Anesthesia and analgesia
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Anesthesia and analgesia · Aug 1992
Modification of a new catheter for air retrieval and resuscitation from lethal venous air embolism: effect of nitrous oxide on air retrieval.
A modification of a new Arrow prototype catheter was evaluated for its ability to retrieve venous air emboli and for its effect on the success rate of resuscitation from venous air emboli in dogs anesthetized with isoflurane and nitrous oxide (66%) in oxygen. In an additional group of dogs, nitrogen was substituted for nitrous oxide in the inspired gases to determine whether the presence of nitrous oxide (as traditionally used in this model of lethal venous air emboli) increased the apparent amount of gas retrieval or altered the success rate of resuscitation. Dogs were placed in the seated position with the head 90 degrees to the horizontal. ⋯ Attempts to aspirate venous air emboli were begun with the first decrease in expired CO2. The amounts of gas retrieved, expressed as a percent of the injected air, and the incidence of successful resuscitation were compared between groups. In both treatment groups (nitrous oxide and nitrogen), the percent of injected venous air retrieved (73% +/- 13% and 65% +/- 21%, mean value +/- SD, respectively) and success rate of resuscitation (four of six dogs in each group) were significantly increased compared with the control group in which no attempt was made to retrieve injected venous air, and none of the six dogs survived.(ABSTRACT TRUNCATED AT 250 WORDS)
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Anesthesia and analgesia · Jul 1992
Comparative Study Clinical Trial Controlled Clinical TrialEvaluation of the endotracheal intubating conditions of rocuronium (ORG 9426) and succinylcholine in outpatient surgery.
The time-course of action and tracheal intubating conditions of rocuronium and succinylcholine under intravenous anesthesia with propofol, alfentanil, and nitrous oxide were studied in 30 patients undergoing outpatient surgery. The neuromuscular effects of both drugs were quantified by recording the indirectly evoked twitch response of the adductor pollicis muscle after ulnar nerve stimulation (0.1 Hz, 0.2 ms supramaximal stimuli). Patients were given either 0.6 mg/kg rocuronium (n = 20) or 1 mg/kg succinylcholine (n = 10) intravenously. ⋯ The recovery of the twitch response to 25%, 75%, and 90% of its control value was shorter after succinylcholine (P less than 0.001) and occurred at 8.1 +/- 2.6, 10.3 +/- 3.9, 11.3 +/- 4.6 and 25.3 +/- 5.0, 33.1 +/- 5.9, 36.1 +/- 6.3 min after succinylcholine and rocuronium, respectively. Also the time required for spontaneous recovery from 25% to 75% of the control twitch response was significantly shorter (P less than 0.001) after succinylcholine (2.2 +/- 1.4 min) than after rocuronium (7.8 +/- 2.1 min). It is concluded that in spite of the pharmacodynamic differences between succinylcholine and rocuronium, the intubating conditions after administration of both compounds are similar and develop at the same rate.
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Anesthesia and analgesia · Jul 1992
Randomized Controlled Trial Comparative Study Clinical TrialCombination of low-dose epidural morphine and intramuscular diclofenac sodium in postcesarean analgesia.
Epidural morphine is used for postcesarean analgesia, and nonsteroidal antiinflammatory drugs are frequently administered to relieve uterine cramps after vaginal delivery. To assess the efficacy of a combination of low-dose epidural morphine and intramuscular diclofenac sodium in postcesarean analgesia, a double-blind, randomized study was conducted. Epidural anesthesia was given to 120 parturients who were randomly allocated into four treatment groups: group A received normal saline solution, 10 mL epidurally and 3 mL intramuscularly (IM); group B received 10 mL of epidural saline solution and 75 mg (3 mL) of diclofenac IM; group C received 2 mg of morphine in 10 mL of epidural saline solution and 3 mL of saline solution IM; and group D received 2 mg of morphine in 10 mL of epidural saline solution and 75 mg of diclofenac IM. ⋯ Incidence of nausea or vomiting, or both, and pruritus occurred more frequently in groups C and D compared with group A or B (P less than 0.05). No bradypnea was observed during the study period. Diclofenac alone was not effective in postcesarean analgesia.(ABSTRACT TRUNCATED AT 250 WORDS)