Anesthesia and analgesia
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Anesthesia and analgesia · Jun 1992
Randomized Controlled Trial Comparative Study Clinical TrialDose-response relations of doxacurium and its reversal with neostigmine in young adults and healthy elderly patients.
Dose-response relationships for doxacurium and neostigmine were established in 24 young (18-40 yr) and 24 elderly (70-85 yr) patients, ASA physical status I or II, anesthetized with thiopental, fentanyl, nitrous oxide, and isoflurane. Mechanomyographic response of the adductor pollicis muscle to the train-of-four stimulation of the ulnar nerve was recorded. Doxacurium (5, 10, 15, or 20 micrograms/kg IV) was administered by random allocation. ⋯ Time to 25% recovery after 30 micrograms/kg was 80.2 +/- 12.2 min in the young versus 133.0 +/- 17.1 min in the elderly (P less than 0.05). Neostigmine-assisted recovery was not significantly different in both groups. The estimated doses of neostigmine to obtain 70% train-of-four recovery after 10 min were 53.6 +/- 7.5 micrograms/kg in the young and 41.6 +/- 5.8 micrograms/kg in the elderly (P = NS).(ABSTRACT TRUNCATED AT 250 WORDS)
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Anesthesia and analgesia · Jun 1992
Randomized Controlled Trial Clinical TrialSore throat after endotracheal intubation.
Nitrous oxide can diffuse into the cuff of an endotracheal tube during tracheal intubation, and the cuff pressure against the tracheal wall may cause mucosal damage. An endotracheal tube has been developed (Brandt Anesthesia Tube) that effectively limits nitrous oxide-related intracuff pressure increases. We determined whether the incidence of postoperative sore throat could be reduced by using this tube. ⋯ In the Mallinckrodt group, 12 of 20 patients had a sore throat and 10 patients had intracuff pressures greater than 25 mm Hg. Only 3 of 20 patients in the Brandt group had a sore throat. We found that the incidence of sore throats after intubation could be significantly reduced by using the Brandt Anesthesia Tube (P less than 0.005).
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Anesthesia and analgesia · Jun 1992
Comparative Study Clinical TrialClinical evaluation of transtracheal Doppler for continuous cardiac output estimation.
A newly developed transtracheal Doppler (TTD) computer for cardiac output determination was studied in nine patients after open heart surgery (coronary artery bypass grafting, n = 4; mitral valve replacement, n = 5). The measurements were compared with those simultaneously obtained by thermodilation. Doppler signals were adequate in 78% of the patients studied. ⋯ Routine patient care can interfere with continuous measurements. Cardiac output determinations by TTD are limited to the period during which the trachea is intubated with the special TTD tube. We conclude that the TTD system does not offer accurate cardiac output determinations and that the routine use of this device is not practical.
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Anesthesia and analgesia · Jun 1992
An updated cross-referenced filing system for anesthesiologists.
A filing system that provides a medical-information retrieval system is useful for medical students, physicians-in-training, and practicing physicians. The present system is an expansion and update of the one proposed by Petty and Carden in 1973. This filing system for anesthesiologists contains a simple numerical index of the major categories in the anesthetic, medical, and surgical literatures. ⋯ This system allows the user to cross-file reprints, locate ones that have been loaned, and keep track of references that may be found in personal bound volumes. The files may be expanded over the years to any desired degree. Finally, this system may be of use either to the individual anesthesiologist or to a department's library.
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Anesthesia and analgesia · Jun 1992
Calcium channels are involved in the hypnotic-anesthetic action of dexmedetomidine in rats.
Our study examined whether calcium channels are involved in the anesthetic action of dexmedetomidine (100-300 micrograms/kg), a highly selective alpha 2-adrenoceptor agonist. To investigate this, we studied the effects of verapamil (1.25 or 2.5 mg/kg), a calcium channel blocker, and BAY K8644 (0.5 or 1 mg/kg), a calcium channel agonist, on the hypnotic-anesthetic effect of dexmedetomidine in rats. ⋯ In contrast, BAY K8644 caused a significantly increased onset of hypnosis (P less than 0.001) and attenuated the anesthetic property of dexmedetomidine. These results suggest that the hypnotic-anesthetic action of dexmedetomidine is influenced by the activation/gating of calcium channels.