bluuebunny/crossref_metadata_2025_split huggingface dataset:
Distribution of Bupivacaine in the Rabbit under Normal and Acidotic Conditions
Authors: Sjöstrand Ulf , Widman Bertil 
Published: December 2008

SUMMARYThe tissue concentration of bupivacaine was determined under normal and acidotic conditions in ether‐anaesthetized rabbits by means of3H‐bupivacaine. The haematocrit in the blood of different organs and their blood volume were studied by a tracer technique, and the tissue concentration of bupivacaine was calculated after measurement of its concentration in arterial and mixed venous blood during infusion of3H‐bupivacaine. At the same dose rate the blood concentration in acidotic animals was significantly higher. The distribution of3H‐bupivacaine between plasma and erythrocytes was studiedin vivoand at a 200 times higher concentrationin vitro; the distribution coefficients were approximately 10 and 280, respectively. The results indicate that bupivacaine does not penetrate blood cells to any appreciable extent but thatin vivothe uptake of bupivacaine in the red blood cells is increased in acidosis. In rabbits with a normal pH the concentration of bupivacaine in the lung was 8 times, and in the liver and kidney 6 times that of the concentration in the blood, while the brain and heart showed the same concentration as in the blood. The excretion of bupivacaine in the bile was pronounced. Thin‐layer chromatography showed that the3H‐labelling was stable and that the3H‐excretion in the bile and urine emanated from3H‐bupivacaine. The lung tissue concentration decreased greatly within 20 min after termination of the infusion. In rabbits with acidosis higher bupivacaine concentration was noted in certain organs, especially the lung, where it was 5 times higher than in animals with a normal blood pH and about 25 times higher than the blood concentration in acidotic rabbits.—The uptake of bupivacaine is discussed from the aspects of nutritive flows, capillary permeability, dissociation form, tissue affinity and electrostatic forces as well as of the pH‐dependence of the tissue affinity.The importance of acidosis in the provocation of central‐nervous toxic reactions is discussed in the light of the dissociation of the bupivacaine molecule. From the results of this study it seems probable that the risk of complications in the use of local anaesthetics of the amide type increases in the presence of acidosis.
Insufflation Pressure and Compressed Gas Ventilation with the Engström Respirator
Authors: Hedensterna G. , Öquist L. 
Published: December 2008

Previous model studies have demonstrated a significant relationship between maximum insufllation pressure in the patient circuit of the Engström respirator and the resultant compressed gas ventilation. In the present study, this relationship has been examined in 16 patients with cardio‐pulmonary disease, necessitating prolonged respirator treatment. Insufflation pressures were measured with electrical transducers, and compressed gas ventilation was determined using gas meters and a pneumatic valve.An exponential relationship was found between maximum insufflation pressure and compressed gas ventilation (r= 0.85, P < 0.001). The residual standard deviation for the regression of compressed gas ventilation on maximum insufflation pressure was of the same magnitude (24% of the mean) as that obtained from the commonly used relation between end‐inspiratory pressure and compressed gas ventilation on the basis of Boyle's law.It is concluded that compressed gas ventilation may be determined with almost the same accuracy from maximum insufflation pressure as from end‐inspiratory pressure. The former procedure has the advantage of obviating the need for graphical recording of the insufflation pressure in the absence of an end‐inspiratory pressure plateau.
Anesthesia for Cesarean Section I: Effects on the Respiratory Adaptation of the Newborn in Elective Cesarean Section
Authors: Kjellmer I. , Magno R. , Karlson K. 
Published: December 2008

