bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Thoracic Epidural Block and the Beta‐1 ‐Adrenoreceptor Agonist Prenalterol on the Cardiovascular Response to Infrarenal Aortic Cross‐Clamping in Man
Authors: Reiz S. , Nath S. , Pontén E. , Friedman A. , Bäcklund U. , Olson B. , Rais O. 
Published: January 2009

Sixteen patients scheduled for abdominal aortic resection and grafting were randomly assigned to two groups to study the cardiovascular effects of infrarenal aortic cross‐clamping. The patients in the first group had received a thoracic. epidural block followed by intravenous administration of the selective beta‐l‐adrenoreceptor agonist prenalterol prior to induction of general anaesthesia. The patients in the second group served as controls and received no specific treatment prior to general anaesthesia.In both groups, aortic cross‐clamping was followed by an equal rise in pulmonary artery diastolic pressure and mean systemic arterial pressure. There was a significant difference in systemic vascular resistance, as the control group had a 46% increase 30 s after cross‐clamping, while the pretreated patients had only a 7% increase at the same time. Moreover, the patients given the thoracic epidural block followed by prenalterol increased their stroke volume and cardiac indices, as compared to the patients in the control group who showed a significant decrease in these parameters.Possible mechanisms for the mode of action of the combined thoracic epidural block and beta‐l‐adrenoreceptor agonist pretreatment are discussed.
Serum Bromide After General Anaesthesia with Halothane
Authors: Meldgaard O. T. , Cold G. E. 
Published: January 2009

Serum bromide was determined in 30 patients during the first few postoperative days after general anaesthesia with halothane. The material comprised a group of younger patients (19–50 years) and a group of elderly patients (>70 years), neither of whom received thiomebumal induction, and a group of younger patients (19–50 years) who received thiomebumal induction.The changes in serum bromide were independent of age and induction with barbiturate, and a maximum rise in serum bromide was found most often 2–3 days after the anaesthesia. All groups showed a rise in serum bromide to thera‐peutically sedative concentrations, and a significant correlation was found between MAC‐hours halothane exposure and serum bromide.
Effect of Segmental Epidural Analgesia upon the Uterine Activity with Special Reference to the Use of Different Local Anaesthetic Agents
Authors: Willdeck‐Lund G. , Lindmark G. , Nilsson B. A. 
Published: January 2009

Segmental epidural block was given to 60 primiparous women during vaginal delivery, and the effect of the block on the uterine activity was studied after the first epidural injection. The women were divided into two main groups, according to whether or not oxytocin was used for stimulating the uterine contractions, and three different local anaesthetics—lidocaine‐adrenaline, bupivacaine‐adrenaline and plain hupivacaine—were tested.There was a transitory decrease in uterine activity in all women after the block was applied. In women with normal uterine activity before the block, a return to almost pre‐analgesic values was noted within 30 min after the block, whereas in women treated with oxytocin there was still a reduction of 15–17% at this time. The reduction was caused by a decreasing intensity and at the same time an increase in the variability of the intensity, manifested as an increase in the coefficient of variation for this variable. There were no significant differences between the local anaesthetic agents tested, hut addition of adrenaline to the bupivacaine solution resulted in a more marked decrease in uterine activity in women treated with oxytocin.
Influence of Epidural Analgesia on the Catecholamine and Cyclic AMP Responses to Surgery
Authors: Engquist A. , Fog‐Møller F. , Christiansen C. , Thode J. , Vester‐Andersen T. , Madsen S. Nistrup 
Published: January 2009

The effects of neurogenic block on plasma concentrations of adrenaline, noradrenaline and cyclic AMP were studied. Eighteen patients were subjected to surgery of moderate or minor extent under enflurane anesthesia with or without epidural analgesia. The results show that adrenaline secretion during surgical stress is a response to neurogenic stimuli, since the increase found in patients subjected to hysterectomy under general anesthesia is blocked by the addition of epidural analgesia. Furthermore, plasma adrenaline after neurogenic block is comparable with adrenaline levels during minor surgical stress.The plasma noradrenaline concentration does not correlate with the extent of trauma. In contrast to adrenaline levels, noradrenaline concentrations varied insignificantly during and after surgery. However, the addition of epidural block induced a postoperative increase in noradrenaline apparently unrelated to changes in heart rate or blood pressure. Simultaneous measurements of the catecholamines and cyclic AMP indicate that adrenaline is of minor importance for plasma cyclic AMP in resting patients, whereas the increase in cyclic AMP elicited by surgery reflects adrenaline‐stimulated beta‐adrenergic activity.
Sister Chromatid Exchanges in Lymphocytes in Operating Room Personnel
Authors: Husum B. , Wulf H. C. 
Published: January 2009

