Acta anaesthesiologica Scandinavica
-
Acta Anaesthesiol Scand · Jul 2000
The dissociation of sedative from spinal antinociceptive effects following administration of a novel alpha-2-adrenoceptor agonist, MPV-2426, in the locus coeruleus in the rat.
MPV-2426 is a novel alpha-2-adrenoceptor agonist developed for spinal pain therapy. In the present study we characterized its sedative and antinociceptive properties following microinjections into the brainstem and intrathecally at the lumbar spinal cord level. ⋯ The results indicate that the sedative potency of MPV-2426 is considerably weaker than that of dexmedetomidine. Additionally, the spread of MPV-2426 within the central nervous system is more limited than that of dexmedetomidine. This could explain why MPV-2426 is sedative only when injected into the LC while antinociceptive effect is obtained when it is injected intrathecally at the lumbar spinal cord level.
-
Acta Anaesthesiol Scand · Jul 2000
Marked enhancement of anti-allodynic effect by combined intrathecal administration of the adenosine A1-receptor agonist R-phenylisopropyladenosine and morphine in a rat model of central pain.
There is often no satisfactory treatment for chronic pain after spinal cord injury. We have previously reported that intrathecal (i.t.) administration of the adenosine A1-receptor agonist R-phenylisopropyl-adenosine (R-PIA) or the opioid morphine has anti-allodynic effects in a model of presumed chronic central pain after photochemically induced spinal cord injury in rats. In the present study, we set out to investigate the possible interaction between i.t. R-PIA and morphine in spinally injured rats. ⋯ These results demonstrate a supra-additive interaction between the adenosine A1-receptor agonist R-PIA and morphine to reduce mechanical allodynia-like behavior in rats with chronic spinal cord injury. The combination of R-PIA and morphine administered spinally may be superior to R-PIA or morphine alone for treating such pain.
-
Acta Anaesthesiol Scand · May 2000
Case ReportsTwo instances of central nervous system toxicity in the same patient following repeated ropivacaine-induced brachial plexus block.
We describe two instances of central nervous system (CNS) toxicity in the same patient following repeated brachial plexus blocks induced by high doses of ropivacaine (6 mg x kg(-1) and 4.5 mg x kg(-1), respectively). Although very high total and free plasma concentrations of ropivacaine were found up to 98 min after induction of the blocks, no signs of cardiovascular toxicity apart from hypertension and sinus tachycardia were observed. ⋯ These high doses, however, resulted in severe toxic CNS symptoms. Therefore, it is stressed that the dose in relation to the weight of the patient must be calculated when administering a large volume of local anesthetic.
-
Inhalational induction is one of the recognized methods for the management of difficult airway. Halothane is the usual choice of agent for this purpose. ⋯ There are various reports for and against the use of sevoflurane for the management of difficult airway. We describe the use of sevoflurane for the management of difficult airway in four patients presenting with airway problems.
-
Acta Anaesthesiol Scand · May 2000
Randomized Controlled Trial Comparative Study Clinical TrialNo difference between bupivacaine in 0.9% and 8% glucose for spinal anaesthesia in small children.
Baricity is one of the most important factors to influence the characteristics of distribution of the local anaesthetic and hence success and spread of the blockade. Bupivacaine is rendered hyperbaric by adding glucose. The effect of differing degrees of hyperbaricity remains to be evaluated. ⋯ These results demonstrate that bupivacaine in 0.9% glucose and in 8% glucose solutions are equally suitable for spinal anaesthesia in small children. Similar success rate, spread and duration of the sensory and motor block are achieved with both baricities of bupivacaine.