The purpose of this study was to evaluate the degree of respiratory depression in the newborn caused by the drugs given to the mother during anesthesia for cesarean section.Two types of induction were compared, one with barbiturate (hexobarbitone) and the other with nitrous oxide, both followed by succinylcholine for intubation. Blood gases were studied in the mother at the time of delivery, and in the child repeatedly during a period of 3 h after the delivery. The infants were delivered by elective cesarean section. There were 16 in the barbiturate group and ten in the nitrous oxide group. The maternal blood gas values were compatible with values in non‐anesthetized adults. The results in both groups of infants were compared with each other and with results from infants after normal vaginal deliveries. The three series show a close correlation, but infants in the barbiturate group had significantly higher Pao2 values during the first 3 h of life, higher Paco2 values during the first 10 min, and complete normalization after 30 min, when compared with the vaginally delivered group. The nitrous oxide group did not show any significant difference from the barbiturate group, either in Apgar scores or blood gas values in the infants. Both techniques allow normal oxygenation of the infant immediately after delivery. On the other hand, mothers in the nitrous oxide group had a higher incidence of negative psychic reactions to anesthesia in comparison with the mothers given barbiturate.
Hyperosmolality and Trauma
Authors: Hallberg D. 
Published: December 2008

The present study shows that various metabolic substrates are of different importance for the maintenance of the osmolality of the body fluids. Many hormones seem to influence the osmolal balance either by influencing the number of particles in a solution or the water balance. The effect of one particular hormone on osmolality can often be difficult to establish, because one effect will start a sequence of regulatory processes.Measurements of plasma and urine osmolality will therefore give a more varied picture of the condition in the body than, for instance, studies of fluid and electrolyte balance alone.
Metabolism of Alcohol
Authors: Hultman E. 
Published: December 2008

Ethanol can be used as a calorie source in normal man. The metabolism of ethanol is, however, quite unique. It changes the redox potential of the liver cells and decreases the activity in the citric acid cycle. These changes have important effects on carbohydrate, fat and protein metabolism in a way which makes the use of this calorie source questionable. Other effects, on hormone and drug metabolism for instance, make the question mark still bigger.In the treatment of post‐traumatic patients, it does not seem justified today to use ethanol as a source of caloric supply. Other effects on normal man achieved by peroral use of ethanol can possibly be tolerated, if they are not experienced too frequently.
Pulmonary Aspiration of Acid: An Experimental Study on Cats
Authors: Vaage J. , Hauge A. 
Published: December 2008

Acid aspiration is followed by a moderate to severe fall in systemic arterial blood pressure, and it has been suggested that release from the lung parenchyma of vasoactive substances may be an important causal factor. We have tested this hypothesis by twice establishing cross circulation between one cat which received hydrochloric acid (4 ml/kg b.w., pH 1.5) intratracheally and another, untreated cat. Instillation of acid caused an immediate fall in heart rate and arterial blood pressure of the aspiration animal, suggesting a reflex inhibition of the heart triggered within the lung. Cross circulation with the untreated animal did not improve the situation of the aspiration animal; nor did it cause any change in arterial blood pressure or lung mechanics in the untreated animal, although most of the blood volumes of the two animals was exchanged.In a separate series of experiments including four cats, we investigated the relative advantages of various patterns of positive pressure ventilation in the treatment of the aspiration syndrome. Early onset of positive pressure ventilation (PPV) with a moderate positive end‐expiratory pressure (PEEP) (+ 6 cmH2O) was an effective treatment. We conclude that local lung tissue injury with a secondary fall in estimated dynamic lung compliance and arterial pH and Po2 is the most important feature in the pathophysiology of aspiration.
Treatment of Post‐Operative Pulmonary Atelectasis by Active Inflation of the Atelectatic Lobe(s) Through an Endobronchial Tube: Case Reports
Authors: Sachdeva S. P. 
Published: December 2008

