bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lack of Impairment in Skills Related to Driving after Intramuscular Administration of Prilocaine or Mepivacaine
Authors: Korttila K. 
Published: January 2009

A saline placebo, 3 mg/kg of 2% plain prilocaine, and 3 mg/kg of 2% plain mepivacaine were injected into the deltoid muscles of 10 healthy subjects in a double‐blind, cross‐over trial.Before and at 0.5, 1.5 and 3 h after injection, psychomotor skills related to driving were measured. When compared to the saline placebo, neither prilocaine nor mepivacaine impaired the parameters of psychomotor function measured. Blood concentrations of prilocaine were significantly (P < 0.001) lower than those of mepivacaine during the whole observation period.It was concluded that in comparison to lidocaine, bupivacaine, or etidocaine, which have been tested previously and found to impair psychomotor performance, mepivacaine and, especially, prilocaine are the anaesthetic agents to be preferred when effects on central nervous system should be avoided, e.g. in outpatient practice.
Acid‐Base Status Before and After Arterial Clamping
Authors: Stokke D. B. , Juhl B. , Juel G. 
Published: January 2009

The necessity of providing alkalizing therapy after re‐establishment of the local circulation was studied in 10 otherwise healthy patients with intermittent claudication. No such necessity was found in providing stable peroperative circulation, normo‐ to slight hypothermia, adequate infusions, and normal acid‐base values prior to arterial clamping.It is pointed out that alkalosis can cause circulatory problems that are just as serious as those occurring with acidosis; therefore the routine use of alkalizing agents during vascular surgery is inadvisable. Should unstable circulatory parameters occur and hypoperfusion be suspected, then repeated control of the acid‐base values is indicated.
Comparison of Electrocardiographic Changes during Microlaryngoscopy under Halothane Anaesthesia induced by Althesin® or Thiopentone
Authors: Saarnivaara Laila , Kentala Eero 
Published: January 2009

The incidences of electrocardiographic (ECG) changes during microlaryngoscopy under halothane anaesthesia were compared by using Althesin® and thiopentone as induction agents.During the procedure the most common ECG change in both groups was junctional rhythm, which occurred in 37% of the patients in the Althesin group and in 29% of the patients in the thiopentone group. The next most common changes in the Althesin group were: ventricular ectopic beats (22%), ischaemic S‐T segment depression (14%), and T wave flattening or inversion (14%); those in the thiopentone group were ventricular ectopic beats (18%) and rapidly ascending S‐T segment depression (12%). As well as during the procedure, some ECG changes were registered in both groups during intubation. ECG changes disappeared without any special treatment after manipulation of the vocal cords or after intubation.There was no statistically significant difference in the total incidence of dysrhythmias between the Althesin and thiopentone groups, but the types of dysrhythmias were different in the two groups. There were more lower nodal rhythms, less serious ectopic beats and more ischaemic S‐T segment depression in the Althesin group than in the thiopentone group.The results suggest that Althesin is useful and superior to thiopentone in patients with a tendency to develop serious ventricular ectopic beats, whereas in patients with heart and coronary arterial disease, Althesin is inferior to thiopentone and should be used with care.
The Cerebrovascular CO2 Reactivity during the Acute Phase of Brain Injury
Authors: Gold Georg E. , Jensen Finn Taagehøj , Malmros Richard 
Published: January 2009

Using the intra‐arterial 133xenon (133Xe) method, the cerebrovascular response to acute PaCo2 reduction was studied in 26 unconscious, brain‐injured patients subjected to controlled ventilation. The CO2 reactivity was calculated as δ In CBF/δ Paco2. The perfusion pressure was defined as the difference between mean arterial pressure and mean intraventricular pressure.Although the CO2 reactivities did not differ significantly from that in awake, normocapnic subjects, it was low in the acute phase of injury, especially in those patients with severe outcome in whom the brain‐stem reflexes were often affected. An increase of the CO2 reactivity with time was observed, indicating normal response after 1–2 weeks.Chronic hypocapnia in six unconscious patients resulted in sustained CSF pH adaptation. The question whether a delay in CSF pH adaptation exerts an influence on the CO2 reactivity, and the influence of cerebral lactacidosis on the CO2 response are discussed.
Anaphylactic Shock in the Monkey: its Hemodynamics and Mediators1
Authors: Pavek Karel 
Published: January 2009

