Acta anaesthesiologica Scandinavica
-
Acta Anaesthesiol Scand · Jan 1986
Randomized Controlled Trial Comparative Study Clinical TrialHemodynamic effects of metocurine during isoflurane anesthesia.
Anesthesia was induced in 42 adults with thiopentone 3-7 mg/kg i.v. and maintained with isoflurane at a constant inspired concentration of 1-2%. After 30 min of hemodynamic stabilization with continuous muscle relaxation and an absence of surgical stimulation, each patient was randomly assigned to one of four metocurine dosage groups: I - control (n = 11); II - 0.2 mg/kg (n = 10); III - 0.3 mg/kg (n = 10); and IV - 0.4 mg/kg (n = 11). ⋯ In Group IV, an increase of 24% in cardiac output was also significant (P less than 0.05). These results, especially in Group IV patients, stand in marked contrast to the lack of hemodynamic effects produced by metocurine during balanced anesthesia.
-
Acta Anaesthesiol Scand · Jan 1986
Randomized Controlled Trial Comparative Study Clinical TrialThe effect of intranasally administered nitroglycerin on the blood pressure response to laryngoscopy and intubation in patients undergoing coronary artery by-pass surgery.
The effect of intranasally administered nitroglycerin (NTG) on the cardiovascular response to laryngoscopy and intubation was studied. Thirty patients scheduled to undergo coronary artery by-pass surgery under thiopentone, enflurane and pancuronium anaesthesia were randomly divided into three groups. Group I received lignocaine 1.5 mg/kg i.v. prior to laryngoscopy and intubation (control group). ⋯ In Group I laryngoscopy and intubation caused a significant increase in mean arterial pressure (MAP) (P less than 0.01), heart rate (HR) (P less than 0.01) and rate pressure product (RPP) (P less than 0.01) compared to preoxygenation values. In Group II and III MAP and RPP remained unchanged, whereas HR increased (P less than 0.01 and P less than 0.01 respectively). It can be concluded that intranasally administered NTG effectively attenuates the pressor response to laryngoscopy and intubation in patients presenting for coronary artery by-pass surgery and that it is more effective and convenient method than intravenous lignocaine.
-
Acta Anaesthesiol Scand · Jan 1986
Comparative StudyAnaesthesia for colonoscopy. An examination of the anaesthesia as an element of risk at colonoscopy.
The importance of anaesthesia as an element of risk at colonoscopy has been examined retrospectively over a 10-year period from 1975 to 1984. The colonoscopic examinations were made by surgical gastroenterologists and anaesthesiologists working in cooperation. In 1242 cases the patients received diazepam/fentanyl anaesthesia during the colonoscopy (Group I) and in 126 cases they received general anaesthesia (Group II). ⋯ The dosing in the patients in Group I averaged: diazepam as premedication 9.2 mg, intravenous diazepam 12.4 mg, intravenous fentanyl 0.14 mg, and the duration of the colonoscopy was 36.5 min. The medication and the duration of the colonoscopy did not vary significantly in the patients with perforation of the large bowel. Our conclusion is that diazepam/fentanyl anaesthesia, administered by experienced staff, is harmless, and that general anaesthesia for colonoscopy did not involve an increased risk of perforation of the large bowel.
-
Peripheral airway pressure (Pp) was measured during high frequency ventilation (HFV) (open system) (1-20 Hz) by retrograde catheters in eight excised dog lungs. Central airway pressure (Pc) and pleural pressure (Ppl) were measured simultaneously. ⋯ With increasing tidal volume Pc, Pp, and Ppl (mean) increased at all frequencies. The increase in end-expiratory pressure indicates an "auto-PEEP" effect, which may contribute to the better gas exchange described during HFV.
-
Acta Anaesthesiol Scand · Jan 1986
Perivascular axillary block VI: the distribution of gelatine solution injected into the axillary neurovascular sheath of cadavers.
Axillary perivascular injection of 50 ml blue-stained gelatine was made in 20 cadavers, and a total dissection of the axilla was performed. The distribution of injected gelatine and the contact between nerves and gelatine were examined on cross-sections of the neurovascular bundle. The spread of gelatine was characterized by: restriction of gelatine to the neurovascular bundle, an upper border of the gelatine which was constantly found to be proximal to the coracoid process, and bulging of the gelatine towards the medial part of the axillary space. ⋯ The median and the ulnar nerves were in all dissections found to be in direct contact with the gelatine, whereas the radial, the musculocutaneous, and the axillary nerves did not always have direct contact with the gelatine. Abduction of the arm to 90 degrees brings the stretched neurovascular bundle close to the lateral wall of the axilla and this compromises perivascular circumferential spread of the injected gelatine. On the basis of the present investigation, it is hypothesized that insufficient circumferential spread is the cause of incomplete axillary blockades, and the perivascular injection of local anaesthetic should consequently be made with the arm along the side of the body.