Articles: general-anesthesia.
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Comparative Study Clinical Trial Controlled Clinical Trial
Muscular relaxation with atracurium, vecuronium and duador under balanced anaesthesia.
The neuromuscular effects of three new nondepolarizing neuromuscular blocking drugs, atracurium, vecuronium and Duador, were investigated in surgical patients under balanced anaesthesia. (The numbers of patients in each study are given in the tables.) There were no significant differences in the neuromuscular effects of the three agents. None showed any cumulation after repeated administration of maintenance doses. Muscular relaxation for upper abdominal surgery was adequate as long as the isometric twitch tension (P) was no more than 25% of control. ⋯ The initial dose of Duador caused a 16.7% increase in heart rate. The findings indicate that the three new muscle relaxants merit further clinical trial. In our opinion, until the results of such studies become available, atracurium should not be used in patients with a history of allergic diathesis and Duador in those in whom increased heart rate may be harmful.
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Comparative Study
Neuromuscular and cardiovascular effects of atracurium during nitrous oxide-fentanyl and nitrous oxide-isoflurane anaesthesia.
The neuromuscular and cardiovascular effects of atracurium were compared during nitrous oxide-isoflurane and nitrous oxide-fentanyl anaesthesia in healthy surgical patients. The dose-response curve was shifted significantly to the left during nitrous oxide-isoflurane anaesthesia (ED50 0.068 mg kg-1) as compared with nitrous oxide-fentanyl anaesthesia (ED50 0.083 mg kg-1). For equipotent doses, the time course of neuromuscular effects (onset and duration) was not appreciably different between the nitrous oxide-isoflurane group and the nitrous oxide-fentanyl group. ⋯ The onset time (time from injection to peak effect) for subparalytic doses of atracurium was approximately 6.5 min and is comparable to the onset time for equipotent doses of pancuronium and vecuronium. The duration of neuromuscular effects of atracurium (time from injection to 95% recovery) was approximately 20 min for subparalytic doses and is the same as that of vecuronium and one-third to one-half that of pancuronium. It is concluded that the peak effect of atracurium is enhanced more by nitrous oxide-isoflurane than by nitrous oxide-fentanyl anaesthesia, but for equipotent doses the time-course is the same.
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Ann Otolaryngol Chir Cervicofac · Jan 1983
[Criteria for choice of an anesthetic technic for laryngeal laser microsurgery using the laser in adults].
Laryngeal microsurgery by means of the laser involves anesthetic constraints regarding mainly the mode of ventilation during operation. The principal techniques and different anesthetic protocols are discussed. The two main criteria for the choice of method appear to be the permeability of the laryngeal passage and the patient's general condition and history. The two principal methods proposed are high frequency jet ventilation and ventilation controlled by a protected intubation tube.
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Infant and small children are not always able to cooperate in impedance measurements. For this reason it was decided, -in special cases, -to perform acoustic reflex examination under general anaesthesia. The first report on stapedius reflex and general anaesthesia was published by Mink et al. in 1981. ⋯ The reflex threshold remains unchanged and the amplitude of muscle contraction is somewhat increased. The method was used: 1. to assess the type and degree of hearing loss in children with cleft palate and/or lip prior to surgery. 2. to exclude neuromuscular disorders with indication of pharyngoplasties. 3. to quantify hearing level in children--mostly multiply handicapped--with retarded speech development. The results of Behavioral Observation and Impedance Audiometry are discussed and evaluated.