Articles: anesthetics.
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Randomized Controlled Trial Comparative Study Clinical Trial
Continuous infusion of fentanyl or alfentanil for coronary artery surgery. Effects on plasma cortisol concentration, beta-endorphin immunoreactivity and arginine vasopressin.
Plasma cortisol, beta-endorphin immunoreactivity (PBEir) and arginine vasopressin (AVP) responses during and after the continuous infusion of fentanyl or alfentanil were studied in 19 patients undergoing coronary artery bypass grafting (CABG). Plasma cortisol concentration decreased significantly in both groups during the anaesthesia and surgery before cardiopulmonary bypass (CPB); an increase was evident during CPB in both groups, but a statistically significant increase was not observed during the rest of the study, including the awakening from anaesthesia. PBEir increased with both opiates immediately after initiation of CPB and remained so during the rest of the study. ⋯ It is concluded that, with continuous fentanyl and alfentanil infusions in a total dose relationship of 1:13 in patients undergoing CABG, cortisol and AVP responses to surgery and CPB can be suppressed. However, during recovery from anaesthesia, the attenuating effect of alfentanil seems to wear off more rapidly than that of fentanyl. PBEir response to CPB and emergence from anaesthesia could not be prevented with either analgesic.
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Randomized Controlled Trial Comparative Study Clinical Trial
Continuous infusion of fentanyl or alfentanil for coronary artery surgery. Plasma opiate concentrations, haemodynamics and postoperative course.
Nine patients received a mean total dose of 110 micrograms kg-1 of fentanyl and 10 patients received alfentanil 1379 micrograms kg-1 as a continuous infusion during coronary artery bypass grafting (CABG). Circulatory stability was well maintained through the induction of anaesthesia and a similar cardiovascular course was achieved with both agents, with the exception of small differences in heart rate and cardiac index immediately before tracheal intubation. ⋯ With the continuous infusion techniques, plasma opiate concentrations could be maintained well above the awakening values during cardiopulmonary bypass. In a total dose ratio of 1:13, fentanyl and alfentanil produced similar haemodynamic profiles and clinical courses in patients undergoing CABG.
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Anaesth Intensive Care · Nov 1986
Anaesthesia for patients with arthrogryposis multiplex congenita: what is the risk of malignant hyperthermia?
Arthrogryposis multiplex congenita has been linked with malignant hyperthermia. A review of the anaesthetic experience at the Royal Alexandra Hospital for Children over a 32-year period revealed no episode of malignant hyperthermia occurring in patients with arthrogryposis multiplex congenita despite many and varied exposures to known triggering agents.
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Vet. Clin. North Am. Food Anim. Pract. · Nov 1986
Legal implications of the extra-label use of drugs in food animals.
Although the Food and Drug Administration has never sanctioned the extra-label use of drugs in animals, it has not, until recently, objected when veterinarians deviated from label instructions as long as such use did not result in violative residues in food products derived from treated animals. However, because of the potential human health hazards associated with abuse of this position, the FDA has developed a less lenient policy toward the extra-label use of drugs in food animals. A brief review of the legislated responsibility and authority of the FDA with particular reference to the extra-label use of drugs in food animals is provided. Emphasis is placed on how anesthetics and anesthesia adjuncts in food animals can pose human health hazards.