bluuebunny/crossref_metadata_2025_split huggingface dataset:
Postoperative Haemodynamics in Patients With and Without Cardiac Disease
Authors: Sörensen M. Bredgaard , Bille‐Brahe N. E. , Engell H. C. , Fölsgaard S. , Ernst Jonna 
Published: January 2009

The cardiovascular reaction to primarily major vascular surgery was examined in 39 patients without cardiac disease and in 11 patients with cardiac disease.In the immediate postoperative period (24 h), patients without cardiac disease showed significant increases in heart rate and cardiac index and a decreased blood volume. The central pressures were increased during the first postoperative hour. Systemic blood pressure and vascular resistance remained unchanged, or decreascd slightly. Postoperative haemodynamics in patients with cardiac discase followed the same trends as in normal patients; there were, however, no significant changes in cardiac index or central pressures, and in general the cardiovascular reaction to operation was less conspicuous than in the group of normal patients. The pre‐operative haemodynamic differences between the two groups were diminished in the immediate postoperative period because therapy could be guided by measuring central pressures.
Transcutaneous Oxygen Tension Measurement I. Age Variation and Reproducibility
Authors: Göthgen I. , Jacobsen E. 
Published: January 2009

In 20 patients, aged 19–80 y and without pulmonary or cardiovascular disease, transcutaneous oxygen tension (tcPo2) and arterial oxygen tension (Pao2) were measured. tcPo2 was measured with a Radiometer® TCM‐I (transcutaneous oxygen monitor) at 43 C°.The age regression for tcPo2 was: tcPo2 = 10.4–0.035 x age (r = 0.406); the rorresponding equation for Pao2 was: 13.8–0.053 x age (r = 0.687). The mean difference between tcPo2 and tcPo2 was 2.6 kPa (s.d. = 0.97) and the ratio tcPo2/ tcPo2, was 0.8.The accuracy of tcPo2 at the level 5.3–13.2 kPa based on 480 measurements was on the average ±1.28 kPa (maximum± 1.73 kPa) at the 95% confidence level.The accuracy of tcPo2 measurements is acceptable for clinical use, and in healthy adults tcPo2 reflects tcPo2.
Intravenous Lidocaine as a Suppressant of Persistent Cough Caused by Bronchoscopy
Authors: Christensen V. , Ladegaard‐Pedersen H. J. , Skovsted P. 
Published: January 2009

The effect of intravenous lidocaine in the treatment of persistent cough occurring after diagnostic bronchoscopies performed under general anaesthesia was investigated in a controlled clinical trial. The study comprised 28 adults patients, all of whom had regained consciousness after anaesthesia. Fifteen patients were treated with lidocaine (1.5 mg/kg body weight) and 13 patients with placebo (saline). In each patient the intravenously injected dose was repeated once after 5 min.In 11 of the 15 patients (73%) who received lidocaine coughing ceased, while it continued in all 13 patients in the placebo group. The difference is highly significant (P< 0.001).None of the patients developed side effects such as hypotension, arrhythmias, central nervous system symptoms or respiratory depression after injection of lidocaine. It is therefore concluded that intravenous lidocaine in man is a safe and useful rough‐suppressant.
Serum Diazepam and Serum Creatine Kinase after Intra‐muscular Injection of Diazepam in Two Different Vehicles
Authors: Bank‐Mikkelsen O. K. , Steiness E. , Arnold E. , Hansen T. , Søbye M. , Lunding M. 
Published: January 2009

Serum diazepam concentration and serum creatine kinase activity (serum CK) were measured in 35 patients (who were divided into three groups (A, B, and C)), over a period of 24 hours after administration of diazepam. An increase in serum CK was regarded as an indication of local muscle injury.In group A, diazepam in a polyethyleneoxydricinolate vehicle was injected intramuscularly; in group B, diazepam in a propyleneglycol‐ether alcohol vehicle was injected intramuscularly; and in group C, diazepam was administered orally, combined with intramuscular administration of the vehicle used in group B.The investigation was double‐blind and randomized.Serum diazepam absorption expressed as the area under the concentration curve was identical in groups A and C and significantly higher than in group B. Serum CK rose in all groups. The differences among the groups were not significant. There were considerable individual variations in all three groups, and almost half the patients showed no increase in serum CK at all.No negative correlation was found between serum diazepam and serum CK. Thus no effect of muscle injury—if present—on absorption rate could be demonstrated.
Haemodynamic Effects of Enflurane in Patients with Valvular Heart Disease
Authors: Christensen V. , Sørensen M. B. , Klauber P. V. , Skovsted P. 
Published: January 2009

