Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Apr 1986
Randomized Controlled Trial Clinical TrialComparative effects of intrathecal bupivacaine and tetracaine on analgesia, cardiovascular function and plasma catecholamines.
Forty otherwise healthy male patients, scheduled for elective inguinal herniotomy, were randomly allocated to spinal anaesthesia with 3 ml 0.5% hyperbaric tetracaine or bupivacaine under double-blind conditions. The extent of blockade (pin-prick and cold sensation), blood pressure and heart rate and plasma catecholamines were measured before and 5, 10, 15, 20 and 30 min after injection, before skin incision. Cephalad spread of sensory and temperature analgesia was insignificantly higher after tetracaine. ⋯ Plasma norepinephrine and epinephrine measurements before spinal puncture and at maximal decrease in mean arterial pressure showed a depressed response to fall in blood pressure in the tetracaine group. It is concluded that spinal anaesthesia with 3 ml hyperbaric 0.5% tetracaine is followed by a more pronounced fall in blood pressure compared to an identical dose of bupivacaine. The more pronounced sympathetic blockade, confirmed by plasma catecholamine measurements, following tetracaine is probably due to a higher cephalad spread of neurogenic blockade, rather than a differential effect on sympathetic nerve fibres.
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Acta Anaesthesiol Scand · Apr 1986
A study of halothane-diethyl ether azeotrope and the Oxford miniature vaporizer.
The performances of an Oxford miniature vaporizer (OMV) and a Fluotec Mark III vaporizer filled with an azeotropic mixture of halothane and diethyl ether were studied. Gas concentrations were estimated using an EMMA gas analyser and a MIRAN spectrophotometer. Calibration tables for both vaporizers were derived. In a small clinical series with air as the carrier gas, to which a small amount of oxygen was added, the azeotrope was found to be a satisfactory anaesthetic agent, giving a short awakening time and an almost pain-free postoperative course.
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Acta Anaesthesiol Scand · Apr 1986
Densities in dependent lung regions during anaesthesia: atelectasis or fluid accumulation?
In previous studied with computed tomography (CT) prior to and during general anaesthesia, we found that densities developed in dependent parts of the lungs immediately after induction of anaesthesia in all examined patients. It was suggested that the densities were atelectases created by compression of lung tissue but an alternative explanation could be accumulation of extravascular fluid in the lung tissue and/or in the pleural space. In the present study the nature of the densities was analysed in further detail. ⋯ The transit time of the contrast medium was of the same magnitude in the densities and the major lung vessels. This indicates that there were no regions with an increased amount of extravascular fluid to delay the contrast passage. These findings oppose the idea of fluid accumulation as the cause of the densities, while atelectasis remains the most plausible explanation.
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Acta Anaesthesiol Scand · Apr 1986
Case ReportsMalignant hyperthermia: clinical course and metabolic changes in two patients.
Two cases of malignant hyperthermia (MH) are presented. One patient was treated symptomatically for the first 6 h until she was given dantrolene. Her clinical course was complicated and the catecholamine and cortisol concentrations were still elevated 24 h after start of treatment. ⋯ However, in spite of the early successful treatment with dantrolene the MH reaction recurred 12 h after the initial symptoms. These two cases demonstrate the importance of early treatment including dantrolene. Successful treatment with dantrolene does not, however, preclude a recurrence of MH, and thus subsequent doses of dantrolene should be given.