Sister chromatid exchanges (SCE) and sister chromatid exchange points (SCE‐points) were counted in lymphocytes in peripheral blood drawn from hospital personnel exposed to anaesthetics as well as from persons not exposed.A total of 38 healthy persons were investigated, representing female nurse anaesthetists, male physicians practising anaesthesia, female nurses from the intensive care unit, and female secretaries.The mean SCE number per cell for each person was used as the variable, and the Mann‐Whitney U‐test was applied to test for differences between groups. The group of secretaries seemed to differ from the other three groups, which appeared identical (P<0.001). Correlation of cigarette smoking and number of SCE could not be demonstrated (r=.255, n = 38).It was concluded that by this method there was no indication of a mutagen effect of long‐term exposure to waste anaesthetic gases such as halothane and nitrous oxide.
The Role of Thiopental and Fentanyl in the Production of Balanced Anaesthesia
Authors: Tammesto T. , Aromaa U. , Korttila K. 
Published: January 2009

In order to clarify the interactions between various doses of thiopental and fentanyl in producing “balanced anaesthesia”, their effects on consciousness, superficial nociception, and respiration and circulation were studied during N2O f O2 inhalation in connection with the induction of anaesthesia. Altogether 60 patients were studied; the drug combinations used were thiopental 5 mg/kg (TPs), thiopental 3 mg/kg (TP,), thiopental 3 mg/kg and fentany1 0.5 μg/kg (TP3Fo5), thiopental 2 mg/kg and fentanyl I pg/kg (TPPFI), thiopental 1 mg/kg and fentanyl 2 μg/kg (TP1F2), and fentanyl 3 μg/kg (F3). Five minutes after the i.v. supplementation of N2O+ O2 anaesthesia, the depth of anaesthesia and analgesia (antinociception) were evaluated from the eyelid reflex and by pinching an inguinal skin fold. Cardiorespiratory parameters were measured during this study period at 1 ‐min intervals.The balance between antinociception and anaesthesia was closest to optimum in groups TP2F1 and TP3Fo5.In pure thiopental groups, the analgesia was poor; only four patients did not respond to the nociceptive stimulus, whereas in group F3 anaesthesia (disappearance of the eyelid reflex) was obtained in only two patients. The respiratory depression was most pronounced in groups receiving 3,2 and 1 μg/kg fentanyl and weakest in groups where only thiopental was used. Blood pressure decreased in all groups but no statistically signscant diKerences were noted.On the basis of the results it seems obvious that attempts to achieve what is called “balanced anaesthesia” by the supplementation of an N2O + O2 mixture with fentanyl only leads to an unnecessarily pronounced respiratory depression, whereas supplementation with thiopental alone does not offer adequate antinociception.
The Role of Diazepam and Fentanyl in the Production of Balanced Anaesthesia
Authors: Aromaa U. , Korttila K. , Tammisto T. 
Published: January 2009

The effects of diazepam‐fentanyl combinations on consciousness, superficial nociception, respiration and circulation during N2O + O2 inhalation were studied in 40 premedicated patients during induction of anaesthesia. The balance between antinociception and anaesthesia was closest to the optimum in patients receiving 0.2 mg/kg of diazepam plus 1 μg/kg of fentanyl; the eyelid reflex was negative in all patients and only two out of ten patients reacted to abdominal pinching. When only 0.2 mg/kg of diazepam was given with N2O + O2, the eyelid reflex was negative in all patients, but half of them reacted to pinching. When the dose of diazepam was reduced to 0.1 mg/kg and patients received 1 or 2 μg/kg of fentanyl, the balance between anaesthesia and antinociception was good, but 30–50% of patients had a positive eyelid reflex and reacted to pinching. No distinct respiratory depression was observed in patients given 0.2 mg/kg of diazepam, whereas seven patients given 0.1 mg/kg of diazepam plus 2 μg/kg of fentanyl had apnoea lasting more than 60 s associated with a significant (P<0.05–0.001) increase in end‐tidal CO2 and PCO2 in arterialised venous blood.No significant changes were observed in blood pressure or heart rate after any of the drugcombinations studied.It appears that an optimal balance between anaesthesia and antinociception with minimal side‐effects during balanced general anaesthesia requires reinforcement of N2O+O2 anaesthesia not only with fentanyl but also with hypnotics or sedatives.
Immediate Hemodynamic Effect of Pharmacological Doses of Methylprednisolone in Dogs, and the Influence of Speed of Injection
Authors: Husum B. , Palm T. , Andersen K. , Vejlsted H. 
Published: January 2009

