Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · May 1989
Randomized Controlled Trial Comparative Study Clinical TrialSpontaneous recovery of residual neuromuscular blockade after atracurium or vecuronium during isoflurane anaesthesia.
With atracurium and vecuronium, spontaneous recovery of residual neuromuscular blockade monitored electromyographically during 0.5% isoflurane anaesthesia was studied in 60 patients undergoing plastic surgery. After thiopentone, in random order, either atracurium 0.5 mg kg-1 or vecuronium 0.1 mg kg-1 was administered and isoflurane added to N2O and O2 mixture. Following spontaneous recovery of both the single twitch amplitude (T1) to 75% of the control value and the train-of-four ratio (TOF ratio) to 75%, incremental doses of the relaxant were given to maintain the T1 at less than 10%. ⋯ The recovery time from T1 75% to TOF ratio 75%, indicating the recovery rate of residual neuromuscular blockade, with atracurium was about 15 min after both the initial and the second recoveries. With vecuronium, the respective recovery times were significantly (P less than 0.001) longer (25.6 min and 38.5 min, respectively). It is concluded that with vecuronium there is slower spontaneous recovery of residual neuromuscular blockade than with atracurium.
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Acta Anaesthesiol Scand · May 1989
Randomized Controlled Trial Comparative Study Clinical TrialIntravenous regional analgesia--a new modification.
A modification of the standard intravenous regional analgesia technique is described whereby excess local anaesthetic solution is removed from the veins of the isolated arm once analgesia has been established. This simple procedure was shown to reduce the incidence of oozing at the site of operation without affecting the quality of analgesia. Measurement of the quantity of local anaesthetic agent removed from the isolated arm 15 min after injection revealed that the amounts removed were small, indicating rapid uptake and binding in the tissues. This would imply that removal of excess local anaesthetic agent from the isolated arm after 15 min does not confer added safety as regards reducing the risk of leakage of agent into the general circulation in the event of cuff failure.
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Acta Anaesthesiol Scand · May 1989
EEG spectral power during halothane anaesthesia. A comparison of spectral bands in the monitoring of anaesthesia level.
The EEG of ten elective abdominal surgery patients was studied during halothane anaesthesia. The EEG was analysed by compressed spectral array. The total power and various power bands were analysed. ⋯ EEG analysis was performed from the data collected before induction and during anaesthesia at steady states of 1 MAC, 1.5 MAC, and 2 MAC. The correlation between deepening anaesthesia and power values was strongest in the 10-14 Hz band power and in the 18-32 Hz band power. This study confirms the usefulness of high frequency power in estimating the effect of halothane in patients.
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Acta Anaesthesiol Scand · May 1989
The influence of 0.5% isoflurane on a vecuronium-induced neuromuscular blockade.
The influence of adding 0.5% isoflurane to a narcotic-based anaesthesia on the duration of effect and recovery time after repetitive administration of vecuronium was studied in ten healthy patients. The twitch response in the adductor pollicis muscle was recorded after supramaximal train-of-four (TOF) stimulation of the ulnar nerve at the wrist. Prior to endotracheal intubation a bolus dose of vecuronium (0.08 mg/kg b.w.) was given. ⋯ Corresponding recovery times were 270 +/- 60 and 280 +/- 70 s (n.s.). Skin temperature remained unchanged and systolic blood pressure showed only minor variations. The addition of 0.5% isoflurane to a narcotic-based anaesthesia causes a moderate increase in duration of effect but no change in recovery time from a repetitive vecuronium-induced neuromuscular blockade of 0.02 mg/kg.
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Acta Anaesthesiol Scand · Apr 1989
Randomized Controlled Trial Comparative Study Clinical TrialIntravenous administration of isosorbide dinitrate attenuates the pressor response to laryngoscopy and tracheal intubation.
In order to evaluate the effect of isosorbide dinitrate (ISDN), administered as a bolus intravenous injection, on the circulatory response to tracheal intubation, mean arterial pressure (MAP), and heart rate (HR) in response to laryngoscopy for 30 s followed by tracheal intubation were compared in patients not receiving ISDN (control) and receiving 40 micrograms/kg or 80 micrograms/kg of ISDN 45 s before starting laryngoscopy. Each group consisted of 10 patients undergoing elective surgery. ⋯ HR increased to a similar extent in the three groups. These results indicate that a bolus injection of ISDN (80 micrograms/kg) is a simple, practical and highly effective means of attenuating the hypertensive response to direct laryngoscopy and tracheal intubation.