Anaphylactic shock (AS) was induced in 15 monkeys, and their hemodynamics were studied in order to identify the mechanisms initiating the low cardiac output (CO) state. Further, in 16 monkeys various substances were used with the aim of mimicking or antagonizing the changes in AS. Initial peripheral collapse was indicated by lowering of the right atrial pressure (RAP). The subsequent development of pulmonary hypertension increased RAP and, by extending venous pooling, reduced filling of the left heart. The degree of pulmonary hypertension or arterial hypotension was a poor indicator of the fall in CO. Hypoxemia and dysrythmias occurred occasionally, but early hemoconcentration was not found. Light depression of CO (—42%), due to venous pooling and reduction in left heart filling, could be corrected by fluid administration. In contrast, severe depression of CO (—81%) associated with ST‐T depression and with decreased cardiac contractility responded less to the fluid load, suggesting that myocardial failure was partly responsible for the low output state.Inhibition of prostaglandin (PG) synthesis by indomethacin did not prevent the development of AS. Injections of PGE2 and PGF2α, alone or together with histamine (Hi), did not mimic AS. PGE2 induced hypotension accompanied by an increase in CO, and PGF2α induced general vasoconstriction and a somewhat diminished CO. Hi induced hypotension and pulmonary hypertension; CO increased after low doses but decreased after sublethal doses. Compound 48/80, a liberator of Hi and slow‐reacting substance (SRS), imitated Hi effects initially, but later mimicked a minor state of AS. Infusion of FPL 55712, a selective antagonist of SRS, prevented AS, and general vasoconstriction occurred instead. In this model of AS, SRS is a more important mediator than Hi or PG.
High Precision Mixing of Anesthetic Gases Based on a New Principle
Authors: Lundsgaard J. S. , Einer‐Jensen N. , Juhl B. 
Published: January 2009

A machine has been constructed for mixing O2 and N2O. It consists of: (a) a proportional pressure and thereby flow regulator at the inlets for O2 and N2O; (b) a digital gas mixer which determines the gas mixture; and (c) a rotameter to measure the outlet flow.The contents of mixtures obtained from the machine were measured with a quadropole mass spectrometer (at 2 and 5 1 min‐1 with downstream pressures of 500 and 3000 Pa). The mean numeric difference between desired and registered vol% O2 varied between 0.3 and 0.5 vol% at the four conditions tested. The maximal deviation was 1.2 vol%. Five conventional machines in daily use at the hospital were also tested. The mean numeric difference for these machines varied between 1.1 and 2.7 vol% O2. The maximum deviation was 7.4 vol%.
Catheter Technique in Axillary Plexus Block Presentation of a New Method
Authors: Selander Dag 
Published: January 2009

A flexible, disposable intravenous catheter can be introduced into the neurovascular sheath in the axilla and used for injection of local anesthetic solution to block the axillary brachial plexus. The technique is described and the results of the first 137 consecutive catheter blocks are reported and compared to a similarly evaluated series of conventional axillary blocks.The catheter method constitutes an interesting alternative to needle techniques and offers the possibility of a continuous axillary block.
The Blocking Effect of Epidural Analgesia on the Adrenocortical and Hyperglycemic Responses to Surgery
Authors: Engquist Allan , Brandt Mogens R. , Fernandes Alvito , Kehlet Henrik 
Published: January 2009

The adrenocortical and hyperglycemic responses to hysterectomy were studied in five groups of patients receiving: general anesthesia (group I), general anesthesia + epidural analgesia extending from Th10‐S4–5 (group II), general anesthesia + epidural analgesia extending from Th8‐S4–5 (group III), general anesthesia + epidural analgesia extending from Th4–6‐S5 (group IV) and epidural analgesia extending from Th4‐S5 without general anesthesia (group V).The results showed that the Cortisol response was abolished in group V, inhibited in group IV and normal in groups II and III. The hyperglycemic response to surgery was inhibited in groups II, III and IV, and abolished in group V.Epidural analgesia from Th4 to S5, preventing the adrenocortical and hyperglycemic responses to hysterectomy, and possibly also inhibiting other components of the endocrine‐metabolic response to surgery, may have important applications in further studies of the physiologic significance of the endocrine‐metabolic response to surgery.
The Effects of PaCO2 Reduction on Regional Cerebral Blood Flow in the Acute Phase of Brain Injury
Authors: Cold Georg E. , Jensen Finn Taagehøj , Malmros Richard 
Published: January 2009

