Anesthesia and analgesia
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Anesthesia and analgesia · Nov 1976
Anesthesia and the modification of response to infection in mice.
Anesthetic-induced immunosuppression, if clinically significant, could modify the natural course of infectious disease in vivo. To test this bypothesis, the localized response to IM Candida albicans and the mortality following fecal peritonitis were examined in anesthetized mice. Using these 2 models, halothane anesthesia was found not to modify the natural history of local sepsis but to significantly accentuate the mortality associated with the more severe infection. Possible explanations for these results include significant inhibition of reticuloendothelial function or plasma opsonization with relatively minor derangements of peripheral leukocyte capability.
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Anesthesia and analgesia · Sep 1976
Comparative StudyA comparative interaction of epinephrine with enflurane, isoflurane, and halothane in man.
Forty-eight patients undergoing transphenoidal removal of pituitary tumors received submucosal injections of epinephrine in saline solution during halothane, enflurane, or isoflurane anesthesia. Twelve additional patients received epinephrine in 0.5 percent lidocaine while anesthetized with halothane. Positive evidence of ventricular irritability was given by the appearance of 3 or more premature ventricular contractions during or following injection. ⋯ From these data, the dose producing a positive response in 50 percent of patients (ED50) was calculated. An ED50 of 2.1 mug/kg for halothane, 3.7 mug/kg for halothane-lidocaine, 10.9 mug/kg for enflurane, and 6.7 mug/kg for isoflurane indicates the relative safety of these agents when epinephrine is injected for hemostasis. The data also suggest that lidocaine given with the epinephrine protects against ventricular arrhythmias.
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Anesthesia and analgesia · Sep 1976
Effect of morphine-diazepam on signs of anesthesia, awareness, and dreams of patients under N2O for cesarean section.
Morphine (0.2 mg/kg) and diazepam (0.1 mg/kg) were injected IV after delivery of the fetus in 68 parturients undergoing cesarean section (CS). General anesthesia was with thiamylal-N2O-O2 (4:2) and muscle relaxant. Twenty-four to 36 hours postoperatively, 1 patient had recall, 1 had unpleasant dreams, and 2 had pleasant dreams. ⋯ Morphine-diazepam combination caused anterograde and retrograde amnesia. During the cesarean, movement of patient, size of pupils, or changes in blood pressure were not indicative of awareness or dreams. During anesthesia, 33 percent O2 produced adequate oxygenation of mother and fetus.
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Anesthesia and analgesia · Sep 1976
Clinical TrialTrain-of-four fade and edrophonium antagonism of neuromuscular block by succinylcholine in man.
Thumb twitch in response to train-of-four stimulation (2 Hz for 2 sec) of the ulnar nerve was measured in 36 patients anesthetized with halothane and N2O and paralyzed with succinylcholine chloride (SCC). Train-of-four fade was detected whenever a block was produced. The train-of-four ratio decreased with continued exposure to SCC. ⋯ The magnitude of antagonism is also predictable in a semiquantitative manner, although complete antagonism cannot be ascertained. The lower the ratio, the more effective the antagonism becomes. Train-of-four fade, therefore, appears to be a consistent and sensitive quantitative sign of phase II neuromuscular block by SCC in man.
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Recent reports have described methods of controlling the level of CO2 during anesthesia with a N2O-relaxant sequence and controlled ventilation. This paper describes a method of predicting and controlling the PaCO2, using body weight for determination of the fresh gas flow from the anesthetic machine, removing the absorbent from the canister while leaving the canister in the circuit, and controlling ventilation at 12 ml/kg and at 12/min.