Acta anaesthesiologica Scandinavica
-
Acta Anaesthesiol Scand · Aug 1988
Randomized Controlled Trial Clinical TrialNeostigmine and edrophonium as antagonists of atracurium and pancuronium.
Edrophonium 0.5 mg/kg or neostigmine 0.04 mg/kg were administered to two groups of 30 patients each for antagonism of atracurium- or pancuronium-induced neuromuscular block at 25% single twitch recovery. Neuromuscular block was studied using both single twitch and train-of-four (TOF) nerve stimulation. The times to 100% single twitch recovery were significantly more rapid for patients receiving edrophonium (P less than 0.01) in both groups (atracurium and pancuronium); the TOF ratios were similar for atracurium, but for pancuronium they were greater after neostigmine than after edrophonium, and only at 25 min were these ratios similar. It is concluded that edrophonium in a dose of 0.5 mg/kg antagonizes neuromuscular blockade induced by atracurium, as does neostigmine in a dose of 0.04 mg/kg, but the former does not consistently antagonize neuromuscular blockade induced by pancuronium even at 25% of single twitch recovery.
-
Acta Anaesthesiol Scand · Jul 1988
Randomized Controlled Trial Clinical TrialEffect of total intravenous anaesthesia with midazolam/alfentanil on the adrenocortical and hyperglycaemic response to abdominal surgery.
The effect of anaesthesia on the hyperglycaemic and adrenocortical response induced by surgery was studied in patients undergoing abdominal hysterectomy. The study group was anaesthetized with midazolam and alfentanil using a totally intravenous anaesthetic technique. A reference group received anaesthesia with thiopentone, alfentanil and nitrous oxide. ⋯ During surgery they returned to pre-induction values, and in the postoperative period they increased to about twice the pre-induction values. It is concluded that midazolam/alfentanil anaesthesia is as effective as anaesthesia induced by thiopentone, alfentanil and nitrous oxide in suppressing the stress-response to surgery until the postoperative period. No signs of prolonged adrenocortical depression were observed.
-
Acta Anaesthesiol Scand · Jul 1988
Case ReportsSuccessful treatment of dural puncture headache with epidural saline infusion after failure of epidural blood patch. Case report.
A case is presented of a 30-year-old female with a 4-month history of post-lumbar puncture headache (PLPHA) resulting from an accidental dural puncture during an attempted epidural anesthetic for cesarean section. Epidural blood patches were attempted at 4 days and 3 months post-lumbar puncture, but were unsuccessful. ⋯ Follow-up to 4 months showed no return of the PLPHA. The rationale for epidural blood and saline patches is discussed.
-
Acta Anaesthesiol Scand · Jul 1988
Randomized Controlled Trial Comparative Study Clinical TrialThe cardiovascular effects of anticholinergic agents administered during halothane anaesthesia in children.
The cardiovascular effects of anticholinergic agents administered during halothane anaesthesia were studied in 31 children aged 1-12 years undergoing peripheral orthopaedic surgery. Either normal saline, glycopyrrolate (10 micrograms.kg-1) or atropine (20 micrograms.kg-1) was administered in randomized double-blind fashion during the induction of anaesthesia with halothane while the electrocardiogram was continuously recorded. After induction, the children were paralyzed with atracurium, intubated, and ventilated. ⋯ Junctional rhythm occurred in 74% (14/19) of the children with dysrhythmias, developed early during induction (mean +/- s.d. time = 2.29 +/- 2.0 min after commencement of induction), and usually resolved before the administration of the study drug (8/14). All dysrhythmias initially occurred before or during induction and none developed during intubation, during incision, during the maintenance of anaesthesia, or after the administration of anticholinergic agents. The data suggest that: 1) a combination of factors present during halothane induction is highly dysrhythmogenic especially for junctional rhythm; 2) junctional rhythm will resolve spontaneously; 3) the administration of an anticholinergic agent during halothane induction is safe but may be unnecessary in children greater than 1 year of age; and 4) the dysrhythmogenic factors present during induction are attenuated during the maintenance of halothane anaesthesia.
-
Acta Anaesthesiol Scand · May 1988
Comparative StudyComparison between a new acceleration transducer and a conventional force transducer in the evaluation of twitch responses.
An acceleration transducer elicits an output voltage proportional to the deformation of the piezo crystal, in accordance with the twitch responses of the applied fingers. The reliability of such a transducer was evaluated by comparing induced twitch responses with those from a force transducer applied on the contralateral arm of an individual during neuromuscular block with vecuronium. ⋯ Also, the twitch heights due to acceleration of the examined thumb correlated extremely well with the twitch height due to twitch tension with the force transducer. It is concluded that the acceleration transducer may be a useful and reliable device for monitoring neuromuscular block, although responses during tetanic stimulation such as tetanic fade cannot be determined by the transducer.