Journal of anesthesia
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Journal of anesthesia · Mar 1996
Oral clonidine reduces thiamylal requirement for induction of anesthesia in adult patients.
Although preanesthetic clonidine, an α-2 agonist, is known to reduce anesthetic requirements, the effect of preanesthetic oral clonidine medication per se on the requirement of thiamylal in adult humans has not yet been examined. One hundred and sixty-one adult patients (14-78 years of age) were randomly assigned to groups that received oral clonidine (5μg·kg(-1) (n=51), 2.5μg·kg(-1) (n=55), or none (n=55)) in addition to 20mg oral famotidine 90min before anesthesia induction. ⋯ Thiamylal requirements were significantly less in both clonidine groups (2.95±0.09 and 3.14±0.10 mg·kg(-1) (mean±SE) for patients receiving 5μg·kg(-1) and 2.5μg·kg(-1) clonidine, respectively) than in the control group (3.81±0.11 mg·kg(-1),P<0.05); however, no difference was found between the two clonidine groups. Although mean blood pressure and heart rate during the study period were significantly lower in both clonidine groups than in the control group, no profound hypotension or marked bradycardia were noted in the clonidine groups.
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Journal of anesthesia · Mar 1996
Effects of age on neuromuscular blockade by vecuronium as measured by accelography under sevoflurane anesthesia.
We evaluated possible differential effects of age on a single bolus intravenous injection of vecuronium using accelography under sevoflurane anesthesia. Thirty anesthetized patients were divided into three groups of 10 patients as follows: group 1=age 1-5 years; group 2=age 20-40 years, and group 3=age >70 years. Vecuronium 0.1 mg·kg(-1) was given to facilitate tracheal intubation. ⋯ Clinical duration, i.e., the time from completion of maximal block to 25% recovery of train-of-four (TOF) ratio in group 1 was significantly shorter than that in group 3 (43.6±12.0 min and 67.3±15.6 min;P<0.01). The reversal time from 25% to 75% of the TOF ratio after the administration of neostigmine in group 1 was not significantly different from those in groups 2 and 3 (172.5±73.9s, 219.0±59.7s, and 222.0±155.7s). The authors conclude that the time to maximal twitch depression after the administration of vecuronium is significantly shorter in children than that in adults, and that the fastest recovery from vecuronium is also observed in children.
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Journal of anesthesia · Mar 1996
Does increasing end-tidal carbon dioxide during laparoscopic cholecystectomy matter?
To examine the adverse effects of peritoneal carbon dioxide (CO2) insufflation during laparoscopic cholecystectomy, both hemodynamic and respiratory alterations were continously monitored in 17 adult patients using noninvasive Doppler ultrasonography and a continuous spirometric monitoring device. During the surgery, which was performed under inhalational general anesthesia, intraabdominal pressure was maintained automatically at 10mmHg by a CO2 insufflator, and a constant minute ventilation, initially set to 30-33 mmHg of end-tidal CO2 (ETCO2), was maintained. ⋯ The stress of 10mmHg pneumoperitoneum was a major cause of hemodynamic changes during laparoscopic cholecystectomy. Some clinical strategies such as deliberate intraabdominal insufflation at the initial phase might be required to minimize these hemodynamic changes.