Articles: nerve-block.
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The plasma concentrations of pancuronium were monitored during i.v. infusions of the relaxant in dogs. Pancuronium was administered at rates which maintained the degree of neuromuscular blockade at three predetermined levels. The concentrations of the drug in the blood were consistent for any one animal but showed considerable overlap for the three levels of paralysis between animals. ⋯ The concentrations at 80% of control were 0.094 microgram ml-1 and 0.083 microgram ml-1 respectively. The agreement between these results suggests a relationship between the plasma concentration of the relaxant and its effect during the termination of the action after a large bolus injection of the drug. As this occurs chiefly during the postdistribution equilibrium, the relatively slow decrease in plasma concentration would appear to become the rate-limiting factor in recovery from paralysis.
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Adverse reactions to paracervical block, including death, are believed to be dose related. By using a modified jet injector instead of the standard syringe-and-needle technique, we obtained equal analgesia with one fifth of the standard milligram dosage of lidocaine in patients undergoing therapeutic abortion. Blood lidocaine levels as determined by gas chromatography were reduced by two thirds with jet injection. These results led us to conclude that jet injection for paracervical block is safer than the syringe-and-needle technique.
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Anesthesia and analgesia · Jan 1978
A new nerve stimulator for monitoring neuromuscular blockade and performing nerve blocks.
A new stimulator is described with characteristics designed to take advantage of recent knowledge of the pharmacology of neuromuscular relaxants and events involved in normal neuromuscular transmission. The stimulator has proven as useful in performance of peripheral nerve blocks as in monitoring neuromuscular blockade.