Articles: human.
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Journal of anesthesia · Apr 1990
Comparative study of intravenous administration of Ringer's lactate, Ringer's acetate and 5% glucose containing these Ringer's solutions in human being.
The effects of the administration of Ringer's lactate (L) and Ringer's acetate (A) solution on blood biochemistry in human subjects operated for tympanoplasty under general anesthesia were investigated. And the feasibilities of the clinical use of Ringer's lactate (LD) and Ringer's acetate (AD) solution containing 5% glucose were also assessed. In all cases the rate of infusion was 500 ml for initial 20 min, and then 5 ml.hr(-1).kg(-1) B. ⋯ In both LD and AD group, the higher blood concentrations of lactate, pyruvate, acetate and glucose were found than in L and A group. Urinary excretions of these metabolites were much higher in LD and AD group than in L and A group. So glucose containing Ringer's lactate or acetate solutions should be administered in appropriate amounts and rate not to induce clinically significant metabolic alterations.
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Journal of anesthesia · Jan 1990
The effects of ulinastatin on cardiac and hepatic energy metabolism in rats subjected to hypovolemic shock.
Ulinastatin is a trypsin inhibitor extracted from human urine. In this study the effects of ulinastatin on myocardial and hepatic tissue concentrations of creatine phosphate (CP), ATP, ADP, AMP, lactate, pyruvate, and glycogen have been investigated in rats which were in hemorrhagic shock state. Hypovolemia was induced by bleeding from the femoral artery, and systolic blood pressure was maintained 40 mmHg for 25 min, then ulinastatin 50,000 units.kg(-1) in saline or saline vehicle was intravenously administered. ⋯ The myocardial tissue CP level was higher in ulinastatin-treated group than that of control group, whereas no significant difference in energy charge between two groups. The hepatic tissue level of AMP, lactate and L/P ratio was lower in ulinastatin-treated group than that of control group, however, no significant difference was found in hepatic tissue level of ATP, ADP and energy charge. From these results it is concluded that ulinastatin can improve the energy metabolism of myocardium to some extent, but not of the liver in rats with hypovolemic shock.
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The aim of this investigation has been to test in humans the reliability and validity of three painful stimuli, i.e, mechanical pressure, a modified submaximum-effort tourniquet technique, and the cold pressure test. Twenty-four untrained subjects (twelve females, twelve males) volunteered in the experiments and, after a trial session were presented with four runs of these three noxious stimuli within 36 h. They assessed the painfulness using a direct scaling technique (category subdividing procedure). ⋯ Repeated mechanical stimulation caused sensitization that did not occur with ischemia or cold. There were no significant differences whether the experiments were performed in the morning or in the evening. Experimental pain induction either by mechanical pressure or by ischemia judged in accordance with the category subdividing procedure produce reliable and valid results; the methods are easily applicable and economic.
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In the past the view has often been expressed that children are less sensitive to pain than adults as a result of the assumption that their nervous system is not as well developed. According to this theory, newborns were not supposed to feel pain at all, and for this reason minor surgery was often performed with inadequate anesthesia. Evidence in the more recent literature and the regular choice of "pain in children" as a topic for congresses exemplify the more and more widespread belief that children of all ages can feel pain and, relative to their developmental stage, suffer accordingly. ⋯ As cognition develops further, the patient's own concept of health and sickness changes, as does the ability to express feelings of pain. In the pathogenesis of pain in children, the dominant types are nociceptor pain (e.g., as a result of trauma or infection) and pain resulting from malfunction (e.g., physical malposition, migraine), whereas nervous pain occurs less frequently. Pediatricians should pay particular attention to the treatment of acute and chronic pain in children.