In 26 unconscious patients with brain injuries, regional cerebral blood flow (rCBF) was measured with a 16‐channel Cerebrograph before and after acute reduction of Paco2 The intra‐arterial 133xenon washout technique was used, and CBF was calculated regionally as initial slope index or stochastic flow. The CO2 reactivity was calculated as ΔIn CBF/ΔPaco2.In supratentorial cortical lesions, an acute fall in Paco2 increased the homogeneity of the regional flow pattern (decrease in the standard deviation of the regional flow values), and reduced the number of focal hyperaemic regions (tissue peaks). The CO2 reactivity in tissue peak regions was generally higher than in regions without tissue peaks. In severely injured patients with a poor outcome (dementia, vegetative survival or death), inverse steal reaction was accounted for in 11% of all regions, but only in 3% of the regions in patients who survived without dementia. Inverse steal reaction was most frequently seen during the first 3 days after the trauma. In repeated CBF studies, an increase in the CO2 reactivity with time was observed after the acute trauma.In comparison with the CO2 reactivity found in normocapnic awake subjects, this increase was higher than expected in several cases.
Anaesthesia for Short‐stay Varicose Vein Surgery
Authors: Aromaa Ulla 
Published: January 2009

The study was undertaken in order to elucidate the suitability of four different types of general anaesthesia and of epidural block in short‐stay varicose vein surgery. Special consideration was given to recovery after anaesthesia. The series consisted of 230 female patients subjected to varicose vein surgery of one lower extremity. The patients' recovery after surgery was observed through tests measuring visual‐motor coordination and through questionnaires. The general anaesthesias used were halothane‐nitrous oxide‐oxygen anaesthesia with spontaneous respiration (Ha), relaxant‐dominated combined anaesthesia (Re), analgesic‐dominated combined anaesthesia (An), and analgesic‐dominated combined anaesthesia with hyperventilation (Hy).Of the general anaesthesias, halothane nitrous‐oxide inhalation anaesthesia gave the fastest recovery, although there were no major differences between it and analgesic‐dominated combined anaesthesia. In contrast, immediate recovery was prolonged after hyperventilation and after relaxant‐dominated anaesthesia. Epidural blockade provided a good alternative to general anaesthesia.
A Comparison between the Influence of Halothane or Fentanyl and Droperidol Anaesthesia on the Adrenergic Receptor Response in Human Adipose Tissue in vitro
Authors: Rosenqvist U. , Lindholm M. , Eklund J. 
Published: January 2009

A comparison was made between the adrenergic receptor response in vitro in human adipose tissue obtained under halothane and neuroleptanaesthesia. In both groups the net release of glycerol was significantly stimulated (P < 0.01) by the combined alpha‐ and beta‐adrenergic agonist, 1‐noradrenaline. In the halothane group, the lipolysis was further increased by the addition of phentolamine (an alpha‐adrenergic blocking agent). No such effect could be demonstrated in specimens from the fentanyl/droperidol group. This difference in response was most probably explained by the fact that droperidol had quite a long‐lasting alpha‐adrenergic blocking property, which totally obliterated the effect of another alpha‐adrenergic blocking agent.The findings stress the importance of using a standardized procedure, including the choice of anaesthetic agents, when human adipose tissue is sampled for metabolic studies in vitro. The results also indicate the possibility of a difference in metabolic effects in vivo between the two procedures.
Some Aspects of Ocular Function after Precurarization
Authors: Eriksen Søren , Bramsen Thorkild , Hommelgaard Peter 
Published: January 2009

Small doses of nondepolarizing relaxants are often recommended as prior medication to suxamethonium in order to avoid or attenuate the side effects elicited by the latter drug. After D‐tubocurarine (0.05 mg/kg b.w. and 0.075 mg/kg b.w.) in unmedicated volunteers, a dose‐dependent recession of the monocular near point of accommodation was recorded. This recession, which parallelled the decrease in grip strength, was 4 cm and 9 cm, respectively. The same doses evoked an exophoria of 14 and 17 prism diopters, respectively.Intraocular pressure was significantly lowered by D‐tubocurarine 0.05 mg/kg b.w., from 2.01 kPa (15.1 mmHg) to 1.64 kPa (12.3 mmHg), and by pancuronium 0.015 mg/kg b.w. from 1.90 kPa (14.3 mmHg) to 1.44 kPa (10.8 mmHg). The decreases lasted for 7 min. Gallamine 0.3 mg/kg b.w. also decreased intraocular pressure, but to a lesser degree, and with statistical significance only during the fourth minute after administration.Relaxation of extraocular muscles may change the slightly ovoid shape of the eyeball into a more spherical one, thereby inducing a fall in intraocular pressure and a recession of the near point of accommodation.
Effects of Intercostal Nerve Blocks (Etidocaine 0.5%) on Chest Wall Mechanics in Cholecystectomized Patients
Authors: Jakobson Sven , Ivarsson Ingrid 
Published: January 2009