Two cases of post‐operative pulmonary atelectasis were treated by a procedure not previously described in the literature. Following bronchoscopic suction, the main bronchus on the affected side was inflated with a mixture of air and oxygen through an endobronchial tube passed under direct vision over a bronchoscope. This resulted in immediate re‐expansion of the atelectatic lung.ZUSAMMENFASSUNGZwei Fälle von postoperativen Lungenatelektasen wurden mit einer Methode behandelt, die bischer in der Literatur nicht beschrieben ist. Nach bronchoskopischer Absaugung wurde der Hauptbronchus der betroffenen Seite mit einer Mischung aus Luft und Sauerstoff über einen Endobronchialtubus aufgebläht. Dieser wurde über ein Bronchoskop gezogen und unter direkter Sicht eingeführt. Die geschilderte Maßnahme führte zu einer sofortigen Re‐Expansion der intubierten Lunge.
The Effect of a Subthreshold Dose of d‐Tubocurarine on the Neuromuscular Blocking Action of Succinylcholine in Anesthetized Man
Authors: Schuh F. T. , Viguera M. G. , Terry R. N. 
Published: December 2008

Dose‐response curves of succinylcholine (SuCh) were obtained in anesthetized patients by means of mechanograms of the flexion‐grip response of the hand to ulnar nerve stimulation. A subparalyzing dose (0.04 mg/kg b.w.) of d‐tubocurarine (d‐TC) administered prior to SuCh (0.025–1.6 mg/kg b.w.) exhibited a shift of the dose‐response curves toward the right, i.e., a diminishing effect on magnitude and duration of the SuCh induced neuromuscular blockade. The effective dose of SuCh required to produce a half‐maximal inhibition of the contractile force (ED50, 0.12 mg/kg before d‐TC) was increased to 0.3 mg/kg (15 min after d‐TC), 0.26 mg/kg (after 30 min), and 0.23 mg/kg (after 45 min). Thus, d‐TC pretreatment employed under clinical conditions to prevent potential hazards of SuCh requires a significant larger dose of SuCh to ensure consistently adequate relaxation.ZUSAMMENFASSUNGDosis‐Wirkungsbeziehungen von Succinylcholin (SuCh) (0,025–1,6 mg/kg Körpergewicht) wurden mit Hilfe von Mechanogrammen der Beuge‐ und Faust‐schlußbewegung der Hand nach elektrischer Ulnarisreizung an narkotisierten Patienten ermittelt. Die Vorausinjektion von d‐Tubocurarin (d‐TC) in der unterschwelligen Dosierung von 0,04 mg/kg Körpergewicht fuhrte zu einer Rechtsverschiebung der Dosis‐Wirkungskurven von SuCh, d.h. d‐TG vermindert Ausmaß und Dauer der neuromuskulären Hemmwirkung von SuCh. Die Effektivdosis von SuCh, die eine halbmaximale Hemmung der Kontraktionskraft bewirkt (ED50; 0,12 mg/kg ohne d‐TC) steigt auf 0,3 mg/kg 15 min nach d‐TC an bzw. 0,26 mg/kg (nach 30 min) und 0,23 mg/kg (nach 45 min). Wird unter klinischen Bedingungen vor einer SuCh Injektion ein Muskelrelaxans vom kompetitiven Typ, z.B. d‐TC verabfolgt, um potentielle Nebenwirkungen von SuCh zu verhuten, ist eine hohere Dosis SuCh erforderlich, um immer eine gute Muskelerschlaffung zu gewährleisten.
The Influence of Acid‐Base Changes on Central Nervous System Toxicity of Local Anaesthetic Agents II
Authors: Englesson S. , Grevsten S. 
Published: December 2008

