Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jul 2002
Electrophysiologic cardiac effects of the new local anesthetic IQB-9302 and of bupivacaine in the anesthetised dog.
Local anesthetics are not free from potentially fatal complications. Therefore every new local anesthetic should be tested to demonstrate a lower, or at least similar, degree of toxicity over clinically used analogs. Most toxic effects from local anesthetics affect the cardiac electrophysiologic function, so the aim of this study was to characterize the electrophysiologic effects of a new long-acting local anesthetic (IQB-9302, Ciprocaine), and compare them with those of bupivacaine in the anesthetized dog. ⋯ IQB-9302 has hemodynamic and cardiac electrophysiologic effects similar to those caused by bupivacaine. Nevertheless, slightly less toxic effects were derived from IQB-9302 administration than with bupivacaine, and, unlike the latter, the former might be less proarrhytmogenic. The new long-acting local anesthetic IQB-9302 may offer clinical advantages compared with bupivacaine.
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Acta Anaesthesiol Scand · Jul 2002
Randomized Controlled Trial Clinical TrialIntraocular pressure more reduced during anesthesia with propofol than with sevoflurane: both combined with remifentanil.
Short-acting anesthetic agents are suitable and commonly used in ocular surgery. Propofol and remifentanil are known to reduce intraocular pressure (IOP), but no information is available regarding the effects of sevoflurane combined with remifentanil on IOP. ⋯ In patients undergoing cataract surgery under general anesthesia with tracheal intubation, anesthetic regimens with propofol as well as with sevoflurane, both combined with remifentanil, decrease IOP significantly. The decrease in IOP was significantly more pronounced in the propofol group than in the sevoflurane group.
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Acta Anaesthesiol Scand · Jul 2002
Clinical Trial Controlled Clinical TrialPharmacokinetics and pharmacodynamics of mivacurium in young adult and elderly patients.
Mivacurium is hydrolyzed by plasma cholinesterase, and is therefore less dependent on liver metabolism and renal elimination than other neuromuscular blocking drugs. This might favor the use of mivacurium in elderly patients. The purpose of this study was to compare the pharmacodynamics and the pharmacokinetics of the three isomers of mivacurium and their metabolites in young adult and elderly patients. ⋯ There were no significant differences in the potency or infusion requirements between the adult and elderly patients, but the rate of recovery was significantly, though only moderately prolonged, in the elderly patients. No significant difference in clearance was seen but the elimination half-lives of the metabolites was longer in the elderly patients.
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Acta Anaesthesiol Scand · Jul 2002
Case ReportsEpidural blood patch for treatment of spontaneous intracranial hypotension.
Spontaneous intracranial hypotension is an uncommon disease caused by cerebrospinal fluid leakage. We reported a case of a 42-year-old male with postural headache who was diagnosed as having spontaneous intracranial hypotension. ⋯ Because cerebrospinal fluid drops from the catheter, it is useful to identify the location of the catheter tip under contrast injection X-ray. Rapid and dramatic relief from the headache was obtained, and no serious complications occurred.
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Acta Anaesthesiol Scand · Jul 2002
Clinical TrialEpidural buprenorphine in management of pain in multiple rib fractures.
Pain from multiple rib fractures may affect pulmonary function, morbidity, and length of stay in the intensive care units. This study describes some clinical characteristics of epidural buprenorphine, a lipophilic and partial opiate agonist with a higher micro receptor affinity than morphine, in combating the pain in multiple rib fractures. ⋯ Epidurally introduced narcotic, like buprenorphine in saline, has been found to be effective in our study to achieve adequate analgesia in treatment of patients with multiple rib fractures. In addition, this methodology of pain relief eliminates the costly delivery system and early discharge, and allows walking epidurals and follow-up on outpatient basis.