Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · May 1985
Comparative StudyVecuronium and atracurium in the elderly: a clinical comparison with pancuronium.
The intubating conditions, time to complete block and duration of clinical relaxation were observed in a group of 101 elderly patients (aged over 65 years) following pancuronium 0.1 mg kg-1, vecuronium 0.1 mg kg-1 or atracurium 0.5 mg kg-1. The intubating conditions in the three groups were similar when assessed at 2 min following relaxant administration. The time to complete block was shortest with vecuronium (4.3 min) in comparison to atracurium (5.0 min) and pancuronium (6.0 min), but the differences were not statistically significant. The duration of clinical relaxation, however, was significantly shorter with vecuronium (37 min) and atracurium (35 min) in comparison to pancuronium (99 min).
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The Venturi circuit was studied with regard to CO2 elimination in a model experiment. A mean concentration of 0.6% CO2 in the fresh gas supply to the patient was accepted. The experiments demonstrated that a soda-lime charge of 200 g will cover the elimination requirements of CO2 in a Venturi circuit for any patient below 100 kg b.w. for a period of 3 h, while a soda-lime charge of 300 g will suffice for 5 h. ⋯ In the Venturi circuit, the size of the soda-lime charge can be adjusted to suit the body weight of the patient and the expected length of the anaesthetic procedure. One soda-lime charge for each anaesthetic procedure is preferable from the point of view of hygiene. The charge should not be less than 200 g.
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Acta Anaesthesiol Scand · Apr 1985
Hypoxic pulmonary vasoconstriction in the human lung: the effect of prolonged unilateral hypoxic challenge during anaesthesia.
The influence of time on the pulmonary vasoconstrictor response to hypoxia was studied in six subjects during general anaesthesia and artificial ventilation prior to elective surgery. The lungs were intubated separately with a double-lumen bronchial catheter. After preoxygenation of both lungs for 30 min, the test lung was rendered hypoxic for 60 min by ventilation with 5% O2 in N2, with the control lung still being ventilated with 100% O2. ⋯ Prolonging the unilateral hypoxic challenge caused no further change in the redistribution of the pulmonary blood flow, but cardiac output and pulmonary artery mean pressure continued to increase to 40%-50% above control values after 1 h of hypoxia. The PVR of the test lung remained unchanged. The findings suggest that there is an immediate vasoconstrictor response to hypoxia in the human lung and that there is no further potentiation or diminution, of the response during a 60-min period of hypoxia.
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The use of regional anaesthesia in paediatric surgery remains controversial although the pharmacological and technical aspects, even in this age group, have been described. Many authors regard regional anaesthesia as contra-indicated, and consequently general anaesthesia is preferred in paediatric surgery. ⋯ Surgically excellent or satisfactory analgesia was achieved in 92-100% of the blocks. No complications were observed.