bluuebunny/crossref_metadata_2025_split huggingface dataset:
ANAESTHESIA AND PREMEDICATION AS FACTORS IN POSTOPERATIVE VOMITING
Authors: Dundee J. W. , Kirwan M. J. , Clarke R. S. J. 
Published: December 2008

SUMMARYPatients having a standard operative procedure in constant surroundings formed the population for a study of some factors influencing postoperative vomiting and nausea. With constant premedication thiopentone and halothane were followed by significantly fewer symptoms than propanidid or cyclopropane. With a constant form of anaesthesia the incidence of emetic sequelae was greater with pethidine 50 mg plus atropine 0.6 mg than with atropine alone, while morphine 10 mg resulted in even more symptoms than pethidine.Where there was a high “control” incidence of sequelae, such as with propanidid or cyclopropane after morphine premedication, the use of halothane reduced the frequency during the first hours after operation, but had little effect with less emetic combinations. Chloroform caused more postoperative vomiting than halothane, and there was some evidence to suggest that induction with thiopentone reduced symptoms.ZUSAMMENFASSUNGPatienten, bei denen unter den gleichen äusseren Bedingungen operative Standardeingriffe durchgeführt wurden, stellten das Vergleichskrankengut einer Studie dar, bei der der Einfluss verschiedener Faktoren auf postoperatives Erbrechen und Brechreiz festgestellt werden sollte. Bei konstanter Praemedika‐tion waren Thiopenton und Halothan von signifikant geringeren Symptomen gefolgt als Propanidid und Cyclopropan. Bei gleichbleibender Art der Narkose war das Auftreten von Brechreiz oder Erbrechen nach 50 mg Pethidin und 0.6 mg Atropin stärker als nach Atropin allein, während sich nach 10 mg Morphin sogar mehr Symptome als nach Pethidin zeigten.In den Gruppen, bei denen es zu einem hohen “Kontroll‐Prozentsatz” von Folgererscheinungen kam, wie z.B. mit Propanidid und Cyclopropan nach Morphin‐Praemedikation, verminderte die Verwendung von Halothan die Häufigkeit während der ersten Stunden nach der Operation, hatte jedoch wenig Wirkung bei den weniger zum Erbrechen reizenden Kombinationen. Chloroform hatte mehr operatives Erbrechen zur Folge als Halothan und manche Anzeichen deuteten darauf hin, dass Einleitung mit Thiopentone die Symptome verminderte.
MUSCLE PAINS AFTER SUXAMETHONIUM
Authors: Dottori Otello , Löf Bengt Ax: son , Ygge Hans 
Published: December 2008

SUMMARYMuscle pains after intermittent administration of suxamethonium are a common complication in modern anaesthetia. They can be prevented to a certain extent through postoperative immobilization of the patient. However, it is important to mobilize the patients as early as possible, particularly in the elderly age groups. In these cases, it is therefore of the greatest importance to prevent postoperative muscle pains, which can be of considerable intensity. We have tried a method in which increasing doses of tubocurarine were given before administration of suxamethonium. At a dosage of 3 mg tubocurarine the patients were kept free from pain, but more suxamethonium was necessary for relaxation. We have found no untoward effects of this method.ZUSAMMENFASSUNGMuskelschmerzen nach intermittierender Verabreichung von Suxamethonium sind eine häufige Komplikation der modernen Anaesthesie. Sie können bis zu einem gewissen Grad durch postoperative Immobilisierung der Patienten verhiitet werden. Es ist jedoch wichtig, die Patienen so rasch wie möglich zu mobilisieren, besonders im höheren Alter. In diesen Fällen ist es daher von grösster Bedeutung, postoperativen Muskelschmerzen vorzubeugen, die von beträchtlicher Intensität sein konnen. Wir haben eine Methode, bei der an‐steigende Dosen von Tubocurarin vor der Verabreichung von Suxamethonium gegeben wurden, ausprobiert. Bei einer Dosierung von 3 mg Tubocurarin konnten die Patienten schmerzfrei gehalten werden, jedoch war für die Er‐schlaffung mehr Suxamethonium erforderlich. Wir haben bei dieser Methode keine unerwünschten Wirkungen gefunden.
Methemoglobin Formation by a Local Anesthetic and Some Related Compounds
Authors: Onji Yutaka , Tyuma Ichiro 
Published: December 2008