This study is a detailed analysis of data obtained from 127 experiments on 90 paralysed and ventilated cats regarding the CNS toxicity of nine local anaesthetic agents as evidenced by seizure activity on the EEG. It is shown that an increase in Pco2or aH+caused increased CNS toxicity, i.e., smaller i.v. doses were required to elicit seizure activity, and that the underlying metabolic acid‐base state can considerably modify this, a metabolic alkalosis decreasing toxicity, and vice‐versa. The probable mechanisms of this process involving relationships between pH and the local anaesthetic cation/base ratios in plasma and neural tissue are discussed. It is finally recommended that local anaesthetic convulsions be treated by adequate artificial ventilation, which by lowering the Pco2in the brain will diminish the local anaesthetic toxicity and thus treat the root cause.ZUSAMMENFASSUNGDiese Untersuchung stellt die Detailanalyse von Ergebnissen dar, die bei 127 Experimental an 90 paralysierten und künstlich beatmeten Katzen gewonnen wurden in Hinblick auf die ZNS‐Toxizität von neun Lokalanaesthetika, dargestellt mittels Krampfaktivität im EEC Es zeigte sich, daß eine Erhöhung des PCo2oder der Wasserstoffionenaktivität (aH+) die ZNS‐Toxizität erhöhte, d.h. es waren geringere i.v. Dosen erforderlich, urn Krampfpotentiale auszulösen. Es zeigte sich ferner, daß der zugrundeliegende metabolische Säure‐Basen‐Status dies beträchtlich modifizieren kann, wobei metabolische Alkalose die Toxizität reduziert und umgekehrt. Der wahrscheinliche Mechanismus, an dem wohl Beziehungen zwischen pH und der Lokalanaesthetika‐Kationen‐Basen‐Relationen im Plasma und im Nervengewebe beteiligt sind, wird diskutiert. Schließlich wird empfohlen, durch Lokalanesthetika bedingte Krämpfe mit adäquater künstlicher Beatmung zu behandeln, damit der Senkung des Pco2im Gehirn die Toxizität des Lokalanaesthetikums vermindert und mithin das Übel an der Wurzel gepackt wird.
Hepatic Blood Flow and Cardiac Output During Halothane Anesthesia: An Animal Study
Authors: Juhl B. , Einer‐Jensen N. 
Published: December 2008

Correlated values of cardiac output and liver blood flow were measured on eight dogs. Measurements were carried out under basis anesthesia with O2‐N2O‐barbiturate‐gallamonium with controlled ventilation as well as during the addition of 0.5% and 1.0% halothane to the inspiratory air. During the latter type anesthesia, a parallel fall in the cardiac output and the liver blood flow was demonstrated. With 0.5% halothane, the fall was on the average 30% and 25% of the initial values respectively, and with 1.0% halothane it was 49% and 45% of the initial values. The individual changes were extremely dependent upon simultaneous changes in Paco2. The fall in cardiac output and liver blood flow was least when the Paco2increased at the same time, and greatest when the Paco2fell simultaneously.No changes were demonstrated in the total peripheral resistance and the resistance in the splanchnic region. It is concluded that changes in the cardiac output and hepatic blood flow brought about by the Paco2are parallel, and this appears to be undiminished during anesthesia with O2‐N2O‐halothane in the concentrations used here.ZUSAMMENFASSUNGAn 8 Hunden wurden die Korrelationswerte des Herzminutenvolumens (HMV) und der Leberdurchblutung gemessen. Diese Untersuchungen wurden in O2‐N2O‐Barbiturat‐Gallamin‐Basisnarkose mit kontrollierter Beatmung durchgeführt und während eines Zusatzes von 0,5 bzw. 1,0% Halothan im Einatemgemisch. Unter Halothan konnte ein parallel verlaufender Abfall des HMV und der Leberdurchblutung nachgewiesen werden. Bei 0,5% Halothan betrug dieser im Durchschnitt 30 bzw. 25% der Ausgangswerte, bei 1% Halothan 49 bzw. 45%. Individuelle Schwankungen waren im höchsten Maße von gleichzeitigen PaCo2‐Veränderungen abhängig. Der Abfall des HMV und der Leberdurchblutung war am geringsten, wenn gleichzeitig das PaCo2anstieg und am stärksten, wenn das PaCo2gleichzeitig absank.Im peripheren Gesamtwiderstand sowie im Gefäß‐widerstand des Splanchnikus‐Bereiches konnten keine Veränderungen nachgewiesen werden. Es wird daraus der Schlu|sZ gezogen, daß die PaCo2‐bedingten Veränderungen des HMV und der Leberdurchblutung miteinander verbunden sind und daß sich dies auch während der Narkose mit O2‐N2O‐Halothan in den hier verwendeten Konzentrationen nicht ändert.
The Effects of Halothane and Methoxyflurane Metabolites on Lipolysis In Vitro
Authors: Mäkeläinen A. , Rosenberg P. 
Published: December 2008

