Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jul 1998
Comparative StudySpinal cord blood flow after intrathecal injection of ropivacaine and bupivacaine with or without epinephrine in rats.
Ropivacaine is a new local anaesthetic available for spinal and epidural anaesthesia. When new drugs are being introduced for spinal application, their effect on spinal cord blood flow (SCBF) should be studied for safety and toxicological aspects. In the present study, SCBF was studied after intrathecal (i.t.) application of ropivacaine and bupivacaine with and without epinephrine. ⋯ Ropivacaine and bupivacaine produce a dose-related, transient decrease in SCBF following i.t. administration in anaesthetized rats. However, the decrease in SCBF produced by both ropivacaine, when epinephrine was added in a concentration of 5 micrograms/ml. These results suggest that ropivacaine, like bupivacaine, may be used for spinal anaesthesia without important effects on SCBF.
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Anaesthetic practice for caesarean section has changed during the last decades. There is a world-wide shift in obstetric anaesthetic practice in favour of regional anaesthesia. Current data concerning anaesthetic practice in patients undergoing caesarean section from Germany are not available. A comparison with figures from the UK, USA, Norway and other European countries might be of general interest. ⋯ Compared to data from 1978, anaesthetic practice for caesarean section has changed with an increase in regional anaesthesia. However, German anaesthetists prefer general anaesthesia for caesarean section. In contrast, anaesthetists in other countries predominantly use regional techniques, and the difference to German practice is striking. International consensus discussion and recommendations as well as comparable European instruments of quality control in obstetric anaesthesia are desirable.
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Acta Anaesthesiol Scand · Jul 1998
Case ReportsAsymptomatic methaemoglobinaemia and its implications.
Anaesthetists are well trained to detect subtle skin signs of life-threatening situations such as cyanosis in hypoxia. However, cyanosis resulting from drug-induced, asymptomatic methaemoglobinaemia is rare and is likely to go undetected preoperatively. Patients presenting with asymptomatic methaemoglobinaemia may, therefore, offer a dramatic challenge to the unprepared anaesthetist. We report a case of methaemoglobinaemia secondary to dapsone ingestion that was diagnosed intraoperatively.
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Acta Anaesthesiol Scand · Jul 1998
Dose-related cardiovascular effects of amrinone and epinephrine in reversing bupivacaine-induced cardiovascular depression.
To ascertain the efficacy of amrinone and epinephrine in reversing bupivacaine-induced cardiovascular depression, we investigated the time course of recovery of cardiac function with 3 doses of both agents after bupivacaine administration. ⋯ Bolus amrinone may have a certain efficacy in reversing bupivacaine-induced cardiovascular depression, and improving cardiac contractility and relaxation dose-relatedly. In contrast to amrinone, bolus epinephrine remains indispensable for resuscitation, causing a rapid, massive, transient and dose-related rise in blood pressure. However, the use of amrinone may be limited predominantly by a decrease in systemic vascular resistance, while the use of epinephrine may be limited predominantly by the generation of serious ventricular dysrhythmias and lack of effectiveness on cardiac index and on cardiac relaxation.