Reports of sudden death of patients during i.v. administration of methylprednisolone (M.P.) prompted the present study of the hemodynamic effect of M.P. given i.v. to dogs. Fifteen healthy, mongrel dogs were anesthetized with thiomeburnal, fentanyl, droperidol, pancuronium and N2O/O2. With ventilation and circulation in steady state, M.P. 30 mg/kgb.w. was given i.v. either as a push bolus (n= 7) or over a5‐min period (n = 8). In the bolus group, mean aortic pressure (MAP) and systemic vascular resistance (SVR) had decreased to 72 and 60%, respectively, 1 min after the start of the steroid injection, while heart rate (HR), cardiac index (CI), mean pulmonary arterial pressure (MPAP) and left ventricular work (LVW) had not changed significantly. In the 5‐min group, the HR increased by 23 %, while the other parameters were unchanged during the injection period. Within 5 min after the termination of the steroid injection all hemodynamic parameters had returned to pre‐injection levels in both groups. Sodium, potassium, magnesium, protein and calcium in serum were unchanged in both groups during the injection period and in the following 15 min. A significant, transient fall in ionized calcium was observed in all six dogs in which this ion was measured.It was concluded that rapid i.v. injection of pharmacological doses of M.P. in hemodynamically stable, anesthehed dogs causes immediate, transient decreases in SVR and MAP. The mechanisms may be an alpha adrenergic blocking action or a direct effect on the muscles in the peripheral vessels, combined with a negative inotropic effect on the myocardium, possibly mediated through an impeded calcium release.
Sympathetic Nervous System Tonicity and Post‐Coronary Artery Bypass Hypertension
Authors: Pratilas V. , Pratija M. G. , Vlachakis N. D. , Owitz S. , Dimich I. 
Published: January 2009

To elucidate the pathogenesis of hypertension following coronary bypass surgery, blood pressure and plasma catecholamine concentration were measured in 28 patients with coronary artery disease who were undergoing myocardial revascularizat ion procedures. Measurements were obtained on arrival in the operating room and 1 and 4 h after surgery.One hour after surgery, plasma norepinephrine (NE) increased significantly by 495k 108 pg/ml (P<0.001) in the coronary artery disease group which developed hypertension, but the increase was not significant in the coronary artery patients who remained normotensive after surgery. However, 4 h after surgery, plasma NE increased significantly and to the same extent in both coronary artery disease groups, regardless of the change in blood pressure.Plasma epinephrine (E) also increased significantly 1 and 4 h after surgery in both groups. The observed change in plasma catecholamine concentration is direct evidence that the stress of surgery is a potent adrenergic stimulus, but the hemodynamic significance of the plasma catecholamine change remains unclear.
Effects of Nitrous Oxide oa S)stolic Time Intervals
Authors: Eriksen S. , Johannsen G. , Frost N. 
Published: January 2009

The elrects of inhalation of oxygen, nitrous oxide/oxygen and nitrous oxide/nitrogen/oxygen on systolic time intervals (PEP (pre‐ejection period) and LVET (left ventricular ejection time)) were investigated in eight healthy persons. Nitrous oxide 40%, administered with oxygen or oxygen /nitrogen, prolonged PEP significantly by 25% and 22%, respectively. Inhalation of oxygen also prolonged PEP but to a significantly minor degree.LVET, heart rate and MAP were unchanged during the experiments. Derivatives from the systolic time intervals, i.e. PEP/LVET, I/PEP2 and ejection fraction changed significantly in the nitrous oxide groups. It is concluded that nitrous oxide depresses cardiac performance, to some degree, even when administered at a rather low concentration.
Pain Relief and Sputum Prostaglandins in Adults Treated with Pethidine, Tilidine and Indomethacin After Tonsillectomy: A Double‐Blind Study
Authors: Saarnivaara L. , Metsä‐Ketelä T. , Männistö P. , Vapaatalo H. 
Published: January 2009

