Anesthesia and analgesia
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Anesthesia and analgesia · Jan 1980
Comparative StudyPercutaneous cervical central venous line placement: a comparison of the internal and external jugular vein routes.
To compare the rate of success and incidence of complications associated with two currently popular routes of percutaneous central venous cannulation, we studied 167 patient in whom either internal or external jugular vein catheterization was attempted. Internal jugular vein (IJV) catheterization (125 patients) was successful in 91%; an intrathoracic location was achieved in 100%; complications occurred in 12.8%. Complications included one case of catheter malposition, one case of tension pneumothorax, and 12 instances of inadvertent carotid artery puncture, one resulting in a paratracheal hematoma and phrenic nerve compression. ⋯ External jugular vein cannulation (42 patients), using a "J" wire technique, yielded a 76% success rate: 93.7% of catheter tips reached an intrathoracic location. No complications occurred. We conclude that IJV cannulation is a more reliable means of percutaneous central venous line placement but is associated with a significant incidence of complications which can be reduced if a technique employing a scout needle and guide-wire is used.
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Anesthesia and analgesia · Nov 1979
Antagonism of pancuronium and its metabolites by neostigmine in cats.
Antagonism by neostigmine of neuromuscular blockade produced by pancuronium or its metabolites was studied in the cat anterior or tibialis muscle-peroneal nerve preparation using constant infusions of muscle relaxants. The ED50 of neostigmine (dose which caused a 50% antagonism) was 16, 11, 29, and 26 micrograms/kg for pancuronium, 3-hydroxypancuronium, 17-hydroxypancuronium, and 3, 17-hydroxypancuronium, respectively. ⋯ We conclude that more neostigmine is required to antagonize 17- or 3,17-hydroxypancuronium neuromuscular blockade than is required to antagonize pancuronium. Conversely, less neostigmine was required to antagonize 3-hydroxypancuronium blockade.
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Anesthesia and analgesia · Nov 1979
Letter Case ReportsMore on intravascular migration of an epidural catheter.