In 20 patients who had undergone cholecystectomy through a right oblique incision, an intercostal nerve block with etidocaine 0.5% was performed on the day after operation — in 10 patients on the right side only and in the other 10 bilaterally. The block was applied to the 5th‐11th intercostal nerves, inclusive.Tidal volumes, respiratory variations in the perimetry of the chest and abdomen, and intraoesophageal and intragastric pressures were recorded before and after the blockades. From analyses of the relations between the relative contributions of costal and abdominal respiration, on the one hand, and intragastric pressure variations, on the other, it was found that before the blockade the intercostal muscles contributed to respiratory movements at rest, but that this contribution decreased after the blockade ‐ to a greater extent after bilateral than after unilateral blockade. It is assumed that this return to a more normal type of breathing at rest implies relief for the patients. The nerve block led to no significant change of the fraction of abdominal breathing. Pulmonary elastance decreased after bilateral blockade, but remained unchanged after unilateral. Changes in the functional residual capacity (FRC) were evaluated by transthoracic electrical impedance pneumography. Signs of a reduction were noted after unilateral blockade, but there appeared to be no change after bilateral blockade.Bilateral intercostal block thus seems more satisfactory than unilateral in certain respects. The differences cannot be ascribed such importance, however, that bilateral blocks should be considered obligatory in cholecystectomized patients. Probably the most important effect ‐ the pain relief‐ is achieved in these patients by a right‐sided block only.
Postoperative Ventilatory Response to Carbon Dioxide Following Neurolept Anaesthesia
Authors: Hansen Vejlsted M. , Jacobsen E. 
Published: January 2009

In order to investigate the duration of respiratory depression following neurolept anaesthesia, 21 patients who had hemilaminectomia performed were subjected to ventilation‐carbon dioxide response tests by a rebreathing method in the postoperative period. Up to 3 1/2 h after start of anaesthesia all patients had a decreased ventilatory response to carbon dioxide. After this period some patients showed a normal respiratory response, while others remained depressed for up to 6 h, the period for which the investigation lasted. Most patients in the depressed group were premedicated with pethidine.We conclude that additional narcotics are contraindicated for a period of 3 1/2 h following the start of nerolept anaesthesia for surgical procedures lasting 1–2 h, while clinical control is still necessary before administration of additional narcotics within 6 h, especially if narcotics have been used as premedication.
Phrenic and Vagal Nerve Activities during Spontaneous Respiration and Positive‐Pressure Ventilation
Authors: Jonzon Anders 
Published: January 2009

Afferent vagal nerve activity from stretch‐receptors in the lung and efferent phrenic nerve activity were recorded during spontaneous respiration and during positive‐pressure ventilation with three different types of ventilators. During spontaneous respiration the efferent phrenic nerve activity slightly preceded the afferent vagal nerve activity. Volume‐controlled ventilation did not alter the phrenic nerve activity when the ventilation was set at a rate equal to that during spontaneous respiration, but afferent vagal volleys increased in duration. At higher frequencies of insufflation spontaneous inspiration was inhibited.An increase in afferent vagal nerve activity and a concomitant slight decrease in efferent phrenic nerve activity were obtained during animal triggered pressure‐controlled ventilation.High‐frequency positive‐pressure ventilation (HFPPV) gave rise to basal, non‐grouped activity in vagal afferents, causing inhibition of inspiration. During HFPPV, spontaneous respiration can take place on activation of other afferents to the respiratory centre.Clinical aspects of respirator treatment from a neurophysiological standpoint are discussed.
High‐Frequency Positive‐Pressure Ventilation (HFPPV) Applied in Bronchoscopy under General Anaesthesia An Experimental Study
Authors: Borg Ulf , Eriksson Ivan , Lyttkens Leif , Nilsson Lars‐Göran , Sjöstrand Ulf 
Published: January 2009

