Articles: general-anesthesia.
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The neuromuscular effects of ORG NC45, used as the sole muscle relaxant, were compared with a succinylcholine-pancuronium sequence in patients during nitrous oxide-fentanyl anaesthesia. The subjects were divided into four groups with ten in each group. After induction of anaesthesia they received either succinylcholine, 1 mg . kg-1 or ORG NC45 in doses of 50, 70 or 90 micrograms . kg-1 and tracheal intubation was done 90 seconds later. ⋯ No cumulative effects were seen with either drug during the first hour of neuromuscular blockade. At the end of the operation the neuromuscular block was antagonized with atropine 18 micrograms . kg-1, and neostigmine 36 micrograms . kg-1 and recovery was significantly more rapid with NC45 than pancuronium. We conclude that the lack of cumulation, easy reversibility and lack of cardiovascular effects suggest that NC45 has advantages over currently available non-depolarizing muscle relaxants but that its onset of action is too slow for rapid intubation.
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Surg Gynecol Obstet · Nov 1982
The effect of general and epidural anesthesia upon neonatal Apgar scores in repeat cesarean section.
One-hundred and ninety-five elective cesarean deliveries were studied to determine the effects of general and epidural anesthesia upon the neonatal condition, as reflected by the one and five minute Apgar scores. Ninety were performed under general anesthesia, 0.5 per cent halothane, 50 per cent nitrous oxide and 50 per cent oxygen; 105 used the epidural technique, 3 per cent chloroprocaine plus 0.75 per cent bupivacaine. All patients were tilted to the left during operation. ⋯ More significantly, no correlation was noted between the duration of anesthesia and the Apgar scores in either group, p greater than 0.1. Specifically, no significant increase was found in depressed infants in the prolonged, greater than or equal to 15 minutes, incision to delivery group, p greater than 0.05. These data seem to suggest that the use of general anesthesia, in the technique described, yields infants with Apgar scores as good as those of infants delivered under regional block anesthesia and that prolonged duration of general anesthesia is not associated with a depression of the Apgar scores.
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Edrophonium's onset and duration of antagonism (n = 26) and atropine requirement (n = 24) were determined under conditions of d-tubocurarine (dTc) neuromuscular blockade and halothane, nitrous oxide anesthesia. Results are compared with previous work in our laboratory on neostigmine and pyridostigmine under similar conditions. dTc was administered by continuous infusion to maintain a 90% depression of muscle twitch tension. Edrophonium (0.03-1.0 mg/kg) was injected as an iv bolus in combination with atropine (0.5 mg). dTc infusion was continued until a stable 90% depression of muscle twitch tension was reestablished. ⋯ In equiantagonistic doses, the duration of antagonism by edrophonium (66 min) did not differ from neostigmine (76 min), but was shorter than pyridostigmine. Edrophonium required one-half the amount of atropine as did neostigmine to prevent bradycardia. The authors concluded that edrophonium has a more rapid onset than neostigmine and an equivalent duration of antagonism, and requires less atropine to prevent bradycardia.