Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Apr 1984
Effects of venous air embolism on the cardiovascular system and acid base balance in the presence and absence of nitrous oxide.
Cardiovascular responses and acid-base changes with graded volumes of intravenously injected air were measured in dogs anesthesized with pentobarbital and either 100% oxygen or 50% oxygen and nitrous oxide. Mean arterial blood pressure decreased significantly with 2.5 ml of air/kg in the oxygen group and at all volumes in the nitrous oxide group. The volume of air embolus appeared to increase more than twice in the presence of 50% nitrous oxide. ⋯ Right atrial pressure increased while left atrial pressure decreased significantly in both groups. With injected volumes of 2.0 and 2.5 ml or air/kg, right atrial pressure exceeded left atrial pressure creating the potential of paradoxical air embolism. The pH and PaO2 decreased while PaCO2 increased significantly during air embolization.
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Acta Anaesthesiol Scand · Apr 1984
Case ReportsBradycardia and cardiac asystole following a single injection of suxamethonium.
Twenty cases of severe bradycardia, including 12 cases of cardiac asystole, following administration of a single dose of suxamethonium to 17 adult patients are presented. Treatment consisted of i.v. atropine in 16 cases, and in four cases external cardiac massage or a precordial thump was also given. ⋯ The mechanism is not known, but it is suggested that i.v. administration of fentanyl at induction may enhance the tendency to bradycardia following suxamethonium. Absence of preoperative atropine may also be of importance.
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Acta Anaesthesiol Scand · Feb 1984
Comparative StudyCatecholamine and endocrine response in children during halothane and enflurane anaesthesia for adenoidectomy.
In 28 children undergoing adenoidectomy, plasma concentrations of catecholamines, ACTH and cortisol were measured. Fourteen children were anaesthetized with halothane (seven non-intubated, seven intubated) and 14 with enflurane (seven non-intubated, seven intubated). During undisturbed anaesthesia, plasma catecholamines were significantly higher with halothane than with enflurane (P less than 0.05). ⋯ It was concluded that plasma catecholamines were higher during halothane than during enflurane anaesthesia in children undergoing adenoidectomy. This difference may be caused by a stimulating effect of halothane on the endogenous catecholamine release. This increased sympathomimetic response during halothane anaesthesia was correlated to the incidence of ventricular arrhythmias previously found with this agent during adenoidectomy.
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Forty healthy, young volunteers received intravenously, in a double-blind and random fashion, 7.5 or 15 micrograms/kg of alfentanil, 1.5 or 3 micrograms/kg of fentanyl, or saline. The ventilatory response to CO2 was measured before and at 4, 20, 30, 50, 80, and 120 min post-treatment. Mental and psychomotor functions were measured before and at 10, 40, 100, 130, and 180 min post-treatment. ⋯ High-dose fentanyl caused more intense and prolonged mental effects than other treatments. Neither drug affected learning or recall, although high-dose fentanyl impaired motor activity. Nausea and vomiting rates were similar between high-dose alfentanil and low-dose fentanyl.
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Acta Anaesthesiol Scand · Feb 1984
Caudal anaesthesia for upper abdominal surgery in infants and children: a simple calculation of the volume of local anaesthetic.
Where the use of non-depolarizing muscle relaxants and antagonists is undesirable in infants and children undergoing abdominal surgery, caudal anaesthesia is frequently adopted, combined with light general anaesthesia. A simple calculation has been derived to determine the volume of local anaesthetic needed to obtain a higher effective anaesthetic level (up to T4-5) for upper abdominal operations using caudal anaesthesia. ⋯ A similar relationship was also demonstrated radiographically in 16 cadavers by studying the spread of radio-opaque solution in the epidural space introduced by the caudal technique. From both statistical studies, a simple formula to determine the required volume of local anaesthetic for upper abdominal surgery was derived: V = D-13, where V is the volume of local anaesthetic in ml and D is the distance from C7 to the sacral hiatus in cm.