Articles: anesthetics.
-
Any drug or blood product administered in the perioperative period has the potential to produce a life-threatening allergic (immune reaction) called anaphylaxis. Anaphylactic reactions represent adverse reactions mediated by immunospecific antibodies (IgE and IgG) that interact with mast cells, basophils, or the complement system to liberate vasoactive mediators and recruit other inflammatory cells. ⋯ Rapid and timely cardiopulmonary intervention with airway maintenance, epinephrine, and volume expansion is essential to avoid an adverse outcome. Severe reactions may be protracted, especially during anesthesia, requiring even larger doses of catecholamines and intensive care observation.
-
Nephrol. Dial. Transplant. · Jan 1988
Randomized Controlled Trial Comparative Study Clinical TrialTopical anaesthesia for fistula cannulation in haemodialysis patients.
The use of a local anaesthetic cream (EMLA; Astra) for arteriovenous fistula cannulation was compared to placebo in a double-blind randomised manner in 26 patients undergoing chronic haemodialysis who were currently using injections of lignocaine. The EMLA cream was highly effective compared to placebo (P less than 0.001) on visual analogue and verbal rating scales as well as ease of venepuncture (P less than 0.01). It also gave more pain relief and improved the ease of venepuncture compared to lignocaine injections. Patients expressed a strong preference for the EMLA cream, which has advantages that outweigh the cost and convenience factors.
-
Operations on the cutaneous surfaces are mainly performed under local anesthesia. Local infiltrative anesthesia is the most frequently used form in cutaneous surgery. ⋯ In contrast to general anesthesia it can be used in risk patients e.g. with ischemic heart disease or respiratory illnesses. Adverse reactions must be taken into account, especially toxic effects, allergy, drug interactions or traumatic lesions of nerves or blood vessels.
-
Int J Clin Pharmacol Ther Toxicol · Jan 1988
ReviewPropofol, the newest induction agent of anesthesia.
Propofol is a rapidly acting intravenous anesthetic agent which has many advantageous kinetic properties explaining its usefulness by bolus dose for induction of anesthesia or for administration by continuous intravenous infusion. It is rapidly distributed in the body with a half-life of only around 2 min and has an efficient hepatic and extrahepatic clearance (total body clearance may exceed liver blood flow). Premedication has little effect on the already good induction characteristics of propofol. ⋯ Propofol has proved to be a useful induction agent regardless of the age of patients, but in the elderly there appears to exist a marked sensitivity to it. Up to now there is no evidence that propofol in emulsion drug form can produce allergic or anaphylactoid reaction more often than other induction agents in use and no severe hematological nor visceral toxicity have been reported. In the present situation, when althesin is not marketed any more due to a high frequency of anaphylactoid reactions and etomidate will have a limited use in clinical practice because of its blocking effect on adrenocortical function, propofol offers an important alternative anesthetic agent to thiopentone.