Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Feb 1997
Randomized Controlled Trial Clinical TrialMetoclopramide reduces the induction dose of propofol.
Metoclopramide has been shown to reduce the dose of thiopentone required for induction of anaesthesia. When propofol is used, there have been conflicting results with one small study showing a reduction in the anaesthetic dose and one study failing to demonstrate any effect. ⋯ The mechanism of reduction of propofol dose by metoclopramide is unknown; it may involve GABA or result from a more complex interaction involving dopamine blockade by metoclopramide.
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Acta Anaesthesiol Scand · Feb 1997
Intravenous induction of general anaesthesia with eltanolone in children 6-15 years of age.
Eltanolone is a short-acting intravenous anaesthetic, formulated as an oil-water emulsion. The aim of the present study was to estimate the anaesthetic dose (ED50) for induction in children 6-10 and 11-15 years of age and to collect safety data. ⋯ The ED50 of eltanolone for induction of anaesthesia in unpremedicated children 6-10 years of age was 0.68 mg/kg and in children 11-15 years of age 0.53 mg/kg. The findings suggest that an induction dose for children 6-15 years of age of about 1 mg/kg would be adequate in most cases. No serious adverse events were recorded. However, the drug has subsequently been withdrawn from further investigation due to an unacceptable incidence of rash and urticaria.
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Acta Anaesthesiol Scand · Feb 1997
Hemodilution significantly decreases tolerance to isoflurane-induced cardiovascular depression.
Hemodilution is used to reduce the need for allogenic blood transfusion. The aim of this study was to evaluate to what extent acute extreme normovolemic hemodilution affects the circulatory response to isoflurane. ⋯ isoflurane-induced cardiovascular depression had adverse effects on cardiac output and oxygen delivery during extreme hemodilution because: 1) The vasodilatory effect of isoflurane was insufficient to compensate for the myocardial depression, and also contributed to a critically low arterial blood pressure; 2) A decrease in cardiac output produced delivery-dependent oxygen consumption and hyperlactemia; and 3) A decrease in myocardial blood flow caused myocardial ischemia which may have exacerbated the myocardial depression.
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Acta Anaesthesiol Scand · Feb 1997
Comparative StudyThe detection of carbon dioxide embolism during laparoscopy in pigs: a comparison of transesophageal Doppler and end-tidal carbon dioxide monitoring.
The aim of the study was to compare the value of transesophageal Doppler and end-tidal carbon dioxide monitoring to detect venous carbon dioxide embolism in pigs during laparoscopic cholecystectomy. ⋯ During laparoscopic cholecystectomy in pigs, transesophageal Doppler was a highly sensitive monitor which provided an earlier detection of CO2 embolism and at lower doses than end-tidal CO2 monitoring.
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Acta Anaesthesiol Scand · Feb 1997
Wound infiltration with liposomal bupivacaine prolongs analgesia in rats.
Wound infiltration with local anesthetics does not reliably produce satisfactory postoperative analgesia, and the dose of local anesthetic which may be safely administered is limited by the potential for systemic toxicity. This study evaluated the efficacy of a slow-release liposomal bupivacaine formulation on duration of wound analgesia. ⋯ The 8-fold increase in duration of wound analgesia and the lower plasma levels seen with the liposomal formulation are explained by gradual drug release from the liposomal depot. These results may have important implications for achieving safe and effective analgesia with wound infiltration techniques in humans.