Anesthesia and analgesia
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Anesthesia and analgesia · Jun 1989
Comparative Study Clinical Trial Controlled Clinical TrialTetanic fade following administration of nondepolarizing neuromuscular blocking drugs.
Fade in response to tetanic stimulation was studied following administration of atracurium 120 or 225 micrograms/kg, vecuronium 23 or 40 micrograms/kg, pancuronium 30 or 60 micrograms/kg, or d-tubocurarine 185 or 450 micrograms/kg. Ten patients received each dose and tetanic fade was measured at maximum block in the patients, who received the lower doses of the relaxants or at 10% recovery in those who received the higher doses. Fade during tetanic stimulation was generally similar in all the groups with the exception of the higher dose of pancuronium which showed a significantly greater fade in comparison with the higher doses of atracurium and d-tubocurarine. If fade in response to tetanic stimulation represents a prejunctional effect, the results from the present study suggest that neuromuscular blocking drugs cannot be differentiated with respect to their relative prejunctional effects by measurement of tetanic fade during established block after administration of clinically useful doses as used in the present study.
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Anesthesia and analgesia · Jun 1989
Maintenance of oxygenation during one-lung ventilation. Effect of intermittent reinflation of the collapsed lung with oxygen.
The aim of this study was to evaluate the effect on oxygenation of intermittent inflation with oxygen of the collapsed lung during one-lung ventilation (OLV). Sixteen patients were studied during pulmonary surgery. Balanced anesthesia with nitrous oxide and an inspired oxygen fraction of 0.5 was used. ⋯ PaO2 increased more than 4 kPa following each inflation in seven patients. In the eighth, PaO2 remained high throughout OLV. Although PaO2 decreased between inflations, it never reached the level observed in controls during 19 minutes of OLV.
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The wall temperatures of the absorptive chambers of a divided soda lime canister were measured in 70 patients to determine the relationship between the difference in temperature of the two chambers and CO2 passage through the first chamber. CO2 passage through the first chamber was detected when the temperature of the second chamber became equal to that of the first. ⋯ When the maximal absorptive capacity of soda lime was reached, the pH of the surface of soda lime granules was still too high to change the indicator color. Exhaustion of soda lime is more reliably recognized by measuring wall temperatures of the chambers than by observing color change of the soda lime granules.