The effects of halothane and methoxyflurane on lipid metabolism in rats were further analyzed by studying the effects of their metabolites on lipolysis in vitro. Trifluoroacetic acid sodium and trifluoroacetaldehyde hydrate caused no alterations in lipolysis in vitro. Trifluoroethanol (TFE) and sodium fluoride stimulated lipolysis in vitro seen as increased accumulation of free fatty acids (FFA) in the adipose tissue and increased release of glycerol into the incubation medium.For trifluoroethanol the Emaxvalues were 3.85 μEq/g per hour of FFA and 1.10 μmol/g per hour of glycerol. The KAvalues were 5.3 times 10‐5M and 6.6 times 10‐5M, respectively. The Emaxvalues for sodium fluoride (NaF) were 2.23 μEq/g per hour of FFA and 0.38 μmol/g per hour of glycerol. The KAvalues were 1.4 times 10‐4M and 1.2 times 10‐4M, respectively. Propranolol (5 times 10‐6M) blocked the lipolytic action of TFE but had no effect on NaF‐induced lipolysis. On the basis of the results, it is suggested that these metabolites may be responsible for the alterations in lipid metabolism and the fatty changes in the liver caused by halothane and methoxyflurane anesthesia.ZUSAMMENFASSUNGDie Wirkungen von Halothan und Methoxyfluran auf den Lipidstoffwechsel bei Ratten wurden durch das Studium der Wirkung ihrer Metaboliten auf die Lipolyse in vitro weiteranalysiert. Trifluoroessigsaures Natrium und Trifluoroazetaldehyd verursachten keine Änderungen der Lipolyse in vitro. Trifluoroäthanol und Natriumfluorid stimulierten die Lipolyse in vitro, erkennbar aus der erhöhten Anhäufung von freien Fettsäuren in den Fettgeweben und erhöhter Freisetzung von Glyzerol in das Inkubationsmedium.Bei Trifluoroäthanol waren die Emax‐Werte 3,85 μEq/g/Stunde für die freien Fettsäuren und 1,10 μmol/g/Stunde für Glyzerol. Die KA‐Werte waren 5,3 × 10‐5M bzw. 6,6 × 10‐5M. Bei Natriumfluorid waren die Emax‐Werte 2,23 μEq/g/Stunde für die freien Fettsäuren und 0,38 μmol/g/Stunde für Glyzerol. Die KA‐Werte waren 1,4 × 10‐4M bzw. 1,2 × 10‐4M. Propanolol (5 × 10‐6M) blockierte die lipolytische Wirkung von Trifluoroäthanol, hatte aber keinen Effekt auf die durch Natriumfluorid induzierte Lipolyse. Auf Grund dieser Ergebnisse wird angenommen, daß die erwähnten Metaboliten für die Störungen des Lipidstoflwechsels und die Fettveränderungen in der Leber verantwortlich sein konnten, die nach Halothan‐ und Methoxyflurannarkosen beobachtet wurden.
Clinical Efficacy of Etidocaine for Intercostal Nerve Block and Lumbar Epidural Block: Double‐Blind Comparisons with Tetracaine and Lidocaine
Authors: Bridenbaugh P. O. , Moore D. C. , Bridenbaugh L. D. , Thompson G. E. 
Published: December 2008