SUMMARYCitanest (L 67, α‐n‐propylamino‐2‐methylpropionanilide) and some related compounds were studied for methemoglobin formationin vitroandin vivo.In vitro,Citanest did not induce met‐Hb formation in red cell suspension. Under the same conditions a related compound, o‐toluidine, in a dose of 40 mg/dl, did produce met‐Hb. Intramuscular injection of Citanest and o‐toluidine in cats induced met‐Hb in the circulating blood.Lidocaine and a related compound, 2,6‐xylidine, did not produce met‐Hb in the cat on intramuscular injection.In clinical experiments on 50 patients who received Citanest (200‐1,600 mg) by epidural injection, met‐Hb, exceeding 10% of the total hemoglobin, was observed in a few cases. The met‐Hb concentration increased roughly parallel with the dose of Citanest administered. The only complication encountered was slight cyanosis in one case, whose met‐Hb concentration was 2.79 g/dl. In most cases maximum met‐Hb concentration was attained three to five hours after administration of Citanest, and met‐Hb disappeared within 24 hours after the injection. On the basis of these results, it is suggested that the safe upper limit of Citanest for a single injection is 10 mg/kg body weight.
Clinical Evaluation of the Regional and Topical Anesthetic Activity of Prilocaine
Authors: Crawford Oral B. 
Published: December 2008

SUMMARYIn terms of clinical effectiveness, prilocaine possesses the same advantages as lidocaine. In addition, it offers a significantly greater duration and safety margin without a vasopressor. On the other hand, prilocaine has a latency that is somewhat longer than lidocaine, and may produce methemoglobinemia. The small difference in latency betwen these agents is of little importance to most clinicians. With respect to methemoglobin formation, dosages of prilocaine equal to the maximally recommended dose of lidocaine do not produce statistically significant amounts of methemoglobin, and at dose levels which are twice in excess of that recommended for lidocaine, prilocaine does not produce clinically significant levels of methemoglobin. Moreover, methemoglobin is rapidly and effectively reverted by methylene blue. Therefore, the production of methemoglobin does not limit the clinical indication for this drug in the dosages recommended. On the basis of our clinical experiences, prilocaine would appear to be the local anesdietic drug of choice for regional anesthesia.
Citanest® (Prilocaine) in Spinal Analgesia
Authors: Crankshaw T. P. 
Published: December 2008

SUMMARYA report of 339 cases of subarachnoid block is presented. Citanest was used in 106 cases. The advantages of this drug are discussed. A very small number with Citanest 1.9% compared with two other drugs (4.6% and 6.5%) required supplementary anaesthesia.
Citanest® in Dental Surgery
Authors: Goldman Victor 
Published: December 2008

SUMMARYA comparison has been drawn between lignocaine, which is regarded as a standard analgesic agent, and the new compound Citanest, and the result of experimental evidence has been collected in order to show the decreased toxicity of the new agent.The results of a large‐scale double‐blind trial in Dental Surgery during which 67 operators participated and over 12,000 cases were reported is considered and the results shown in histograms. From this investigation it is apparent that a 3% Citanest solution with adrenaline 1:300,000 was found to be as effective as the standard lignocaine solution but in infiltration analgesia of the soft tissue lasts for a considerably shorter period of time. Various interesting side‐effects have been discussed and the action of different concentrations of adrenaline and other local analgesic agents have been compared.The incidence of initial pain with 3% Citanest solution was significantly lower and the onset of analgesia was equal in time to that following the use of lignocaine.It is suggested that this solution having a very low content of adrenaline, i.e. 1:300,000, would be effective in cases when surgery is likely to be completed in 30 minutes and could be employed in patients with a raised blood pressure and other arteriosclerotic conditions.
The Postimmersion Syndrome
Authors: Jacobsen Erik , Palm Leif 
Published: December 2008

