Anesthesia and analgesia
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Anesthesia and analgesia · Jun 1981
Celiac plexus block: a roentgenographic, anatomic study of technique and spread of solution in patients and corpses.
Techniques for blocking the celiac plexus were evaluated by conventional posteroanterior and lateral x-rays and computed tomography (CT) in 20 patients with intractable pain due to carcinoma of the pancreas and by determining spread of injected dye at the time of autopsy in three corpses. The results showed that (a) the site for insertion of the needles should not be more than 7.5 cm lateral to the spinous process of a lumbar vertebra, (b) needles should be placed bilaterally, (c) the depth to which needles are inserted is greater than previously recommended, and (d) at least 25 ml of solution should be injected through each needle.
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Anesthesia and analgesia · Jun 1981
Benzodiazepines protect mice from local anesthetic convulsions and deaths.
Median convulsant (CD50) and median lethal (LD50) doses of intraperitoneal lidocaine, bupivacaine, and etidocaine were determined in 149 mice. Another 496 mice were pretreated with intramuscular diazepam, lorazepam, or midazolam, 1 mg/kg. Fifteen minutes later, lidocaine, bupivacaine, or etidocaine was given intraperitoneally and the incidence of convulsions and deaths recorded. ⋯ In equal intramuscular doses, midazolam proved to be the most effective anticonvulsant and diazepam the least. Etidocaine and bupivacaine convulsions were more difficult to suppress than those induced by lidocaine. On the other hand, the lethality of lidocaine was least reduced by these benzodiazepines.
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Anesthesia and analgesia · May 1981
Fentanyl-air-oxygen anesthesia for ligation of patent ductus arteriosus in preterm infants.
In 10 premature infants (1123 +/- 263 g), fentanyl citrate (30 to 50 microgram/kg) was used in conjunction with pancuronium (0.1 mg/kg) as the sole anesthetic for transthoracic ligation of patent ductus arteriosus. Ventilation was controlled with air and oxygen in concentrations sufficient to maintain transcutaneous PO2 between 50 and 70 torr. Circulatory stability was easily maintained throughout the procedure. "Stiff chest" was avoided by the use of muscle relaxants, and the infants were awake within 1 hour after the procedure.
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Anesthesia and analgesia · May 1981
Exposure to nitrous oxide and neurologic disease among dental professionals.
Questionnaires, mailed to approximately 30,000 dentists and an equal number of dental assistants requesting information regarding professional exposure to anesthetics and health problems, showed an increased incidence of neurologic complaints in dental professionals who worked with nitrous oxide. The most striking differences were noted in individuals reporting symptoms of numbness, tingling, and/or muscle weakness. ⋯ For dental assistants heavily exposed to nitrous oxide, a 3-fold increase in these same complaints was noted. In view of recent evidence that nitrous oxide abuse may lead to polyneuropathy, the results suggest that occupational exposure to nitrous oxide by both dentists and dental assistants may be associated with similar neuropathy.