Etidocaine, a new long‐acting local anesthetic, was used in clinical double‐blind trials in 22 patients having elective abdominal surgery under bilateral intercostal block anesthesia and in 31 patients having elective lower abdominal surgery under lumbar epidural block anesthesia. Etidocaine proved to produce an onset of anesthesia equivalent to lidocaine and more rapid than tetracaine. The total duration of anesthesia with etidocaine for lumbar epidural anesthesia was approximately 6 h and for intercostal block the duration was approximately 11 h.These studies would indicate the clinical effectiveness of etidocaine as a long‐acting local anesthetic agent worthy of additional clinical trials; also, that visceral pain is not always blocked in the classical fashion but is easily obtunded with light general anesthesia.ZUSAMMENFASSUNGEtidocaine, ein neues langwirkendes Lokalanaesthetikum, wurde bei 22 Patienten während elektiver bauchchirurgischer Eingriffe in bilateralem Intercostalblock und bei 31 Patienten mit Unterbaucheingriffen unter lumbaler Epiduralanaesthesie im Doppelblindversuch getestet. Dabei stellte sich heraus, daß Etidocaine bezüglich des Wirkungseintrittes dem Lidocain gleichwertig, dem Tetracain überlegen ist. Die Gesamtdauer der Anaesthesie mit Etidocaine war bei der Lumbal‐Epiduralanaesthesie ungefähr 6, beim Intercostalblock ungefähr 11 Stunden. Diese Untersuchungen deuten auf die klinische Wirksamkeit von Etidocaine als langwirkendes Lokalanaesthetikum hin, das wert wäre, weiterhin klinisch untersucht zu werden. Obwohl der viszerale Schmerz nicht immer in der klassischen Weise blockiert ist, kann er leicht durch oberßächliche Allgemeinnarkose ausgeschaltet werden.
Atropine, Neostigmine and Airway Resistance
Authors: Kjellberg M. , Heinonen J. 
Published: December 2008

This study was performed to find out whether the two common modes of administration of atropine and neostigmine used for reversal of neuromuscular blockade ‐ neostigmine preceded by atropine, or both drugs given simultaneously ‐ differ in their effects on airway resistance.Peak expiratory flow (PEF) and airway resistance (Raw) were measured in eight healthy volunteers after intravenous administration of 1) a placebo, 2) atropine only (0.0075 mg/kg), 3) neostigmine (0.015 mg/kg) preceded by atropine and 4) atropine together with neostigmine. Airway resistance and thoracic gas volume (Vtg) were measured with a volume‐constant body plethysmograph. No statistically significant differences were found when the changes in PEF, Raw and Raw x Vts from the basal values were compared between the four experiments. At 30 min Raw was decreased by 28.6% after atropine, but this decrease is not significantly different from that after placebo (21.4%).ZUSAMMENFASSUNGDiese Untersuchung wurde unternommen, um herauszufinden, ob die zwei gebräuchlichen Anwendungsarten von Atropin und Neostigmin zur Aufhebung einer neuromuskulären Blockade ‐ Atropin vor Neostigmin oder beide Mittel gleichzeitig ‐ in ihrer Wirkung auf den Atemwegswiderstand differieren.Bei acht gesunden Probanden wurden PEF (ex‐spiratorischer Spitzenstrom) und Raw (Atemwegswiderstand) gemessen und zwar nach i.v. Verabreichung von 1) einem Plazebo, 2) Atropin allein (0,0075 mg/kg), 3) Neostigmin (0,015 mg/kg) im Anschluß an Atropin und 4) Atropin und Neostigmin gleichzeitig. Atemwegswiderstand und thorakales Gasvolumen (Vtg) wurden mittels volumenkonstantem Ganzkörper‐Plethysmographen bestimmt. Beim Vergleich der Veränderungen von PEF, Raw und Raw x Vtb gegenüber den Ausgangswerten ergab sich kein signifikanter Unterschied zwischen den vier Versuchsreihen. 30 Minuten nach Atropin war Raw um 28,6% vermindert, doch unterschied sich diese Abnahme nicht signifikant von der nach dem Plazebo gefundenen (21,4%).