Anesthesia and analgesia
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Anesthesia and analgesia · Jan 1991
Comparative Study Clinical Trial Controlled Clinical TrialA blinded comparison of noninvasive, in vivo phosphorus nuclear magnetic resonance spectroscopy and the in vitro halothane/caffeine contracture test in the evaluation of malignant hyperthermia susceptibility.
Malignant hyperthermia (MH) is a potentially fatal, anesthetic-induced syndrome. Currently, the only accurate means of diagnosing susceptibility to this syndrome is the testing of biopsied skeletal muscle for its contracture response to halothane and caffeine. A less invasive means of diagnosis is needed. ⋯ The NMR test and contracture test demonstrated an overall agreement of 93% with a copositivity of 96% and conegativity of 87%. The sensitivity and specificity of the NMR test is estimated to be 98.8% +/- 11.8% and 95.3% +/- 20.3%, respectively. The role of 31P NMR in the diagnosis of MH susceptibility and possible mechanisms underlying the observations are discussed.
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Anesthesia and analgesia · Jan 1991
Randomized Controlled Trial Clinical TrialCerebral blood flow autoregulation is preserved during cardiopulmonary bypass in isoflurane-anesthetized patients.
In 21 patients undergoing elective coronary artery bypass surgery, cerebral blood flow (CBF) was measured during hypothermic nonpulsatile cardiopulmonary bypass to test the hypothesis that isoflurane abolished the mean arterial pressure-CBF relation (pressure-flow autoregulation). Cerebral blood flow was determined by 133Xe clearance. The patients were randomly divided into three groups according to anesthesia during cardiopulmonary bypass: group 1 received midazolam and fentanyl; group 2 received, in addition to midazolam and fentanyl, 0.6% isoflurane; and group 3 received, in addition to midazolam and fentanyl, 1.2% isoflurane. ⋯ Isoflurane decreased mean arterial pressure significantly (P less than 0.05) and was associated with lower CBF. Increasing the mean arterial pressure 29% in group 1, 25% in group 2, and 34% in group 3 had no effect on CBF. We conclude that, within the range studied, pressure-flow CBF autoregulation is preserved during isoflurane anesthesia administered for cardiopulmonary bypass.