Acta anaesthesiologica Scandinavica. Supplementum
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Acta Anaesthesiol Scand Suppl · Jan 1995
The role of muscle relaxants in total intravenous anaesthesia.
For total intravenous anaesthesia (TIVA), all drugs that are required as part of the anaesthetic method are administered intravenously. This is usually taken to imply the use of intravenous infusions. It is normal practice to administer muscle relaxants intravenously, although other routes have been used. ⋯ It should cause negligible side-effects. For administration by infusion, an agent with an intermediate (e.g., atracurium) or short (e.g., mivacurium) duration of action is essential to ensure a rapid recovery of effect on termination of the infusion. The routine use of neuromuscular monitoring is recommended when a continuous infusion of a relaxant is used.
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PvCO2 that would result from full O2Hb desaturation at a given O2-CO2 exchange ratio, in the absence of metabolic acid, may be termed maximum respiratory venous PCO2 (PvmrCO2). This theoretical condition of 100% O2 extraction, in the absence of metabolic acid, should simulate maximum aerobic PCO2 in tissue, provided that PCO2 of tissues and large veins is similar. Hence, the value of PvmrCO2 is of interest in identifying critical tissue PCO2. ⋯ It is concluded that the PvCO2 versus SO2 relation is not linear when arterial [Hb] and/or [BE] vary. An equation that predicts in vitro PvmrCO2 as a function of arterial [BE], [Hb], RQ, and PaCO2 is provided. It's accuracy in vivo should be testable.