SUMMARYTwo cases of the postimmersion syndrome are described. This term designates the entity developing after a primarily non‐fatal submersion. Both patients experienced a brief asymptomatic interval. Afterwards the symptoms of dyspnoea, cyanosis and tachycardia progressed rapidly. None of the changes in blood chemistry characteristic of drowning was found. One patient died 5 hours after admission, whereas the other survived. The clinical course and the pathological picture seem to indicate that the postimmersion syndrome is caused by aspiration of swallowed water, which is transferred to the lungs from the stomach. The pronounced resemblance between the syndrome reported and Mendelson's syndrome is emphasized. The principles of treatment suggested in the literature are discussed.ZUSAMMENFASSUNGEs werden zwei Fälle von Post‐Immersionssyndrom beschrieben. Dieser Ausdruck umschreibt das Gesamtzustandsbild das sich nach primär nicht töd‐lichem Ertrinken entwickelt. Bei beiden Patienten bestand ein kurzes symp‐tomloses Intervall. Anschliessend bildeten sich rasch die Zeichen von Dyspnoe, Zyanose und Tachycardie aus. Die Veränderungen des Blutchemismus waren nicht charakteristisch für Ertrinken. Ein Patient starb 5 Stunden nach der Aufnahme, der andere überlebte. Der klinische Verlauf und das pathologische Bild scheinen darauf hinzudeuten, dass das Post‐Immersionssyndrom durch die Aspiration verschluckten Wassers zustande kommt, welches durch Erbre‐chen oder Regurgitation vom Magen in die Lunge gelangt. Es wird auf die auffallende Ähnlichkeit des berichteten Syndroms und des sogenannten Men‐delsohn‐Syndroms speziell hingewiesen. Die Grundzüge der Behandlung, wie sie im Schrifttum vorgeschlagen wurden, werden diskutiert.
Some Pharmacological and Toxicological Properties of a New Long‐Acting Local Analgesic, Lac‐43 (Marcaine®), in Comparison With Mepivacaine and Tetracaine
Authors: Henn F. , Brattsand R. 
Published: December 2008

SUMMARYThe toxicological and pharmacological properties of mepivacaine, LAC‐43 (Marcain®)—a new local analgesic—and tetracaine were studied in experiments on animals and man using “classical” test methods. The experiments were performed by the “blind” technique; whenever possible, the results were subjected to statistical analysis and compared with those published by other investigators.LAC‐43, which is chemically closely related to mepivacaine, is more similar to tetracaine as regards its local analgesic and toxicological potencies. Thus, the acute toxicity in mice, guinea pigs and rabbits in different routes of application is about the same for LAC‐43 and tetracaine and roughly 4 times higher than that of mepivacaine. Furthermore, LAC‐43 and tetracaine have the same tissue toxicity—about 6 times higher than that of mepivacaine, but LAC‐43 has a lower cumulative and infusion toxicity relatively to mepivacaine and absolutely to tetracaine. In infiltration and conduction analgesia, LAC‐43 and tetracaine are about 3 times more potent than mepivacaine, and in surface analgesia both drugs are still more potent than mepivacaine, tetracaine being the most active.In spite of being an amide, LAC‐43 has shown evidence of being rapidly metabolised, and as the clinical experiments so far published have given promising results, it should be worth while to subject this new local analgesic drug to thorough investigations.
Axillary Plexus Block
Authors: Hollmén Arno 
Published: December 2008

