Acta anaesthesiologica Belgica
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Acta Anaesthesiol Belg · Jan 1989
ReviewCentral anticholinergic syndrome (CAS) in anesthesia and intensive care.
Many of the drugs used in anesthesia and intensive care may cause blockade of the central cholinergic neurotransmission. Acetylcholine is of significance in modulation of the interaction among most other central transmitters. The clinical picture of the central cholinergic blockade, known as the central anticholinergic syndrome (CAS), is identical with the central symptoms of atropine intoxication. ⋯ In some intoxications with psychoactive agents, physostigmine is useful for reversal of the central nervous symptoms of the acute intoxication itself. In addition it can be used for prevention of some withdrawal states. In
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Acta Anaesthesiol Belg · Jan 1989
Randomized Controlled Trial Clinical TrialTransdermal fentanyl against postoperative pain.
60 patients (ASA class I-II) undergoing knee arthrotomy received in a double blind fashion, a transdermal drug delivery system, containing either fentanyl (delivery rate of 75 micrograms/hour)--Fentanyl TTS--or placebo. The system remained in place for 24 hours. ⋯ No significant side effects were seen. Concerning escape medication, a highly statistically significant difference in favour of Fentanyl TTS was found (p less than 0.001).
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Acta Anaesthesiol Belg · Jan 1989
Randomized Controlled Trial Comparative Study Clinical TrialA contribution to the monitoring of neuromuscular blockade: an evaluation of the Datex Relaxograph.
The Datex Relaxograph is a neuromuscular transmission monitor, which measures the degree of neuromuscular blockade during anesthesia. In order to evaluate the reliability of the Relaxograph, results, obtained with this apparatus, were compared with simultaneous mechanical measurements obtained with the Myograph 2000 (Biometer). Although there was a good correlation between the two throughout the study, a shift towards mechanical responses was observed in all cases. ⋯ Results show that neither drug offers major clinical advantages over the other. In a third study, a new bolus-constant infusion regimen of atracurium was evaluated. Results show that it produces a predictable and stable neuromuscular blockade.
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Acta Anaesthesiol Belg · Jan 1989
Comparative StudyA study of epidural morphine and sufentanil anesthesia for abdominal aortic surgery.
Thirty six comparable patients, ASA 2, without cardiac disease, underwent aortic disobliteration, 19 under epidural 100 micrograms/kg morphine (EM) and 17 under epidural 2 micrograms/kg sufentanil (ES), combined with general anesthesia. To compare the hemodynamics, measurements were taken pre-operatively, after induction of general anesthesia, during aortic dissection, aortic cross-clamping and 3-5 minutes after the first revascularisation. Plasma and CSF drug levels were measured at intervals in 6 patients in the EM end 5 patients in the ES group. ⋯ Notable was the absence of significant changes in filling pressure, CI and left ventricular function during aortic cross-clamping. After revascularization a significant decrease in systolic blood pressure occurred in association with an increase in heart rate in the EM group. The influence of the plasma and CSF concentrations of morphine and sufentanil on the hemodynamic changes during surgery were evaluated.
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Acta Anaesthesiol Belg · Jan 1989
Comparative StudyInfluence of equipotent doses propofol and thiopentone on arterial pressure and heart rate at induction of anesthesia. A comparison between young and old patients.
To compare the influence on arterial pressure (AP) and heart rate (HR) at induction, twenty-eight 25-40 years and twenty-nine 65-80 years old unpremedicated patients were anesthetized with propofol 1.5 mg/kg or thiopentone 2.5 mg/kg. Simultaneously respectively propofol 9 mg/kg/h or thiopentone 6 mg/kg/h was infused. Additional bolus were eventually supplied (propofol 20 mg, thiopentone 25 mg). ⋯ AP decrease before intubation was identical in both old groups and slightly more important in young propofol than young thiopentone patients. AP increased significantly more (p less than 0.01) in both thiopentone groups immediately and 3' post-intubation, when also rate pressure products were significantly higher. It was concluded that propofol provided a more favorable cardiovascular situation than thiopentone, especially in the elderly.