Articles: anesthetics.
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Acta Anaesthesiol Scand · Apr 1981
Interscalene brachial plexus block: area of analgesia, complications and blood concentrations of local anesthetics.
In a prospective clinical study including 100 patients, the consequences of using the interscalene approach to block the brachial plexus were investigated according to the area of analgesia, complications, and blood concentrations of local anesthetics. Sufficient analgesia of the shoulder and the upper part of the arm was obtained in 98-99% of the cases, whilst the area of analgesia in the forearm and the hand was more variable. ⋯ No toxic reactions were seen. The complications were in accordance with those reported in other publications.
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Sevoflurane, 3% and 4% in oxygen was administered to four dogs for 3 hours. Sevoflurane was metabolized to inorganic fluoride and hexafluoroisopropanol. Serum fluoride concentrations reached peak values during 2 to 3 hours into anesthesia and averaged 18.5 micrometer/L (n = 2) and 20.0 +/- 4.8 (mean +/- SD) micrometer/L (n = 4) following 3% and 4% sevoflurane exposure, respectively. ⋯ Immediately after anesthesia, observed mean (n = 6) serum fluoride concentrations were 2.9 +/- 0.5 micrometer/L and 2.5 +/- 0.6 micrometer/L, respectively. Hepatic microsomal enzyme induction produced by pretreatment with either phenobarbital or polychlorinated biphenyls (PCBs) resulted in an approximately 5-fold increase in serum fluoride concentrations following anesthesia with sevoflurane when compared to noninduced rats exposed to sevoflurane. A comparison of serum fluoride concentrations between the rat and dog indicates that the amount of sevoflurane metabolized is lower in the rat than in the dog, and the fluoride concentrations observed in both animal species during sevoflurane anesthesia are not expected to produce nephrotoxicity.
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The aim of the present investigations was to see, if halothane (h), enflurane (e), isoflurane (i), and methoxyflurane (m) exert cytostatic or cytotoxic effects. The experiments were performed on suspension cultures of an established line of Ehrlich ascites tumor cells, which were gased by a mixture of N2 (78%), O2 (20%), and CO2 (2%) to which the volatile anaesthetics in 5 different concentrations were added by vaporizers. Under standardized conditions (incubation time: 24 or 48 hrs; initial cell density: 2 X 10(5) cells/ml culture medium) the following results were obtained: 1. ⋯ With exception of m, which produced a significant decrease of the cellular protein content in the dose range 1.5-2.0 vol% and of the cellular DNA content in all concentrations applied the 3 other anaesthetics caused an increase of the cellular protein content and a somewhat smaller increase of the cellular nucleic acids content. The obtained results indicate that the effect of anaesthetic agents on dividing cells is not due to the same mode or site of action, but to an influence on different stage of the cell cycle, particularly the interphase. Colchicine-like c-mitosis were not obtained.