1Otolaryngological Hospital, University of Helsinki. Helsinki, and Department of Biomedical Sciences, University of Tampere, Tampere. Finland.The pain‐relieving effects of pethidine (1 mg/kg i.m.), tilidine (2.5 mg/kg i.m.) and indomethacin (100 mg rectally) were investigated in 87 voluntary adult patients after tonsillectomy in a double‐blind study. All the drugs relieved pain equally. The maximal emerr appeared 60–75 min after drugadministration, and lasted until the end of the 120‐min observation period. Bleeding from the operative site w'as the most common side effect. It appeared in 28, 24 and 3% of the patients treated with indomethacin, tilidine and pethidine, respectively. Two patients in the indomethacin group and one patient in the tilidine group needed a suture for stopping the bleeding, whereas the bleeding in the pethidine group stopped without any special treatment. Further side effects were headache, dizziness, nausea and vomiting. Their incidence ranged from 0 to 17% in various groups.On the evening of the operative day, the indomethacin patients received another dose of indomethacin, whereas the other patients received a plarebo suppository. On the following morning, the pain score was lowest and the speech least impaired in the indomethacin patients. After indomethacin, the axillary temperature remained below 37oC, whereas it was slightly elevated in the other groups. In all groups the blood leucocyte count was significantly increased. The control values for the excretion of prostaglandin F., in sputum ranged from 2.9 to 3.9 ng/8 min. The values were increased by 233, 183 and 29% in pethidine, tilidine and indomethacin group, respectively. The control values for prostaglandin E ranged from 1.5 to I.9 ng/8 min. There was an increase of 205, 111, and 80% in the pethidine, tilidine and indomethacin group, respectively.The results suggest that. of the drugs studied, pethidine is most convenient for treatment of throat pain immediately after tonsillectomy in adults. During the later postoperative period, indornethacin may be used for alleviation of pain and inflammatory responses.
A Comparison Between Reaction Time Measurement and Critical Flicker Fusion Frequency Under Rising Nitrous Oxide Inhalation in Healthy Subjects
Authors: Wernberg M. , Nielsen S. F. , Hommelgaard P. 
Published: January 2009

Ten subjects volunteered to inhale a test gas containing 0, 10, 20 and 30% nitrous oxide. After equilibration at each nitrous oxide concentration, the reaction time was measured using both the single‐hand and the double‐hand methods, and then the critical flicker fusion frequency was measured. Using the flicker fusion frequency test, significant changes from the normal range were found at 20 and 30% nitrous oxide in the test gas, whereas no significant changes were found with the fusion flicker frequency test. No significant prolongation was found with either double‐hand or single‐hand reaction time measurements until 30% nitrous oxide in the test gas was reached.It is concluded that critical flicker fusion frequency measurement is a simpler, more time‐saving and more sensitive method for the estimation of the changes which nitrous oxide produces in healthy subjects than reaction time measurement, and that critical flicker fusion frequency measurement will presumably be a useful supplement to clinical examination as an objective method for the estimation of postanaesthetic recovery in patients.
Epidural Analgesia and Perinatal Retinal Haemorrhages
Authors: Maltau J. M. , Egge K. 
Published: January 2009

The incidence and magnitude of retinal haemorrhages in a group of neonates delivered spontaneously (n = 50), whose mothers received epidural analgesia during labour, has been compared to those of a spontaneously delivered control group (n=50) who received conventional analgesia. The second stage of labour was significantly longer in the epidural group (P<0.001), which contained a higher number of primiparas than did their controls. Still, a lower incidence of retinal haemorrhages was noted in the epidural group (P<0.01).The study indicates that epidural analgesia offers a certain degree of protection against perinatal retinal haemorrhages in the spontaneously delivered neonate.
Effects of Hydrocortisone, Phenoxybenzamine and Propranolol on the Blood Plasma Levels of Adrenaline and Noradrenaline During Hemorrhagic Hypotension in the Dog
Authors: Hellman A. , Häggendal E. , Häggendal J. , Lundberg D. 
Published: January 2009

