Articles: anesthetics.
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Anesthesia and analgesia · May 1980
Assessment of block of the sciatic nerve in the popliteal fossa.
Success of block of the sciatic nerve in the popliteal fossa in 130 patients was assessed by an anesthesiologist at the time of surgery. The patients were evaluated for complications by the anesthesiologist during postoperative rounds and by the orthopedic surgeon at the 1-month follow-up visit. Acceptance of the block by the patient was judged by answers on a questionnaire filled out by the patients after they had gone home. ⋯ Two patients described sensations compatible with postoperative paresthesias, and two others described sensations that may have been paresthesias; in none did the sensations last longer than 1 month. Assessment of the blocks by the anesthesiologist in all 130 patients in the study revealed that anesthesia satisfactory for completion of the operative procedure was achieved in 107 (82.3%). General anesthesia was needed in eight patients (6.2%), and in 15 patients (11.5%) intravenous sedation or injection of the site of surgical incision with local anesthesia (or both) was needed.
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In five adult horned sheep long-term cerebro-spinal fluid pressure measurements were carried out before, during and after ten spinal-anaesthetics with the help of a canula which was fixed on the skull. In the lumbar subarachnoid space the pressure-course was recorded also, before and after the injection of local-anaesthetic. The following reproducible phenomena were found: Rapid pressure increase after injection, increase of cardio-respiratory oscillations and in two cases a sharp decrease of pressure after removal of the spinal needle. A connection between this and the cause of postural headache in man is postulated.
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J. Pharmacol. Exp. Ther. · Apr 1980
Structure-activity relations for frequency-dependent sodium channel block in nerve by local anesthetics.
Different local anesthetic drug structures differ significantly in their capabilities for producing frequency (f)-dependent sodium channel block. Voltage-clamped frog myelinated nerve preparations have been utilized in order to investigate structure-activity relations for several modes of local anesthetic drug action, including the kinetics of f-dependent excitability block. ⋯ In addition, f-dependent block increments are greater for drugs of lower lipid solubility, supporting the "modulated drug receptor" hypothesis that intracellular drug forms participate in the open channel binding involved in f-dependent blocking. Finally, molecular size has been shown to be a very important determinant of closed channel block escape rates with smaller drug structures showing faster escape rates from f-dependent increments in channel block.