Anesthesia and analgesia
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Anesthesia and analgesia · Sep 1992
Neuromuscular pharmacology in rat neonates: development of responsiveness to prototypic blocking and reversal drugs.
The neonatal pharmacology of neuromuscular drugs was studied in vivo in newborn rats and in vitro in neonatal phrenic nerve-hemidiaphragm preparations. Drugs used to probe neuromuscular development in rat neonates were physostigmine, edrophonium, neostigmine, 4-aminopyridine, d-tubocurarine (dTc), and succinylcholine. The prejunctional actions of these drugs were monitored in relation to neonatal age by the appearance of stimulus-evoked repetitive discharge initiated by motor nerve endings and the occurrence and magnitude of the resulting enhancement of twitch tension. ⋯ Rat neonates showed resistance to dTc blockade when tested by neonatal phrenic nerve-hemidiaphragm preparations in vitro. Relationships between age and 85%-95% transmission block declined to the adult level by week 5. This result indicates that in rat neonates, pharmacodynamic rather than pharmacokinetic mechanisms predominate in the development of responsiveness to dTc.
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Anesthesia and analgesia · Sep 1992
Comment Letter Biography Historical ArticleRalph Waters' ghost and the AUA.
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Anesthesia and analgesia · Aug 1992
Randomized Controlled Trial Comparative Study Clinical TrialEffects on biliary tract pressure in humans of intravenous ketorolac tromethamine compared with morphine and placebo.
This study compared the effect of ketorolac tromethamine with that of morphine and placebo on biliary tract pressure. Intraoperatively, 31 anesthetized patients received either ketorolac (30 mg IV, n = 16) or morphine (5 mg IV, n = 15) after a cholecystectomy or gallstone removal. Intrabiliary tract pressure was measured 5 min after dosing. ⋯ In the morphine group, there was significant increase in pressure over baseline. Postoperatively, there was no significant difference between ketorolac and placebo. We conclude that ketorolac has little or no effect on biliary tract dynamics; therefore, ketorolac may be a logical choice for analgesia in those situations in which spasm of the biliary tract is undesirable.
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Anesthesia and analgesia · Aug 1992
Randomized Controlled Trial Comparative Study Clinical TrialEsmolol is more effective than sodium nitroprusside in reducing blood loss during orthognathic surgery.
The goal of this study was to compare the efficacy of esmolol and sodium nitroprusside (SNP) as primary drugs for producing controlled hypotension and limiting blood loss during orthognathic surgery. Thirty ASA physical status I and II patients (mean age 22 yr) undergoing LeFort I maxillary osteotomies were randomly assigned to receive either esmolol (n = 15) or SNP (n = 15) as the primary drug to induce hypotension. ⋯ The mean arterial blood pressure during the hypotensive period was 58.7 +/- 0.7 (mean +/- SEM) and 61.8 +/- 0.4 mm Hg for esmolol and SNP, respectively (P less than 0.001). In addition, 40% +/- 4% of the observed values in the esmolol group and 53% +/- 3% in the SNP group were outside the target range for mean arterial blood pressure (difference significant at P less than 0.05), and a greater proportion of the deviations were above 65 mm Hg in the SNP group than in the esmolol group (0.64 vs 0.46, respectively, P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)