Acta anaesthesiologica Sinica
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Acta Anaesthesiol. Sin. · Dec 1996
Comparative StudyThe comparative potency of intravenous nicardipine and verapamil on the cardiovascular response to tracheal intubation.
Two different types of calcium channel blockers (namely nicardipine and verapamil) have been used widely in clinical practice. However, no clinical studies have previously been performed to ascertain the relative potency of intravenous verapamil and nicardipine in the attenuation of cardiovascular response to tracheal intubation. ⋯ These results suggest that verapamil and nicardipine attenuate the hypertensive response to tracheal intubation without significant adverse effects in healthy patients. The dose ratio (ED50 nicardipine and ED50 verapamil for MAP) with 95% confidence interval was revealed to be 2.3 (1.82-7.41).
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Acta Anaesthesiol. Sin. · Dec 1996
Randomized Controlled Trial Comparative Study Clinical TrialProphylaxis against acid aspiration in regional anesthesia for elective cesarean section: a comparison between oral single-dose ranitidine, famotidine and omeprazole assessed with fiberoptic gastric aspiration.
Acid aspiration syndrome is still an important cause which contributes to maternal mortality in obstetric anesthesia. In this study, we compared famotidine, ranitidine, omeprazole with placebo for prophylaxis against aspiration pneumonitis in elective Cesarean section under regional anesthesia. ⋯ Our data demonstrated that parturients under regional anesthesia were at a higher risk of aspiration pneumonitis than generally thought. Single dose of ranitidine or famotidine administered orally three hours before surgery provided a more effective means to control and neutralize gastric secretion than omeprazole in parturients.
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Acta Anaesthesiol. Sin. · Dec 1996
Randomized Controlled Trial Clinical TrialCo-administration of midazolam decreases propofol dose during anesthesia in endoscopic laryngeal microsurgery.
Propofol is commonly used in total intravenous anesthesia (TIVA) for brief surgical procedures because it offers rapid recovery and has fewer side effects. However, concomittent use of other adjuvant agents has been considered so that the same anesthetic effects can be achieved at lower doses of propofol which is more expensive without compromising rapid recovery and increasing the adverse effects. This study was therefore designed to evaluate the co-administration of midazolam and propofol during anesthesia for endoscopic microsurgery and test its influences on the consumption of propofol and the quality of anesthesia. ⋯ Our result suggests that co-administration of midazolam and propofol in TIVA appears to be safe, effective, and economic alternative to that with propofol alone. The effects were synergic but side effects were not.
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Opioids relieve painful stimuli by interacting with the opioid receptor subtypes, mu, delta, and kappa, in brain regions and spinal cord. Tolerance reduces medication effectiveness and causes a right-hand shift in the dose-response curve. The mechanisms involved in the development of opioid tolerance remain not clear. ⋯ The NMDA receptors can also induce the synthesis of NO (nitric oxide) through the activation of NOS (NO synthase). NOS inhibitors were also shown to prevent the development of opioid tolerance, therefore, NO was suggested to play a role in opioid tolerance development. Although much evidence indicates the reasons of opioid tolerance, it is still worth further investigation to explore the mechanisms of multiplicity of opioid receptors and complexity of intracellular biochemical events.
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Acta Anaesthesiol. Sin. · Dec 1996
Detection of cerebral desaturation during cardiopulmonary bypass by cerebral oximetry.
As oxygen consumption increases acutely during rewarming period in extracorporeal cardiopulmonary bypass (CPB), it is crucial to maintain cerebral oxygen delivery at this critical moment. The aim of this study was to evaluate the effectiveness of a cerebral oximeter (INVOS 3100, Somanetics Corporation, Troy, MI, USA) in monitoring cerebral oxygen balance during rewarming in CPB by correlating optical spectroscopic determinations with jugular bulb oxyhemoglobin saturation measurements. ⋯ Jugular bulb desaturation which correlated inversely with rewarming speed as disclosed in this study indicated that the temperature change during rewarming was crucial for cerebral oxygen balance. Being less sensitive and still more unspecific, the INVOS 3100 cerebral oximeter is incapable and not recommended for monitoring cerebral oxygen saturation in CPB.