In eight patients undergoing cardiac surgery for aortic and/or mitral valvular disease, mean arterial blood pressure (MAP), central venous pressure (CVP), cardiac index (CI), stroke index (SI), pulmonary capillary wedge pressure (PCWP), and pulmonary arterial mean pressure (PAMP) were measured after premedication with diazepam‐scopolamine (I), after breathing 100% oxygen (II), and on controlled respiration (111) after induction of anaesthesia with enflurane‐02, and endotracheal intubation facilitated by succinylcholine.All measurements were done prior to surgery. Enflurane anaesthesia was found not to affect cardiac index. The average SI decreased by 27%, but was compensated for by an average increase in heart rate (HR) of 33%. The average systemic vascular resistance (SVR) decreased by 14%.All other measured parameters were found to be unaffected by enflurane‐02 anaesthesia. It is concluded that the cardiovascular stability observed in healthy young normals during enflurane anaesthesia is preserved in patients with moderate to severe heart failure, making enflurane an anaesthetic agent well suited for patients with cardiac disease.
Postoperative Haemodynamics in Patients With and Without Cardiac Disease
Authors: Sørensen M. Bredgaard , Bille‐Brahe N. E. , Engell H. C. , Følsgaard S. , Ernst Jonna 
Published: January 2009

The cardiovascular reaction to primarily niaior vascular surgery was examined in 39 patients without cardiac disease and in 11 patients with cardiac disease.In the immediate postoperative period (24 h), patients without cardiac disease showed significant increases in heart rate and cardiac index and a decreased blood volume. The central pressures were increased during the first postoperative hour. Systemic blood pressure and vascular resistance remained unchanged, or decreased slightly. Postoperative haemodynamics in patients with cardiac disease followed the same trends as in normal patients; there were, however, no significant changes in cardiac index or central pressures, and in general the cardiovascular reaction to operation was less conspicuous than in the group of normal patients. The pre‐operative haemodynamic differences between the two groups were diminished in the immediate postoperative period because therapy could be guided by measuring central pressures.
Transcutaneous Oxygen Tension Measurement 11. The Influence of Halothane and Hypotension
Authors: Gøthgen I. , Jacobsen E. 
Published: January 2009

The influence of halothane‐oxygen mixtures on three different transcutaneous oxygen electrodes was investigated. The influence of hypotension caused by halothane and halothane‐nitroprusside on transcutaneous oxygen tension measurement (tcPo2) in halothane‐anaesthetized patients was examined as well. The electrodes differed with respect to polarization voltages (630 mV or 500 mV) and electrolyte composition (silver chloride or silver bromide).A change dependent on halothane concentration was demonstrated in the electrode readings, both with a polarization voltage of 630 mV and with silver bromide as electrolyte. Using an electrode with 500 mV in polarization voltage and silver chloride as electrolyte, no changes were observed in the readings.During induced hypotension, the tcPo2 values fell in proportion to the mean arterial blood pressure. In patients with a mean arterial blood pressure over 11 kPa a tcPo2/Pao2 ratio of 0.6 was found.It is concluded that tcPo2 monitoring during halothane anaesthesia can be influenced in at least two ways, apart from changes in Pao2: (1) by oxygen electrode error due to the halothane; and (2) by changes in skin blood flow.In comparison to the changes in tcPo2 due to the haemodynamic effects of halothane anaesthesia, the changes due to halothane error are small.
Halothane Anaesthesia and Suxamethonium III. Atropine 30 s Before a Second Dose of Suxamethonium During Inhalation Anaesthesia: Effects and Side‐Effects
Authors: Brandt M. R. , Viby‐Mogensen J. 
Published: January 2009

The protection against bradycardia afforded by atropine given intravenously just prior to a second dose of suxamethonium during halothane inhalation anaesthesia was studied in 100 healthy, adult patients randomly allocated to one of five groups characterized by dosage of atropine.ECG monitoring was continuous, and regular determinations were made of serum potassium, Paco2, Pao2, and blood pressure.Slowing of the heart rate was seen in more than 50% of patients in each group, but bradycardia (heart rate <60 beatslmin) was seen only in patients receiving the lowest dose of atropine ‐ 0.0075 mg/kg. In the other four groups (atropine 0.01 mg/kg‐0.02 mg/kg), bradycardia prophylaxis was effective, but at the cost of serious ventricular arrhythmias in 15% of the patients. The incidence of these arrhythmias seemed to increase with increasing atropine dosage. Marked tachycardia was also seen.Because of the incidence of side effects in this and other studies, no absolute recommendation can be made about suxamethonium bradycardia prophylaxis during halothane inhalation anaesthesia, but our present experience suggests that atropine in a dose not exceeding 0.01 mg/kg, given 30 s prior to a second dose of suxamethonium is best.
Intravenous Lidocaine as a Suppressant of Persistent Cough Caused by Bronchoscopy
Authors: Christensen V. , Ladegaard‐Pedersen H. J. , Skovsted P. 
Published: January 2009

