Journal of anesthesia
-
Journal of anesthesia · Sep 1994
Flecainide is effective against premature supraventricular and ventricular contractions during general anesthesia.
The effect of intravenously administered flecainide on premature supraventricular (PSCs) and ventricular contractions (PVCs) which developed under general anesthesia was evaluated. Flecainide was infused intravenously at a rate of 0.2 mg/kg/min until the efficacy of this drug appeared or for 10 min; thus, the maximum dose was determined to be 2 mg/kg. Flecainide was administered to 10 patients who experienced more than 5 supraventricular and/or ventricular contractions/min for a period of more than 5 min (PVCs, 4 patients; PSCs, 6 patients). ⋯ This dose of flecainide did not affect the heart rate and QRS interval, but caused a transient decrease in systolic blood pressure from 127±6 mmHg (SE) to 114±6 mmHg, a 14% increase in the PQ interval, and a 6.3% increase in the QT interval. These results suggest that flecainide is a promising drug for the treatment of PSCs and PVCs which develop during general anesthesia. Transient hypotension and cardiac conduction disturbances immediately after injection may occur when flecainide is used intravenously.
-
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.
-
Journal of anesthesia · Sep 1994
Therapy with antibody to tumor necrosis factor against endotoxin shock in rabbits.
The purpose of this study was to determine the efficacy of treatment with anti-tumor necrosis factor (TNF) antibody in preventing the deleterious effects of endotoxin. Polyclonal anti-TNF antibody was produced by immunizing rabbits. Experiments were carried out on 16 rabbits intravenously infused with the lethal dose of lipopolysaccharide (LPS). ⋯ Prominent histopathological changes in the liver and kidney were evident in the LPS group. In contrast, pathologic changes in the tissue from the anti-TNF antibody group were considerably less prominent. These results support the idea that TNF plays a central role in mediating the pathophysiologic changes during endotoxin shock.
-
Journal of anesthesia · Sep 1994
The effect of pentobarbital sodium on the dorsal horn of the spinal cord.
The effect of intravenously administered pentobarbital sodium on the activity of single unit in Rexed lamina V of the transected feline lumbar spinal cord was studied using an extracellular microelectrode recording technique. Pentobarbital sodium 1.0 mg·kg(-1), 2.5 mg·kg(-1), and 5.0 mg·kg(-1) administered intravenously suppressed both the spontaneous and the evoked activity in Rexed lamina V cells, known to respond principally to noxious stimuli, in a dose-dependent manner. ⋯ We conclude that pentobarbital sodium intravenously administered has a suppressive effect on single unit activity of cells in Rexed lamina V and probably has an analgesic effect. Its suppressive effect is dose-dependent.