Der Anaesthesist
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We observed 20 patients undergoing middle-ear surgery under NLA in combination with halothane for controlled hypotension in respect to haematocrit, plasma protein concentration, plasma volume (Evans Blue) and intravascular protein mass during and after anaesthesia and surgery. As surgical bleeding was almost nil and infusion therapy was not necessary, patients behaved as a "closed system". With the start of anaesthesia we found a significant decrease of haematocrit and plasma protein concentration, being complete after 45-60 min, and unchanged thereafter until the end of anaesthesia. ⋯ Just after termination of anaesthesia we observed a significant increase in haematocrit and plasma protein concentration compared to control values with a downward trend over the next hour. At that point we also measured a decrease in plasma volume by 10% and in plasma protein mass by 6% compared to controls. These findings are interpreted as part of an "arousal reaction" with a temporary disequilibrium between transcapillary filtration rate of water and proteins and back transport of these substances via lymph flow.
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1. Time of onset and duration of action of various doses of pancuronium, tubocurarine, alcuronium , metocurine or dimethyltubocurarine, gallamine and fazadinium were studied by means of mechanomyograms of the hand muscles (twitch) following supramaximal electrical stimulation of the ulnar nerve (100-120 V, 0.2 ms, 0.2 Hz) in 293 patients during neurolept anaesthesia. -2. With an intravenous injection rate of about 5s there was no difference in latency time, however, the time of onset was found to be dose dependent. ⋯ The relation between the duration of action and the dosage of a muscle relaxant could sufficiently be described by the equation Y = a x Yb and straightened applying a double-logarithmic plot. The values of a and b for various degrees of recovery were obtained by regression analysis. Thus, the duration of action can be predicted by substituting of dose values into the above equation.