The effect of intravenous lidocaine in the treatment of persistent cough occurring after diagnostic bronchoscopies performed under general anaesthesia was investigated in a controlled clinical trial. The study comprised 28 adults patients, all of whom had regained consciousness after anaesthesia. Fifteen patients were treated with lidocaine (1.5 mg/kg body weight) and 13 patients with placebo (saline). In each patient the intravenously injected dose was repeated once after 5 min.In 11 of the 15 patients (73%) who received lidocaine coughing ceased, while it continued in all 13 patients in the placebo group. The difference is highly significant (P< 0.001).None of the patients developed side effects such as hypotension, arrhythmias, central nervous system symptoms or respiratory depression after injection of lidocaine. It is therefore concluded that intravenous lidocaine in man is a safe and useful cough‐suppressant.
Theoretical Considerations on the Potential Hazards of Hyperventilation During Anaesthesia
Authors: Sørensen S. C. 
Published: January 2009

The purpose of this paper is to evaluate the effect of hyperventilation on cerebral oxygenation. The best estimate of cerebral oxygenation is cerebral venous Po2 (Pvo2). Po2 has been considered in relation to Paco2, during normoxaemia. In order to compare the effects of hyperventilation with the effects of hypoxaemia, Pvo2 has also been considered in relation to Pao2, when Paco2 is constant. Thc results indicate that the low Paco2 values which may be seen in the operating room with manual ventilation have the same effect on cerebral oxygenation as severe hypoxaemia.It is emphasized that the brain is better protected against threats to cerebral oxygenation, e.g. hypotension, if Pao2, is kept close to normal during anaesthesia. During neurosurgical anaesthesia the advantages of excessive hyperventilation must be weighed against the threat it poses to oxygenation in healthy areas of the brain.
I. Thoracic Epidural Analgesia An Experimental Study in Sheep of the Effects on Central Circulation, Regional Perfusion and Myocardial Performance during Normoxia, Hypoxia and Isoproterenol Administration
Authors: Ottesen S. , Renck H. , Jynge P. 
Published: January 2009

Some circulatory effects of thoracic epidural analgesia (TEA) were investigated in splenectomized, open‐chest sheep during normoxia, hypoxia and isoproterenol administration. During normoxia, TEA caused comparatively marked reductions in systemic arterial blood pressure, total peripheral resistance and cardiac output. A fall in heart rate was not compensated for by any rise in stroke volume. Myocardial contractility (LV dp/dt/IP) was not affected by TEA. The proportion of cardiac output diverted to the blocked area was markedly increased. Compensatory vasoconstriction was not observed within the unblocked area in six out of nine animals. Myocardial blood flow showed a pronounced reduction in accordance with the calculated changes of heart work, so that myocardial oxygen extraction remained unchanged.Studies under hypoxia revealed that cardiac responses to hypoxia in the sheep are mediated chiefly by neurogenic factors. TEA abolished the hypoxia‐induced rise in heart rate but did not affect the increase in pulmonary vascular resistance caused by hypoxia.The administration of isoproterenol during TEA increased systemic arterial blood pressure, but due to further fall in total peripheral resistance it was not fully normalized. Cardiac output and heart rate increaied markedly. Myocardial oxygen consumption and blood flow increased but did not reach control levels.
II. Haemodynamic Alterations Secondary to Lumbar Epidural Analgesia and their Modification by Plasma Expansion and Adrenaline Administration An Experimental Study in the Sheep
Authors: Ottesen S. , Renck H. , Jynge P. 
Published: January 2009

