Anesthesia and analgesia
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Anesthesia and analgesia · Sep 1982
Comparative StudyComparison of venous admixture during high-frequency ventilation and conventional ventilation in oleic acid-induced pulmonary edema in dogs.
High-frequency jet ventilation (HFJV) was compared with conventional ventilation ventilation during oleic acid-induced pulmonary edema in dogs. HFJV, when combined with positive end-expiratory pressure (PEEP), returned arterial PO2 (PAO2) and venous admixture to preoleic acid levels, even with tidal volumes as low as 4.8 ml/kg and rates of 300 min-1. When HFJV was compared with conventional (low-frequency, high tidal volume) ventilation at the same Flo2 and level of PEEP, Pao2 was lower and venous admixture higher with HFJV. ⋯ At each level of PEEP, cardiac and stroke indices were not different between the two methods of ventilation. The ability to eliminate CO2 with lower peak airway pressures or to increase PEEP without further increases in peak airway pressure are the primary advantages of HFJV during severe lung injury. Oxygenation is as efficient during HFJV as during conventional ventilation in this model of pulmonary edema when comparisons are made at the same peak airway pressure, but less efficient at the same PEEP.
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Anesthesia and analgesia · Aug 1982
Randomized Controlled Trial Clinical TrialLow-dose fentanyl blunts circulatory responses to tracheal intubation.
The effect of fentanyl, 8 micrograms/kg, used as an adjunct to thiopental for induction of anesthesia, on the circulatory response to tracheal intubation was investigated in 36 patients undergoing major vascular surgery. Patients were randomly assigned to receive either thiopental, 6 mg/kg, alone (N = 18), or thiopental, 3 mg/kg, along with fentanyl, 8 micrograms/kg (N = 18), for induction of anesthesia. ⋯ Increases in systolic blood pressure, diastolic blood pressure, and pulmonary capillary wedge pressure with intubation were also significantly greater following administration of thiopental than following fentanyl-thiopental. Doses of fentanyl that are low enough to cause little postoperative respiratory depression significantly blunt postintubation hypertension when used as an adjunct to thiopental.
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Anesthesia and analgesia · Aug 1982
Maternal, fetal, and neonatal responses after epidural anesthesia with bupivacaine, 2-chloroprocaine, or lidocaine.
The effects of epidural analgesia on fetal heart rate, fetal heart rate variability, uterine activity, maternal blood pressure, newborn Apgar scores, neonatal acid base status, and the early neonatal neurobehavioral status were studied in 150 parturients during labor and delivery. Group I (n = 50) received 0.5% bupivacaine, group II (n = 50) received 2% 2-chloroprocaine, and in group III (n = 50) received 1.5% lidocaine. None of the three local anesthetics used had any significant effect on either base line fetal heart rate, beat-to-beat variability, or uterine activity. ⋯ The difference in incidence of late deceleration patterns between groups I and II was statistically significant (p less than 0.025). Early neonatal neurobehavioral status did not differ among the three groups of neonates nor did any of the neonates in the three groups score lower than a control group of 20 neonates whose mothers did not receive any analgesia or medications for labor or delivery. It is concluded that epidural anesthesia as administered in this study has no significant effect on the base line fetal heart rate, uterine activity, or neurobehavioral status of the neonate, and that bupivacaine is associated with a higher incidence of what appears to be transient abnormalities of fetal heart rate.
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Anesthesia and analgesia · Aug 1982
Cardiopulmonary resuscitation with interposed abdominal compression in dogs.
This study was conducted to evaluate the hemodynamic effectiveness of a new modification of cardiopulmonary resuscitation (CPR), termed interposed abdominal compression-CPR (IAC-CPR). IAC-CPR utilizes all the steps of standard CPR with the addition of abdominal compressions interposed during the release phase of chest compression. Ventricular fibrillation was induced electrically in 10 anesthetized dogs, and either IAC-CPR or standard CPR was initiated while arterial and venous blood pressures and cardiac output were monitored. ⋯ Brachial arterial blood pressure averaged 87/32 mm Hg during IAC-CPR vs 58/16 mm Hg during standard CPR. Cardiac output (+/- SE) averaged 24.2 +/- 5.7 ml/min/kg during IAC-CPR vs 13.8 +/- 2.6 ml/min/kg during standard CPR. IAC-SPR requires no extra mechanical equipment, and, if proven effective in human trials, may improve resuscitation success in the field and in the hospital.