Articles: anesthetics.
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Z Orthop Ihre Grenzgeb · Mar 1987
[Percutaneous lumbar facet denervation. Indications and significance in chronic backache].
The lumber facet joints have been established as a source of low back pain which may radiate to the leg. Because there are no reliable clinical signs which confirm the diagnosis injections of an anaesthetic agent into the joints are necessary. Therapeutically a percutaneous radiofrequency destruction of the medial branches of lumbar dorsal rami may relieve such pain. Success rate, however, is depending on a careful selection of patients.
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Anaesth Intensive Care · Feb 1987
ReviewThe role of pharmacokinetics in anaesthesia: application to intravenous infusions.
Pharmacokinetic concepts describe the relationship between drug dose and resulting plasma concentration. A drug's pharmacokinetic profile can be described by distribution and elimination half-lives, initial volume of distribution, steady-state distribution volume, and metabolic and distributional clearance. ⋯ The most rapid method of achieving a constant plasma concentration involves using a variable rate of drug infusion that adjusts for the metabolic clearance and distribution of the drug. Computer-driven infusion pumps can be used to rapidly achieve, then maintain, constant plasma concentrations of a drug.
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J Cardiothorac Anesth · Feb 1987
Hemodynamic variables and the incidence of prebypass ischemia during sufentanil/O2/pancuronium anesthesia in patients undergoing coronary artery surgery.
It has been suggested that sufentanil is a superior anesthetic to fentanyl for patients undergoing myocardial revascularization. This study was performed to determine the incidence of prebypass myocardial ischemia using sufentanil, 20 micrograms/kg for patients undergoing coronary artery bypass grafting (CABG). Twenty-seven patients with normal left ventricular function, scheduled for elective CABG, were studied. ⋯ Three patients (11.1%) had perioperative myocardial infarctions, two of whom had prebypass myocardial ischemia. It is concluded that the incidence of prebypass ischemia with sufentanil anesthesia approximates 26%, which is similar to other studies using sensitive ECG monitoring techniques for the detection of ST segment changes. Hemodynamic instability, in the form of bradycardia, hypertension and hypotension, but not tachycardia, may have contributed to the incidence of prebypass ischemia.
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Complications of local anaesthesia in general have been considered in so far as they may be confused with adverse effects of local anaesthetic drugs. Local anaesthetics may give rise to adverse reactions by a number of mechanisms. They affect nerve conduction and vasculature at the site of injection: a local effect; but is it unlikely that they ever produce an irreversible noxious effect on nerve fibres. ⋯ Ignorance or carelessness are frequently causative factors in serious reactions. Adequate oxygenation is vital in prophylaxis and immediate treatment of systemic toxicity, while resuscitative skill and equipment must always be to hand. Idiosyncrasy or allergy can only rarely be an excuse for adverse reactions to local anaesthesia.