Techniques for ventilation in bronchoscopy under general anaesthesia using intermittent positive‐pressure ventilation directly via the fixed side‐arm of the open bronchoscope have recently been described by several authors. Our present technique utilizes a high pressure oxygen/nitrous oxide gas mixture which is obtained from a gas‐conditioning system. This gas is intermittently supplied at a high insufflation frequency to the side‐arm of the open bronchoscope.In lung model experiments and experiments in dogs the use of Storz bronchoscopes 4–9 mm in diameter was studied. With the volumes of delivered gas kept constant, the lung model studies showed that the “intrapulmonary pressure” increases with decreasing insufflation frequencies; in parallel the “pulmonary ventilation” decreases due to increasing gas loss through the outer opening of the open bronchoscope. In both the dog and the lung model experiments increasing frequencies resulted in reduced pulmonary ventilation. Both of these studies showed that when the relative insufflation time was shortened from 32 to 22 % of the period time ventilation increased. As demonstrated previously, the central venous pressure and the pulmonary arterial pressure were not affected by this type of high‐frequency positive‐pressure ventilation.It is concluded that this study favours an insufflation frequency (f) of 60 per min and a relative insufflation time (t%) of 22% to be used in the clinical situation.If f/t% is kept at 60/22 in bronchoscopic HFPPV the driving gas pressure is the principal determinant of the total gas input and pneumatic valve function, which are the main factors in the generation of tidal volume and alveolar ventilation with this “open” ventilator system. Consequently, and as may be demonstrated clinically (Eriksson & Sjöstrand 1977a), the ventilation of the patient is regulated by the driving gas pressure. As there is no air entrainment with bronchoscopic HFPPV the oxygenation is regulated by means of the oxygen concentration in the oxygen/ nitrous oxide mixture delivered intermittently to the side‐arm of the bronchoscope.
Flow Requirements in the Hafnia Modifications of the Mapleson Circuits during Spontaneous Respiration
Authors: Christensen K. N. , Thomsen A. , Hansen O. , Jørgensen S. 
Published: January 2009

The Mapleson A, B, C and D circuits can be changed into non‐polluting circuits by employing continuous gas evacuation directly from the circuit, via an ejector flowmeter (Jørgensen 1974); Mapleson A and C circuits with this modification have been described previously as the Hafnia A and C circuits (Christensen 1976, Thomsen & Jørgensen 1976).If evacuation from a closed reservoir is employed, total removal of the expired and surplus gases from the operating theatre is obtained (Jørgensen & Thomsen 1976). There will be resistance to expiration in all the circuits with a relief valve for the discharge of surplus gas. If surplus gas is continuously removed directlyfrom the anaesthetic circuit, the patient breathes in an air compartment at ambient pressure, as long as the removal rate equals the inflow of fresh gas. The relief valve is only included in the circuit to ensure that high pressures do not develop. As in any other circuit, the relief valve remains open except during controlled ventilation. A dumping valve may also be included as a safeguard against low pressures (Jørgensen & Thomsen 1976).The flow requirements of the Hafnia B and D circuits and the corresponding Mapleson circuits have been studied in conscious, spontaneously breathing subjects, and the results are discussed in relation to the flow requirements of other semi‐closed systems.
Concentration and Elimination of Anaesthetic Gases in Operating Theatres Influence of Anaesthesia Apparatus Leakages
Authors: Berner Ole 
Published: January 2009

Halothane and nitrous oxide (N2O) concentrations were measured in operating theatres, in the areas corresponding to the inhalation zones or the anaesthetists and operating nurses. The measurements were performed in an operating theatre with a non‐recirculating air exchange rate of 20/h. This was performed partly in model experiments and partly during the administration of anaesthesia by intubation.In the model experiments, the measurements were taken both with and without a specially constructed scavenging system. During anaesthesia, the measurements were taken exclusively with the scavenging system, although well‐defined leakages were fitted into the otherwise gas‐tight anaesthetic system. The results were supplemented by smoke experiments which showed the air distribution patterns.The investigation showed that the gases were concentrated over and around the operating table. Activities during surgery diluted this concentration. Furthermore, it was shown that leakage in the anaesthetic system significantly influences the achieving of a low gas‐air mixture. Halothane concentrations in the inhalation zone of the anaesthetist and operating nurse can be reduced to 0.02 and 0.01 p.p m. respectively, if the anaesthetic system is completely gas‐tight.