Journal of anesthesia
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Journal of anesthesia · Sep 1994
RETRACTED ARTICLE: Airway occlusion pressure is an indicator of respiratory depression with isoflurane.
The purpose of this study was to elucidate the respiratory depressant effects of isoflurane (0%-1.0%) using airway occlusion pressure (P0.1), a known index of the output of the respiratory centers, in ten anesthetized patients. P0.1 was measured as the pressure change obtained after the first 0.1 sec of spontaneous inspiration against the occluded airway. A significant decrease in minute volume ([Formula: see text]) and a significant increase in PaCO 2 were not observed during the periods of isoflurane 1.0% at the end-tidal concentration compared with those of control period (0% isoflurane) (P<0.05), whereas a significant decrease in P0.1 was observed during the period of isoflurane 0.5%. Our results suggested that P0.1 was a more sensitive indicator of respiratory depression than PaCO 2 or[Formula: see text], and the respiratory center was depressed with a considerably lower concentration (0.5%) of isoflurane.
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Journal of anesthesia · Sep 1994
The pharmacodynamics of rocuronium in pediatric patients anesthetized with halothane.
The aim of this study was to determine the neuromuscular blocking potency of rocuronium (ORG 9426) in 4-to 14-year old children anesthetized with halothane. After induction of anesthesia, the ulnar nerve was stimulated with electrical impulses of 0.2 ms duration every 12 s and the force of contraction of the thumb (P) was continuously recorded. Doses of 0.12, 0.16, 0.20, and 0.24 mg·kg(-1) rocuronium were administered, in a randomized fashion, to 4 groups of 12 patients each. ⋯ When at termination of anesthesia T4/T1 ratios were lower than 0.75, the residual neuromuscular block could be antagonized with 0.5 mg·kg(-1) edrophonium in 2 min. Rocuronium, 0.3 mg·kg(-1) caused a 13.5% increase of heart rate but had no effect on blood pressure. In conclusion, in 4 to 14-year-old children, rocuronium appears to have a more rapid onset and shorter duration of action than other steroid-type muscle relaxants.
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Journal of anesthesia · Sep 1994
Effects of halothane and enflurane on the peripheral vasoconstriction and shivering induced by internal body cooling in rabbits.
General anesthetic agents have central and peripheral effects on body temperature regulation, and its alterations are related to the depth of anesthesia. To evaluate the effect of halothane and enflurane on thermoregulation, we investigated the threshold of body core temperatures to induce peripheral vasoconstriction and shivering in spontaneously breathing rabbits. Rabbits were anesthetized with halothane or enflurane at 0.0 (control), 0.2, and 0.4 MAC (minimum alveolar concentration). ⋯ The incidence of peripheral vasoconstriction was not significantly affected by halothane or enflurane. However, the incidence of shivering decreased in a dose-dependent fashion with both anesthetic agents. At 0.2 MAC, the incidence of shivering in the enflurane group was significantly higher than that in the halothane group, suggesting that suppression of shivering by halothane is stronger than enflurane.
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The purpose of this study was to determine the mortality rate in 527 critically ill patients with multiple organ failure (MOF), treated in our ICU between August, 1986 and January, 1992, and to compare it with the results obtained in a group of patients studied who had been treated between October, 1978 and July, 1986. The relationship between the mortality rate and each type of organ failure and the extent of organ system involvement was also investigated. ⋯ The mortality rate of patients with the failure of two organs in the present study was significantly lower than that found in those in the previous study. Although artificial organ mechanical life support technology other than that for patients with renal failure is still unsatisfactory, these results suggest that the prognosis of patients with MOF is improving.