (6.0 min). Additional doses of atropine were necessary following edrophonium 1.5 mg/kg.
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Acta Anaesthesiol Scand · Jul 1985
Comparative StudyEtomidate infusion and adrenocortical function. A study in elective surgery.
The adrenocortical response to a short tetracosactrin (Synacthen) test was studied in 11 patients receiving either etomidate infusion or thiopentone infusion used to maintain anaesthesia for abdominal hysterectomy. Pethidine was used as the narcotic component. ⋯ No suppression was found in patients receiving thiopentone infusion. It is concluded that etomidate cannot be recommended for routine induction and maintenance of anaesthesia.
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Acta Anaesthesiol Scand · Jul 1985
Etomidate anesthesia inhibits the cortisol response to surgical stress.
Plasma cortisol was measured in 18 patients undergoing gynecological procedures under etomidate or methohexital and nitrous oxide anesthesia. Plasma ACTH was also measured in three patients in each group. The mean plasma cortisol concentration before anesthesia was comparable in both groups. ⋯ The increase in plasma ACTH was equivalent in the two groups. Therefore, etomidate is a potent inhibitor of the adrenal response to surgery. The absence of clinical consequences associated with the blunted response suggests that a major increase in adrenal hormone production may not be necessary during surgery.
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Acta Anaesthesiol Scand · Jul 1985
Multiple intercostal blocks by a single injection? A clinical and radiological investigation.
Three different techniques for producing multiple intercostal nerve blocks using bupivacaine were compared in volunteers. The techniques used were multiple injections at intercostal nerves 7-11, or a single injection employing a needle or a catheter inserted in the 9th intercostal space. The injections were made at the costal angle. ⋯ The distribution of cutaneous analgesia was limited to three segments or less following a single injection. No difference in blood levels of bupivacaine could be found. It is concluded that the single injection technique of producing multiple intercostal nerve blocks is inferior to the multiple injection technique.
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The currently available methods for local anaesthetic block of the sciatic nerve are difficult to perform. Here we describe a new and easier technique for the block. ⋯ The technique was found to be safe and effective in over 100 cases. It can be learnt quickly and is easily remembered.