British journal of anaesthesia
-
The most important clinical properties of local anaesthetic agents are potency, onset, duration of action and relative blockade of sensory and motor fibres. These qualities are related primarily to the physicochemical properties of the various compounds. ⋯ In general, the local anaesthetics for infiltration, peripheral nerve blockade, and extradural anaesthesia can be classified into three groups: agents of low potency and short duration, for example procaine and chloroprocaine; agents of moderate potency and duration, for example lignocaine, mepivacaine and prilocaine; and agents of high potency and long duration, for example amethocaine, bupivacaine and etidocaine. These local anaesthetics also vary in terms of onset: chloroprocaine, lignocaine, mepivacaine, prilocaine and etidocaine have a rapid onset, while procaine, amethocaine and bupivacaine are characterized by a longer latency period.
-
Randomized Controlled Trial Clinical Trial
Atracurium and vecuronium: effect of dose on the time of onset.
The time intervals measured from the administration of either atracurium or vecuronium to maximum or 95% neuromuscular blockade (Tmax) were compared in 70 patients using the evoked compound action potential of the adductor pollicis muscle. Equipotent doses, calculated from the relationship between dose and response for both drugs obtained in an earlier study, were compared. The doses of atracurium and vecuronium ranged from 0.135 to 0.5 mg kg-1 and from 0.02 to 0.1 mg kg-1, respectively. ⋯ Similarly, no change in Tmax occurred at doses of vecuronium in the range 0.02-0.05 mg kg-1 and 0.06-0.1 mg kg-1. Tmax changed significantly in the dose ranges atracurium 0.2-0.24 mg kg-1 and vecuronium 0.05-0.06 mg kg-1. There was no significant difference in Tmax when equipotent doses of atracurium and vecuronium were compared.
-
This report describes the management of a poor risk Nepalese patient (active pulmonary tuberculosis, haemoglobin concentration 4.6 g dl-1, weight 28.5 kg) requiring emergency Caesarean section for fetal distress. Subarachnoid blockade (0.5% bupivacaine plain 3.5 ml) was satisfactory; blood loss was around 400 ml and was replaced with Haemaccel and lactated Ringer's solution (blood was not available). Although unresponsive at birth, the child had an Apgar score of 10 at 15 min.