SUMMARYIn axillary plexus blocks employed in surgical procedures involving the upper extremity, comparisons were made between anaesthesias produced by 2% mepivacaine (Carbocaine®) with epinephrine 1:200,000 and 0.25 and 0.5% LAC‐43 (Marcaine®) with epinephrine 1:200,000, as to the effectiveness of the anaesthesia, duration of the anaesthesia, as well as the occurrence of post‐operative pain with each drug. The series of 59 blocks was divided according to the anaesthetics used into three comparable groups. The intensity of anaesthesia in various cutaneous and motor branches of the axillary plexus was used as the criterion for success of the blocks. This anatomical criterion was also compared with operability. As regards latency there are no statistically significant differences between the agents. Mepivacaine as 2% solution + epinephrine was found to be definitely more efficient than 0.5 or 0.25% LAC‐43 as regards the intensity of anaesthesia in various nerves. There were, however, no noteworthy differences in operability between mepivacaine and 0.5% LAC‐43, but 0.25% LAC‐43 proved to be unsatisfactory in this respect. The duration of both sensory and motor depression (anaesthesia) was prolonged more than twice with LAC‐43 (both 0.5 and 0.25%). The pain caused by operative trauma appeared after 12 hours with 0.5% LAC‐43 and after approx. 9 hours with 0.25% LAC‐43 and after about 3 1/2 hours with 2% mepivacaine. There were no noticeable side effects or neurological complications.
AETIOLOGY AND TREATMENT OF FAT EMBOLISM
Authors: Liljedahl Sten‐Otto , Westermark Lars 
Published: December 2008

SUMMARYThe aetiology of the so‐called fat embolism is discussed, and the treatment of five cases widi this syndrome is described.In our opinion, fat embolism is the result of a traumatic stress‐induced intravascular coagulation and disturbances in fat metabolism.A clinical programme is given for early prophylactic treatment, including adequate colloid infusions, high caloric supply, sedatives and “sympathico‐lytics,” and heparin. More than 20 severe traumatic cases with considerable risk of fat embolism were treated according to this programme. Most of them did not show any severe symptoms of fat embolism.In the five cases in which clinical symptoms of fat embolism appeared, the initial prophylactic treatment was not quite in accordance with our present treatment programme. After further intensive respiratory and circulatory therapy four of the five patients survived. In die fifth case, therapy started late; the pulmonary changes were too severe to allow adequate ventilation, and die patient died of respiratory insufficiency. The use of corticosteroids in two patients resulted in clinical and radiographic improvement.ZUSAMMENFASSUNGDie Ätiologie der sogenannten Fettembolie wir ddiskutiert und die Behand‐ung von 5 Fällen mit diesem Syndrom beschrieben.Nach unserer Auffassung ist die Fettembolie das Resultat einer durch den traumatischen Stress bedingten intravaskulären Koagulation und von Störungen im Fettstoffwechsel.Für die frühprophylaktische Behandlung wird ein klinisches Programm erstellt, das ausreichende Kolloidinfusionen, hohe Kalorienzufuhr, Sedativa, Sympatikolytika und Heparin beinhaltet. Mehr als 20 Unfallpatienten mit beträchtlichem Fettembolierisiko wurden, diesem Programm entsprechend, behandelt. Die meisten von diesen zeigten keine schweren Symptome von Fettembolie.Bei den 5 Fällen, bei welchen die klinischen Symptome der Fettembolie aufschienen, war die anfängliche prophylaktische Behandlung nicht ganz im Einklang mit unserem derzeitigen Therapieplan. Nach weiterer intensiver Behandlung von Atmung und Kreislauf überlebten 4 dieser 5 Patienten. Beim fünften Fall begann die Behandlung zu spät; die pulmonalen Veränderungen waren zu schwer um eine adäquate Beatmung zu ermöglichen. Der Patient erlag seiner Ateminsuffzienz. Die Anwendung von Corticosteroiden bei zwei Patienten führte zu klinischer und röntgenologischer Besserung.
CORRELATION OF CARDIAC PLETHYSMOGRAPHY WITH OTHER CIRCULATORY RECORDINGS DURING THE ACTION OF ANESTHETICS AND CARDIAC STIMULANTS
Authors: Bernhoff S. A. S. , Bagwell E. E. , Walton R. P. 
Published: December 2008

