British journal of anaesthesia
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We have studied the relative pre- and postjunctional neuromuscular blocking effects of Org 9426 in the isolated rat hemidiaphragm muscle using twitch tension and electrophysiological recording techniques. Postjunctional effects were assessed from decreases in twitch height and from end-plate current amplitude and time constant of decay. ⋯ There were no significant differences between the relative pre- and postjunctional effects of Org 9426 and those of previously studied steroidal neuromuscular blocking compounds. It is concluded, therefore, that the rapid onset and short duration of Org 9426 seen in vivo is not a consequence of a strong prejunctional, relative to postjunctional, blocking effect of the compound.
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We studied 16 healthy ASA physical status I patients (aged 13-71 yr for sevoflurane and 22-74 yr for isoflurane) to determine maximum blood concentrations on awakening (MBCawake) from sevoflurane and isoflurane anaesthesia, and determined if age and duration of anaesthesia significantly influenced MBCawake. After operation, the end-tidal concentration of anaesthetics was decreased gradually. During recovery from anaesthesia, patients were asked repeatedly to open their eyes. ⋯ There was no significant correlation between age and blood:gas partition coefficient for sevoflurane and isoflurane. Awakening alveolar concentrations (MACawake) calculated from MBCawake were 0.61 (SE 0.05)% for sevoflurane and 0.39 (0.02)% for isoflurane, and correlated significantly with age. The ratios of awakening alveolar concentration to MAC were reasonably constant--0.33 for sevoflurane and 0.33 for isoflurane.
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Comparative Study
Comparison of the use of the laryngeal mask and face mask by inexperienced personnel.
Ten junior doctors with no postgraduate anaesthetic experience attempted to ventilate the lungs of 50 anaesthetized patients, using either a laryngeal mask or a Guedel airway and face mask. Success was defined as the production of two successive tidal volumes exceeding 800 ml within 40 s. The failure rate was significantly greater using the laryngeal mask compared with the face mask (P < 0.05) and the average time was significantly longer with the laryngeal mask than with the face mask (P < 0.01). The results from this investigation suggest the laryngeal mask airway cannot be recommended as a resuscitation device for use by inexperienced operators.
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The purpose of this study was to identify EEG changes associated with low-dose propofol infusion producing only sedative effects, and to describe the memory effects of low-dose propofol infusion. Ten healthy volunteers underwent EEG monitoring (at Fz, Cz, Pz and Oz electrode sites) before, during and after propofol 0.5 mg kg-1 i.v. bolus and 75 micrograms kg-1 min-1 as an infusion. Mean serum concentration of propofol during infusion was 0.86 (SD 0.14) micrograms ml-1. ⋯ Nine of 10 subjects had partial amnesia for complex visual scenes presented during infusion, recalling less than 50% of the material. Stronger cueing was required to retrieve information presented during propofol infusion, with an increase in mean retrieval time from 95.4 (41.2) s to 426.8 (83.1) s. EEG and memory effects resolved quickly after the end of infusion.(ABSTRACT TRUNCATED AT 250 WORDS)