Articles: anesthetics.
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Randomized Controlled Trial Comparative Study Clinical Trial
Evaluation of local anesthesia agents using a new force-sensitive lid speculum.
Three commonly used injection anesthetics, bupivacaine .75%, mepivacaine 2%, and lidocaine 2% were evaluated for onset, completeness and duration of akinesia following modified O'Brien facial nerve block, using a new force-sensitive lid speculum. All three agents provided facial akinesia that was profound within six minutes of the time of injection. The onset and the depth of anesthesia were roughly the same with all three agents. ⋯ Akinesia produced by mepivacaine was adequate for about 90 minutes, and lidocaine for 15-30 minutes. A newly-described force-sensitive speculum was utilized in this study. It is an effective instrument for measuring completeness of akinesia, and may have clinical usefulness.
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Acta Anaesthesiol Scand · Jun 1983
Sister chromatid exchanges and structural chromosome aberrations in lymphocytes in operating room personnel.
Information on possible chromosomal damage in humans after long-term exposure to trace concentrations of waste anaesthetic gases is scarce. We examined peripheral lymphocytes in operating room personnel for both chromosome aberrations and sister chromatid exchanges (SCE). Following a standardized procedure of cultivation and staining, 30 cells from each person were scored for SCE and 100 cells from each person were examined for chromosome aberrations. ⋯ Examination of SCE and chromosome aberrations yielded corresponding qualitative results. With both tests, no statistically significant difference was observed between the four groups of persons. It was concluded that by examination of both SCE and chromosome aberrations in peripheral lymphocytes in operating room personnel, no indication was found of a mutagenic effect of long-term exposure to trace concentrations of waste anaesthetic gases.
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One of the very real complications possible in the use of local anesthetic agents is a relative overdose of the drug, resulting in an inordinate and potentially dangerous serum level. Even when using strict and careful technique, problems can occur. The reactions cited in the aforementioned cases were most likely the result of the accidental intravenous injection of a local anesthetic agent. ⋯ Nevertheless, local anesthetics are potentially toxic and their use should be approached with knowledge of and a healthy respect for their associated complications. It should also be remembered that virtually all local anesthetic toxic reactions are preventable and treatable. Their occurrence need not necessarily result in a poor outcome.
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Comparative Study
Catecholamine and cortisol responses to sufentanil-O2 and alfentanil-O2 anaesthesia during coronary artery surgery.
The effects of alfentanil-O2 and sufentanil-O2 anaesthesia on plasma catecholamines and cortisol were investigated in 32 patients undergoing coronary artery bypass grafting operations. After lorazepam-atropine premedication and pancuronium pretreatment, alfentanil was given to 16 patients at a rate of 3 mg.min-1 and sufentanil was given to 16 patients at 300 micrograms.min-1 until the patients were unconscious; at this time they were given succinylcholine and were intubated. After intubation an amount of alfentanil or sufentanil equal to the dose producing unconsciousness was infused over the next 30 min, at which time the operation began. ⋯ During bypass both hormones became increased and remained increased at the end of operation. Plasma cortisol decreased after incision and remained decreased until the end of operation. These data indicate that alfentanil-O2 and sufentanil-O2 anaesthesia produce similar changes in plasma catecholamines and cortisol as does fentanyl-O2 anaesthesia and hormonal effects are, therefore, not an explanation for any advantages the newer narcotics may have over fentanyl.