Articles: anesthetics.
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SPINA is a program developed with LOTUS 1-2-3 that simulates the pharmacokinetics of an infusion of intravenous anaesthetic drugs. SPINA incorporates a database which contains records of multiple-compartment pharmacokinetic models. The models have been obtained from the literature. ⋯ To perform the pharmacokinetic simulation, the anaesthetist has to choose a pharmacokinetic model in which the program determines the turn-over rates, and displays a sequence of infusion steps. On request, SPINA provides the graphs for the theoretical drug distribution and for the infusion rate required to maintain the target concentration. SPINA therefore allows one to simulate the administration of intravenous anaesthetic drugs and to optimize their delivery.
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Southern medical journal · Nov 1989
Case ReportsTopical TAC (tetracaine, adrenaline, cocaine) solution for local anesthesia in children: prescribing inconsistency and acute toxicity.
The topical anesthetic solution TAC (tetracaine, adrenaline, cocaine) has gained widespread acceptance as the preferred local anesthetic for repairing skin lacerations in children. Despite this popularity, there are no universally accepted guidelines for its application. We report the case of a 6-month-old infant who had respiratory distress and seizures after TAC administration. ⋯ Among the 20 (63%) with restrictions, there is wide variability in the way it is prescribed. TAC solution is a highly potent anesthetic agent with significant toxicity potential. Research into appropriate dosages, absorption, and actions needs to be undertaken before its widespread acceptance as the drug of choice for providing local anesthesia in children.
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Prevention of damage of occupational exposure to anaesthetic gases and vapors consists in limitation of pollution and in biological and environmental monitoring. Reduction of polluting concentrations can be obtained only by using both ventilation of the operating room and active scavenging; proper behaviour in accordance with prevention rules and psychologic involvement of personnel is also needed. ⋯ Acts and regulations in force at present in Italy and technical specifications concerning this problem are than reviewed. The author notices that in many cases, standards dealing with requirements to be satisfied should be established before performance standards; at any rate, regulations should also be more compulsive.
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Comparative Study
[A comparison of hemodynamic changes with sufentanil-O2 and fentanyl-O2 anesthesia for coronary bypass grafting].
Hemodynamic changes were investigated in twenty patients undergoing coronary artery bypass grafting. Thirteen patients received sufentanil-O2 anesthesia and seven patients had fentanyl-O2 anesthesia. Systolic, diastolic, as well as mean arterial blood pressures, heart rate and rate pressure product (RPP) were measured before and after intubation, one minute after skin incision, and one minute after sternotomy. ⋯ Diastolic pressure was not significantly changed in each group. Stable hemodynamic parameters with no ST-T change were noticed during surgical procedure in each group. We conclude that sufentanil is a superior narcotic agent than fentanyl for the patients undergoing CABG, and it effectively blocks sympathetic reflex activity.
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Anesthesia and analgesia · Oct 1989
Clinical Trial Controlled Clinical TrialEffect of injection rate on level and duration of hypobaric spinal anesthesia.
The purpose of this study was to determine whether injection rate affects the spread of hypobaric spinal anesthesia. Hypobaric spinal anesthesia was performed on 20 patients for total hip arthroplasty. Dural puncture was performed with a 22-gauge Whitacre needle. ⋯ Four-segment regression of anesthetic levels took significantly longer in the slow injection group. Local anesthetic mixtures used were consistently hypobaric compared to patient CSF. We conclude that slow injection of hypobaric tetracaine through a 22-gauge Whitacre needle produces lower levels of spinal anesthesia that tend to be of longer duration than levels resulting from fast injection.