The adrenergic aspects of the mechanism(s) of the vasodilating action of phenoxybenzamine and massive doses of hydrocortisone were studied in anesthetized dogs subjected to controlled hemorrhagic shock. During the predrug hypotension period with decreased cardiac output and heart rate, the plasma adrenaline and noradrenaline levels were both increased. Phenoxybenzamine injected alone augmented the cardiac output and heart rate and reduced the plasma adrenaline without changing the plasma noradrenaline concentration.However, if the adrenergic alpha‐receptor blocker was administered in combination with massive doses of hydrocortisone, the degree of vasodilation increased further with a concomitant increase in the concentrations of the two plasma catecholamines. Thus there seems to he no clear‐cut relationship between hemodynamic changes and plasma catecholamines. The present findings illustrate the extreme complexity of plasma catecholamine kinetics during hypovolemic shock.
Influence of Sodium Nitroprusside and Dobutamine on the Haemodynamic Effects Produced by Each Other
Authors: Meretoja O. A. 
Published: January 2009

To determine the possible modifying influence of potent inotropic medication and of sodium nitroprusside on the haemodynamic effects produced by each other, ten patients were treated 4 h after open‐heart surgery with constant infusions of nitroprusside (NP) and dobutamine (DOB), separately and in combination. In consequence of reduced left ventricular filling pressure, NP produced, the cardiac index fell tolerably, although systemic and pulmonary vascular resistances were typically lowered. These haemodynamic effects of NP were identical, with and without simultaneous DOB‐infusion.Dobutamine (6 μg/kg/min) did not affect systemic or pulmonary arterial mean pressures, nor the filling pressures of right or left ventricle. It augmented the cardiac index by 18%, but as a result of a 17beats/minrisein heart rate, the stroke volume remained unchanged during DOB‐infusion, whereas systemic vascular resistance was significantly lowered. The cardiovascular responses to DOB were independent of the simultaneous NP‐infusion.To conclude, the haemodynamic changes brought about by NP or DOB are not affected by each other, but when combined they produce additive, beneficial haemodynamic effects. Myocardial oxygen consumption, reflected as the rate‐pressure‐product (R‐P‐P), was slightly reduced during the combination therapy, due to the summation of the marked decrease of R‐P‐P which KP produced and the moderate increase of R‐P‐P produced by DOB.
Peripheral Circulation During Sufentanyl and Morphine Anesthesia
Authors: Berthelsen P. , Eriksen J. , Ahn N. Chr. , Rasmussen J. P. 
Published: January 2009

Sufentanyl is a newly developed potent, short‐acting fentanyl‐like morphinomimetic. No independent studies of the peripheral circulation during sufentanyl anesthesia are available. In the present study we compared the effects of sufentanyl and morphine on the peripheral perfusion in dogs. The effects of total β‐blockade during sufentanyl and morphine anesthesia were also evaluated. We elected to record skeletal muscle surface pH (m‐pH) continuously as an index of the microcirculation and cellular function. Arterial and mixed venous blood gases and acid‐base status were measured to determine the respiratory component of changes in m‐pH. Hematocrits, plasma electrolytes and plasma proteins were analyzed in order to permit calculations of fluid‐shifts between the blood and the interstitial fluid. Sufentanyl (0.01 nig/kg) had no adverse effects on the peripheral perfusion. Morphine (4 mg/kg) caused a severe and rapid fall in m‐pH from 7.29 to 7.11 during the 30‐min experimental period. At the same time, calculated blood volume decreased by 20%. This hypovolemic deterioration of the circulation was probably caused by a histamine‐mediated increase in capillary pressure with filtration of plasma from the circulation to the interstitial fluid.Calculated systemic vascular resistance was not correlated to the quality of the peripheral perfusion. Propranolol administered during sufentanyl and morphine anesthesia did not influence the peripheral perfusion. On the basis of the present study we recommend human studies on sufentanyl, and discourage the use of high‐dose morphine anesthesia.