Haemodynamic alterations secondary to the induction of lumbar epidural analgesia (LEA) were investigated in splcnectomized, open‐chest sheep. A considerable reduction in systemic arterial blood pressure (PAa) and total peripheral resistance (TPR) occurred. Cardiac output (Qpa) was reduced non‐significantly as a fall in heart rate (HK) was counteracted by an increase in stroke volume (SV). Myocardial blood flow (MBF) was reduced in parallel with myocardial oxygen consumption (MVO2), so that myocardial oxygen extraction (O2 uc myocardium) remained unchanged. No convincing signs of compensatory vasoconstric‐tion were noticed in the non‐blocked area, and the proportion of QPA diverted to the blocked area (Qap/ca) was increased only non‐significantly.Administration of dextran 70 was followed by an increase in QPA, mainly due to an increase in SV. PAa increased only slightly as TPR was further reduced. MUF rose only non‐significantly, but O2 uc myocardium increased somewhat. A reduction of vascular resistance in the blocked area was recorded, and in comparison with the control value Qap/ca was markedly increased in most animals.The effect of adrenaline in three different dosages (0.362, 1.91 and 3.62 μg/min) was studied on the circulatory changes induced by the combination of LEA and dextran administration. The smallest dose resulted in a still further reduction of TPR, but in an increase in Qpa, so that PAa remained unchanged. The two largest dosages resulted in increases in PA2 as Qpa increased with unchanged TPR. It is postulated that the rise of Qpa was a result of improved niyocardial contractility and increased venous return to the heart. MVO2 as well as MBF increased, but O2 uc myocardium was unchanged.Plasma expansion alone is considered insufficient to counteract the systemic arterial hypotension caused by LEA, but the additional administration of adrenaline in dosages of around 0.1 μg/kg/min restores systolic arterial blood pressure without any untoward effects upon regional perfusion.
Paresthesiae or No Paresthesiae? Nerve Lesions after Axillary Blocks
Authors: Selander D. , Edshage S. , Wolff T. 
Published: January 2009

Seeking paresthesiae when performing a peripheral nerve block may increase the risk of post‐anesthetic neurological sequelae. To test this hypothesis, we prospec‐tively followed two groups of patients who underwent hand surgery with an axillary block. In one group, the axillary plexus was located by actively seeking paresthesiae; in the other, pulsations of the axillary artery indicated an adequate position of the injection needle. Mepivacaine 10 mg/ml, with or without adrenaline, was used. The study included 533 patients, 290 in the paresthesia group and 243 in the artery group.Although unintentional, paresthesiae were elicited in 40% of patients in the artery group. Postanesthetic nerve lesions were seen in ten patients, eight in the paresthesia group and two in the artery group, all of whom had been blocked by mepivacaine with adrenaline. Symptoms varied between light paresthesiae lasting a few weeks, and severe paresthesiae, ache and paresis lasting more than 1 year. The etiology suspected was needle and perhaps injection trauma to the nerves during blocking. We conclude that whenever possible nerve blocks should be performed without searching for paresthesiae.
Restlessness and Shivering after Naloxone Reversal of Fentanyl‐supplemented Anaesthesia
Authors: Tammisto T. , Tigerstedt I. 
Published: January 2009

To study the significance of normalization of ventilatory or thermal homeostasis during naloxone reversal, 95 patients were given naloxone after thiopental‐N2O‐O2‐relaxant anaesthesia supplemented with fentanyl (6 μg/kg/h). If naloxone 0.16 mg was given to combat postoperative apnoea during hypercapnia (end tidal carbon dioxide concentration (ETco2) 8%), minute ventilation and respiratory rate were significantly higher during the first minutes as compared to the normo‐capnic patients. Shivering occurred in 44% in the hypercapnic group, as compared to about 30% if naloxone was given during normocapnia (ETco25%). Postoperative pain and restlessness were significantly increased in the hypercapnic group. During normocapnia, untoward reactions were less frequent (40%) if naloxone was given in smaller increments (0.08+0.08 mg) rather than in one dose (0.16 mg) (72%). This was mainly due to nausea (8% compared to 32%). The incidence and severity of shivering showed a positive correlation to the duration of anaesthesia (r = 0.42) and to the total amount of fentanyl (r = 0.32), but not to the actual postoperative oesophageal temperature (r=—0.13).The results indicate that though untoward reactions after naloxone reversal are aggravated by naloxone‐induced normalization of deranged homeostatic mechanisms, their aetiology probably should be sought in an acute abstinence syndrome.
The Effect of Local Anaesthetic Agents on the Contractility of Human Myometrium in Late Pregnancy: An in Vitro Study
Authors: Willdeck‐Lund G. , Nilsson B. A. 
Published: January 2009

