Anaesthesia
-
Randomized Controlled Trial Clinical Trial
Dose-responses for edrophonium during antagonism of vecuronium block in young and older adult patients.
The dose-response relationship for edrophonium during antagonism of vecuronium-induced neuromuscular blockade was studied in two groups of adult patients of mean (SD) age 35 (10.0) years (n = 42) and 77 (5.4) years (n = 42) respectively. Neuromuscular block was monitored by recording the force of contraction of the adductor pollicis muscle following train-of-four stimulation. ⋯ The dose-response curves showed no significant difference between the two age groups except at 10 min. The estimated dose of edrophonium required for attaining a train-of-four ratio of 0.7 at 10 min was 0.9 and 1.3 mg.kg-1 in the younger and older groups, respectively (p < 0.05).
-
Comparative Study Clinical Trial Controlled Clinical Trial
Comparison of direct blood pressure measurement at the radial and dorsalis pedis arteries during surgery in the horizontal and reverse Trendelenburg positions.
The differences in simultaneous arterial pressure measurements from the radial and dorsalis pedis arteries were studied in anaesthetised adult patients in either the horizontal or reverse Trendelenburg position. Significantly higher pressures were measured from the dorsalis pedis artery than from the radial artery in both positions, even allowing for the hydrostatic effect on the dorsalis pedis arterial pressure in the non-horizontal group. If the dorsalis pedis artery is to be used to measure direct arterial blood pressure, we recommend that readings be compared with an arm sphygmomanometer to avoid potentially dangerous hypotension being missed.
-
Comparative Study
Discrepancy of recovery times related to potency between atracurium and mivacurium simultaneously administered in isolated forearms.
Recovery from potent non-depolarising muscle relaxants is slower than from the less potent agents. However, recovery from mivacurium, which is more potent than atracurium, is faster than from atracurium following systemic administration. ⋯ In these experiments, the recovery times from maximum block to 50% recovery of control twitch height were significantly longer with mivacurium than with atracurium (mean 25.2(SD 4.7) versus 22.6(3.1) min, p < 0.01). We found that the evidence that mivacurium has a slower recovery than the less potent atracurium may be true using the bilateral, isolated forearm technique and that the discrepancy might be due to a difference in the pharmacokinetic variables of the two drugs.