Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Feb 1986
Comparative StudyAtelectasis during anaesthesia and in the postoperative period.
Transverse sections of lung tissue were studied in patients by computerized tomography during anaesthesia and in the postoperative period. Eight patients were studied during intravenous (thiopentone) and six during inhalational (halothane) anaesthesia. The latter patients were studied during both spontaneous and mechanical ventilation. ⋯ The densities remained in nine of ten patients 1 h postoperatively, and they remained in five of ten patients 24 h after anaesthesia. The densities are considered to be compression atelectases which may develop as a result of relaxation of the diaphragm. They may be important contributors to postoperative pulmonary complications.
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Acta Anaesthesiol Scand · Feb 1986
Comparative StudyPharmacokinetics of physostigmine after intravenous, intramuscular and subcutaneous administration in surgical patients.
The pharmacokinetics of physostigmine after intravenous, intramuscular or subcutaneous administration as well as its arousal effect after anaesthesia have been studied in surgical patients in the early postoperative period. After intravenous administration physostigmine had a very rapid plasma elimination with a plasma clearance ranging from 47 to 163 l/h with a mean +/- s.d. of 92.5 +/- 37.7 l/h. The volume of distribution was 46.5 +/- 19.2 l, while distribution and plasma elimination half-lives were 2.3 and 22 min, respectively. ⋯ The duration of action was similar after intramuscular injection but onset was delayed by 20-30 min. It was concluded that a plasma concentration of 3-5 ng/ml of physostigmine should be exceeded if an adequate analeptic effect is to be achieved, meaning that 2 mg of physostigmine had to be administered subcutaneously in order to achieve a satisfactory reversal of sedation. The short duration of action may hamper the use of physostigmine as an agent for reversal of drug-induced sedation and anticholinergic effects after surgery.
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Acta Anaesthesiol Scand · Jan 1986
Randomized Controlled Trial Comparative Study Clinical TrialHemodynamic effects of metocurine during isoflurane anesthesia.
Anesthesia was induced in 42 adults with thiopentone 3-7 mg/kg i.v. and maintained with isoflurane at a constant inspired concentration of 1-2%. After 30 min of hemodynamic stabilization with continuous muscle relaxation and an absence of surgical stimulation, each patient was randomly assigned to one of four metocurine dosage groups: I - control (n = 11); II - 0.2 mg/kg (n = 10); III - 0.3 mg/kg (n = 10); and IV - 0.4 mg/kg (n = 11). ⋯ In Group IV, an increase of 24% in cardiac output was also significant (P less than 0.05). These results, especially in Group IV patients, stand in marked contrast to the lack of hemodynamic effects produced by metocurine during balanced anesthesia.
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Acta Anaesthesiol Scand · Jan 1986
Randomized Controlled Trial Comparative Study Clinical TrialThe effect of intranasally administered nitroglycerin on the blood pressure response to laryngoscopy and intubation in patients undergoing coronary artery by-pass surgery.
The effect of intranasally administered nitroglycerin (NTG) on the cardiovascular response to laryngoscopy and intubation was studied. Thirty patients scheduled to undergo coronary artery by-pass surgery under thiopentone, enflurane and pancuronium anaesthesia were randomly divided into three groups. Group I received lignocaine 1.5 mg/kg i.v. prior to laryngoscopy and intubation (control group). ⋯ In Group I laryngoscopy and intubation caused a significant increase in mean arterial pressure (MAP) (P less than 0.01), heart rate (HR) (P less than 0.01) and rate pressure product (RPP) (P less than 0.01) compared to preoxygenation values. In Group II and III MAP and RPP remained unchanged, whereas HR increased (P less than 0.01 and P less than 0.01 respectively). It can be concluded that intranasally administered NTG effectively attenuates the pressor response to laryngoscopy and intubation in patients presenting for coronary artery by-pass surgery and that it is more effective and convenient method than intravenous lignocaine.
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Acta Anaesthesiol Scand · Jan 1986
Comparative StudyAnaesthesia for colonoscopy. An examination of the anaesthesia as an element of risk at colonoscopy.
The importance of anaesthesia as an element of risk at colonoscopy has been examined retrospectively over a 10-year period from 1975 to 1984. The colonoscopic examinations were made by surgical gastroenterologists and anaesthesiologists working in cooperation. In 1242 cases the patients received diazepam/fentanyl anaesthesia during the colonoscopy (Group I) and in 126 cases they received general anaesthesia (Group II). ⋯ The dosing in the patients in Group I averaged: diazepam as premedication 9.2 mg, intravenous diazepam 12.4 mg, intravenous fentanyl 0.14 mg, and the duration of the colonoscopy was 36.5 min. The medication and the duration of the colonoscopy did not vary significantly in the patients with perforation of the large bowel. Our conclusion is that diazepam/fentanyl anaesthesia, administered by experienced staff, is harmless, and that general anaesthesia for colonoscopy did not involve an increased risk of perforation of the large bowel.