British journal of anaesthesia
-
Randomized Controlled Trial Comparative Study Clinical Trial Retracted Publication
Post-tetanic count and single twitch height at the onset of reflex movement after administration of vecuronium under different types of anaesthesia.
We have studied post-tetanic count (PTC) and single twitch height at the onset of reflex movement to carinal stimulation after administration of vecuronium with five different types of anaesthesia. Seventy-five adult patients were allocated randomly to five groups of 15 patients each, to receive one of the following anaesthetics: neuroleptanaesthesia (fentanyl and droperidol) or 1 MAC of either halothane, isoflurane, enflurane or sevoflurane with 66% nitrous oxide in oxygen. ⋯ Single twitch heights at the onset of reflex movement were similar (2.0-2.7% of control values) between the five groups. In contrast, PTC at the onset of reflex movement to carinal stimulation differed (7.4-17.0) between groups.
-
Historical Article
A short history of fires and explosions caused by anaesthetic agents.
The first recorded fire resulting from the use of an anaesthetic agent occurred in 1850, when ether caught fire during a facial operation. Many subsequent fires and explosions have been reported, caused by ether, acetylene, ethylene and cyclopropane, and there has been one reported explosion involving halothane. ⋯ The use of flammable agents has decreased significantly in recent years and although fires and explosions from nonanaesthetic causes, for example gastrointestinal gases, skin sterilizing agents and laser surgery, may continue to occur, those from gaseous and volatile anaesthetic agents may now be of historical interest only. This article reviews some of the more relevant and enlightening reports of the past 150 yr.
-
Randomized Controlled Trial Clinical Trial
Thenar muscle blood flow and neuromuscular effects of vecuronium in patients receiving balanced or isoflurane anaesthesia.
We have tested the hypothesis that isoflurane potentiates non-depolarizing neuromuscular block via an increase in muscle blood flow. Anaesthesia was induced with thiopentone 4-5 mg kg-1 in 30 adult male patients of ASA physical status I or II and was maintained with 70% nitrous oxide in oxygen supplemented with either a bolus dose of fentanyl 4 micrograms kg-1 followed by an infusion of 1 microgram kg-1 h-1 (balanced anaesthesia group, n = 15) or 1.1% end-tidal isoflurane (isoflurane group, n = 15). Vecuronium 0.1 mg kg-1 was given for neuromuscular block. ⋯ Thenar muscle blood flow was comparable in the two groups throughout the study. We conclude that isoflurane prolonged vecuronium-induced neuromuscular block. This prolongation was not related primarily to increase in muscle blood flow.
-
Injection of formalin into the hindpaw of a rat induces a biphasic response in pain-related behaviours, such that C-fibre activation during phase 1 triggers a state of central sensitization characterized by a longer lasting phase 2. As the inhibitory neurotransmitter gamma-aminobutyric acid (GABA) may participate in processing of nociceptive inputs, we hypothesized that pentobarbitone and propofol, i.v. anaesthetics with known GABAA agonist properties, would interfere with development of central sensitization and thereby modify the phase 2 hyperalgesic response. ⋯ In contrast, propofol had no effect on phase 2 formalin-induced pain behaviour. Thus we conclude that pentobarbitone, but not propofol, produced pre-emptive analgesia in this model, presumably by suppressing noxious stimulation-induced central sensitization via activation of GABAA receptors.
-
We have compared the effects of two different frequencies of train-of-four stimulation of the ulnar nerve (2-Hz stimulation once every 10 or 20 s) on onset time and potency of atracurium, vecuronium and mivacurium during balanced anaesthesia. The adductor pollicis EMG was recorded simultaneously in both hands of 24 children aged 2-12 yr. After administration of an ED50 dose of each blocker, onset times were mean 21 (SEM 10) s shorter (P < 0.05) and decreases in neuromuscular function were 22 (3)% greater (P < 0.001) in the hand which was stimulated once every 10 s. We conclude that it is not possible to compare potency estimates of neuromuscular blocking agents if different stimulation patterns have been used.