Anesthesia and analgesia
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Anesthesia and analgesia · Jul 1976
Case ReportsIntraoperative awakening for early recognition of possible neurologic sequelae during Harrington-rod spinal fusion.
To permit early recognition of possible cord trauma due to spinal fusion with Harrington-rod instrumentation, 42 patients were awakened introperatively for testing voluntary motor function of the limbs. N2O-O2-curare and morphine were used for anesthesia in all patients. ⋯ The awakening caused no displacement of Harrington rods in any patient. No neurologic sequelae were found.
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Anesthesia and analgesia · May 1976
Case ReportsProlonged neuromuscular blockade with pancuronium in the presence of acute renal failure: a case report.
Prolongation of neuromuscular block following pancuronium administration to anephric patients has been reported. A patient is described whose postoperative course after resection of gangrenous bowel was complicated by acute renal failure and prolonged neuromuscular blockade. A large intraoperative dose of pancuronium was administered without monitoring neuromuscular transmission with a peripheral nerve stimulator. ⋯ The absence of renal excretion considerably increases the duration of action of curare when given in high doses. It has been suggested that doses of pancuronium greater than 3.6 mg/sq m or multiple doses would result in prolonged neuromuscular block in patients without renal function. The case reported illustrates the importance of monitoring neuromuscular transmission during administration of pancuronium in the presence of renal insufficiency to avoid this complication.
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Anesthesia and analgesia · May 1976
Comparative Study Clinical Trial Controlled Clinical TrialAn evaluation of memory under regional anesthesia with IV lorazepam as a premedicant.
Forty male volunteer patients undergoing regional anesthesia were evaluated for alertness and memory in a double-blind study which compared IV lorazepam (4 mg) plus IM meperidine (50 mg) with IV placebo plus IM meperidine (50 mg) as premedicants. The data indicate no significant retrograde effects. ⋯ A significant number of patients over age 40 were judged to be excessively sedated after administration of lorazepam. However, respiration, blood pressure, and pulse did not appear to be differentially affected by lorazepam and there were no adverse changes even in patients considered to be oversedated.
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Anesthesia and analgesia · May 1976
Comparative StudyThe effect of enflurane, isoflurane, fluroxene, methoxyflurane and diethyl ether anesthesia on ouabain tolerance in the dog.
Digitalis tolerance in dogs anesthetized with enflurane, isoflurane, fluroxene, methoxyflurane, and diethyl ether was compared with that in dogs anesthetized with pentobarbital. Ouabain dosage needed to cause ventricular tachycardia was significantly higher than that of pentobarbital with all agents except fluroxene, as was the LD50. The relative potency of these anesthetics in converting ouabain-induced ventricular tachycardia to sinus rhythm, in order of descending effectiveness, was: diethyl ether, methoxyflurane, enflurane, fluroxene, isoflurane, pentobarbital.