British journal of anaesthesia
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Some of the cellular targets affected by volatile anaesthetics (e.g. halothane) which contribute to the negative inotropic effects of these agents are also affected during the progression of diabetic cardiomyopathy. A previous report suggested that halothane inhibited contraction to a lesser extent in papillary muscle from diabetic animals and so the aim of this study was to investigate possible mechanisms underlying this effect. ⋯ In contrast to a previous report, we could find no evidence of amelioration of the negative inotropic effect of halothane in myocytes from the STZ-induced diabetic rat. Contractility, the cytosolic Ca(2+) transient, SR Ca(2+) content and myofilament Ca(2+) sensitivity were qualitatively similar in control and STZ myocytes and were all depressed to the same extent by halothane.
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Comment Letter Case Reports
Epidural abscess complicating insertion of epidural catheters.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of articaine and bupivacaine/lidocaine for sub-Tenon's anaesthesia in cataract extraction.
Articaine is the most widely used local anaesthetic for dental anaesthesia in Germany, Italy and The Netherlands and has recently been introduced and licensed for dental use in the UK. We have previously shown articaine to be superior to a standard mixture of bupivacaine 0.5%/lidocaine 2% for peribulbar anaesthesia. Sub-Tenon's anaesthesia arguably provides a safer method of anaesthetic delivery for cataract surgery. A blunt cannula is used in this technique, thus greatly reducing the risk of globe perforation, intrathecal injection and sight-threatening periocular haemorrhage. ⋯ Articaine 2% is safe and effective for sub-Tenon's anaesthesia and is a suitable alternative to the traditional bupivacaine 0.5%/lidocaine 2% mixture.
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Randomized Controlled Trial Clinical Trial
Effect of remifentanil infusion rate on stress response to the pre-bypass phase of paediatric cardiac surgery.
Opioids are used routinely to eliminate the stress response in the pre-bypass phase of paediatric cardiac surgery. Remifentanil is a unique opioid allowing a rapidly titratable effect. No data are available regarding a suitable remifentanil dose regimen for obtunding stress and cardiovascular responses to such surgery. ⋯ In infants and children under 5 yr, remifentanil infusions of 1.0 micro g kg(-1) min(-1) and greater can suppress the glucose increase and tachycardia associated with the pre-bypass phase of cardiac surgery, while 0.25 micro g kg(-1) min(-1) does not. Remifentanil should be used with caution in neonates with complex congenital heart disease.