Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jul 1999
ReviewThe role of stress in anaesthetists' health and well-being.
Stress is an inevitable part of our personal and professional lives. When poorly managed, stress will accumulate to levels that become injurious to our health and well-being. Burnout is one such consequence. ⋯ The role of the medical marriage and dual-career relationships are scrutinized. The importance of retaining the humanistic essence of medicine is emphasized. Stress management strategies and coping responses, including self-care and humor, are discussed.
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Acta Anaesthesiol Scand · Jul 1999
Investigation of fading responses induced by non-depolarising muscle relaxants in the evoked EMG of the gastrocnemius muscle of the cat.
During partial neuromuscular blockade indirect repetitive nerve stimulation causes fade in the response of the muscle. We studied the intensity of the fade induced by intravenous administration of three steroidal muscle relaxants, and investigated the mechanism of fade by comparing with results obtained during partial blockade with animal toxins and vesamicol. ⋯ Our results suggest that non-depolarising muscle relaxant-induced fade is caused by an inhibitory effect on acetylcholine release. Pancuronium seems to have a higher potency of presynaptic inhibition of acetylcholine release than both rocuronium and vecuronium.
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Acta Anaesthesiol Scand · Jul 1999
Pharmacology of G-1-64, a new nondepolarizing neuromuscular blocking agent with rapid onset and short duration of action.
Chances are slim that a clinically useful ultra-short-acting neuromuscular blocking agent of rapid onset will emerge from the benzylisoquinolinium or the aminosteroid series to which all currently popular relaxants belong. G-1-64 is a promising prototype of a new series of bis-quaternary ammonium salt of bistropinyl diester derivatives we have synthesized and studied in the laboratory. ⋯ With favorable neuromuscular blocking characteristics and modest side effects, G-1-64 and similar derivatives may have clinical potential.
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Acta Anaesthesiol Scand · May 1999
Interaction between fluconazole and midazolam in intensive care patients.
Midazolam is used for sedation of intensive care unit (ICU) patients and it is extensively metabolised by CYP3A4 enzymes. The antimycotic fluconazole is often used in these patients as well and has been shown to inhibit CYP3A4-mediated drug metabolism. ⋯ In ICU patients receiving fluconazole, reduction of midazolam infusion rate should be considered if the degree of sedation is found to be increasing.
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Acta Anaesthesiol Scand · May 1999
Comparative StudyPreoperative anxiety is associated with a high incidence of problematic behavior on emergence after halothane anesthesia in boys.
In our clinical experience, children who are crying before anesthesia are more likely to show agitated behavior on emergence. ⋯ The boys who were anxious before anesthesia showed a significantly greater incidence of problematic behavior on emergence from halothane anesthesia, compared with the boys who were calm before anesthesia.