Four local anaesthetic agents, lidocaine, prilocaine, bupivacaine and etidocaine with and without adrenaline, were tested regarding their influence on the contraction amplitude, tone and frequency of contractions of human myometrium in vitro. All four drugs had a dose‐related inhibitory effect on the amplitude. This was enhanced by adrenaline. The two short‐acting and the two long‐acting agents were tested in equianalgesic doses in a crossover test. Lidocaine and etidocaine had a significantly greater inhibitory effect on the spontaneous myometrial contractions than prilocaine and bupivacaine. With all drugs, except etidocaine, the tone increased with increasing drug concentrations in the bath. The changes in frequcncy were inconsistent.Based on the concentrations required to produce 50% inhibition, lidocaine, bupivacaine and etidocaine were, respectively, 1.3, 6.5 and 8.3 times more potent than prilocaine; the corresponding figures for the anaesthetic effect on isolated nerves are reported to be 1.5, 5.3 and 5.3.The inhibitory effect of etidocaine declined with time, in contrast to the other local anaesthetic agents tested.
Additive Effects of Hypothermia and Phenobarbitol upon Cerebral Oxygen Consumption in the Rat
Authors: Hägerdal M. , Keykhah M. , Perez E. , Harp J. R. 
Published: January 2009

The quantitative effects of a combination of hypothermia and phenobarbital on cerebral oxygen uptake (CMK) was studied in rats, curarized and artificially ventilated with 70% nitrous oxide in oxygen. Cerebral blood flow (CBF) was measured with a modification of the Kety & Schmidt (1948) technique, using 133xenon as a tracer. Arteriovenous difference in oxygen content over the brain was measured and CMRo2 was calculated. Four groups were studied. Group 1 was a control group. The three experimental groups were injected with phenobarbital intraperitoneally: Group 2 with 50 mg/kg body weight; Group 3 with 150 mg/kg; and Group 4 with 50 mg/kg of phenobarbital, and, in addition, body temperature was lowered to 32°C in this group. CMRo2, in groups 2, 3 and 4 was reduced by 22, 37 and 43%, respectively, compared to Group 1. The changes in CBF were of the same magnitude. In a previous study we have found that CMRo2 decreases by 5% per 1°C decrease in body temperature. The value for CMRo2 in Group 4 is close to the value obtained if the effect of 50 mg/kg body weight of phenobarbital on CMRo2 is added to the effect of a temperature reduction of 5°C.It is concluded that the effects of barbiturates and hypothermia on CMRo2 are additive.
Arrhythmias During Halothane Anesthesia IV. The Influence of a Single Dose of Suxamethonium
Authors: Andersen J. R. , Eikard B. 
Published: January 2009

The effect of a single dose of suxamethonium on cardiac rate and rhythm during halothane anesthesia with barbiturate induction was studied in a prospective, triple‐blind trial with 28 patients. No atropine was given and patients were not intubated.A slight but significant preponderance of sinus‐bradycardia without hemodynamic consequrnces was found in the group given suxamethonium. Suxametlionium did not provoke ventricular ectopies or conduction disturbanccs.It is concluded that in anesthesia with barbiturate induction, but without atropine or intubation, the use of a single dose of suxamethonium is a safe procrdure with regard to cardiac rate and rhythm.
Can Postoperative Pulmonary Conditions be Improved by Treatment with the Bartlett‐Edwards Incentive Spirometer after Upper Abdominal Surgery?
Authors: Lyager S. , Wernderg M. , Rajani N. , Boggild‐Madsen B. , Nielsen L. , Nielsen H. C. , Andersen M. , Møller J. , Silberschmid M. 
Published: January 2009

During the immediate postoperative course after upper abdominal surgery. pulmonary complications often occur, caused, inter alia, by reduced regional ventilation and by atelectases as a result of: (1) narrowing of the small peripheral bronchi, and (2) impaired respiratory function. Based on these pathophysiological mrchanisms, an instrument (Bartlett‐Edwards Incentive Spirometer) has been devised, which aims at giving the patient an opportunity of sustained maximal inspiration under standardized and controlled conditions. The use of this instrument has been followed by reports of a considerable reduction in postoperative pulmonary complications.In a controlled clinical investigation of the pre‐ and postoperative condition of the lungs, we were unable to show any beneficial effect of the instrument. In general, we have a low frequency of severe postoperative pulmonary complications, as compared with the results reported in the literature. We ascribe this to our very effective pre‐ and postoperative respiratory therapy.