SUMMARYHeart size changes as measured by plethysmography with the pneumopericardium were correlated with several other circulatory parameters during synchronous recordings. The relative effects of rate, arterial pressure and blood volume on these measurements were estimated. The observations obtained with anesthetic agents and with cardiac stimulants provide further information on the degree to which such measurements can be taken as an index of positive or negative inotropism. The highly sensitive capabilities of the plethysmo‐graphic method is demonstrated.ZUSAMMENFASSUNGDie durch die Plethysmographie mit dem Pneumoperikardium gemessenen Veränderungen der Herzgrösse wurden mit anderen zirkulatorischen Para‐metern durch synchrone Registrierung in Beziehung gebracht. Die relativen Auswirkungen von Frequenz, arteriellem Druck und Blutvolumen auf diese Messungen wurden bestimmt.Die mit Narkosenmitteln und mit Herzstimulantien gewonnenen Beo‐bachtungen zeigen uns ferner bis zu welchem Grad solche Messungen als ein Zeichen von positivem oder negativem Inotropismus angesehen werden kon‐nen. Die Empfindlichkeit der plethysmographischen Methode wurde demon‐striert.
ELEGTROCARDIOGRAPHIG CHANGES DURING INDUCTION WITH THIOPENTAL AND PROPANIDID
Authors: Salmenperä A. , Scharlin M. , Eerola R. 
Published: December 2008

SUMMARYElectrocardiographic changes during thiopental and propanidid induction were studied. The quality of the changes did not differ greatly. Tachycardia was more common after propanidid than after thiopental. When the time of the appearance of arrhydimias was considered, tachycardia without other arrhythmias occurred more often after propanidid than after thiopental. In the thiopental group, other electrocardiographic changes occurred mostly during or after intubation. Other factors investigated in this study, such as sex, premedication, difficulties in intubation, the amount of drugs or the rate of injection, did not seem to exert any influence on the occurrence of arrythmias during induction.ZUSAMMENFASSUNGEs wurden die elektrokardiographischen Veränderungen während der Narkoseeinleitung mit Thiopental bzw. Propanidid untersucht. Die Unter‐schiede in der Qualität waren nur gering. Tachycardie trat nach Propanidid häufiger als nach Thiopental auf. Bezüglich des Zeitpunktes des Auftretens der Arrhythmien kam es nach Propanidid häufiger zu Tachycardien ohne andere Arrhythmien als nach Thipoental. Bei der Thiopental‐Gruppe kamen andere EKG‐Veränderungen meist während oder nach der Intubation vor. Andere Faktoren, die in diese Untersuchung einbezogen wurden, wie z.B. Geschlecht, Prämedikation, Intubationsschwierigkeiten, die Menge der Mittel oder die Injektionsgeschwindigkeit, schienen keinen Einfluss auf das Auftreten der Arrhythmien wahrend der Einleitung zu haben.
EFFECTS OF INTRA‐ARTERIAL MEPIVACAINE AND BUPIVACAINE ON NEUROMUSCULAR TRANSMISSION IN MAN
Authors: Telivuo Leo 
Published: December 2008

SUMMARYThe effects of intra‐arterial mepivacaine and bupivacaine on neuromuscular transmission in man were studied. A partial neuromuscular block produced by nortoxiferine was increased by mepivacaine and bupivacaine. A neuromuscular blocking action of mepivacaine and bupivacaine could be demonstrated after 2‐second and 30‐second intra‐arterial injections. The neuromuscular blocking activity of bupivacaine is three to four times as great as the activity of mepivacaine. Their effect might be attributable to an acetyl‐choline‐inhibiting action on the motor‐end plate.ZUSAMMENFASSUNGEs wurden die Wirkungen von intraarteriell verabreichtem Mepivacain und Bupivacain auf die neuromuskuläre Übertragung beim Menschen unter‐sucht. Ein durch Nor‐Toxiferin erzeugter partieller neuromuskulärer Block wurde durch Mepivacain und Bupivacain verstärkt. Eine neuromuskulär blockierende Wirkung von Mepivacain und Bupivacain konnte 2 Sekunden und 30 Sekunden nach intraarterieller Injektion demonstriert werden. Die neuromuskuläre Blockade durch Bupivacain ist 3‐4 mal stärker als die durch Mepivacain verursachte. Als Wirkungsmechanismus könnte eine azetylcholinhem‐mende Wirkung an der motorischen Endplatt angesehen werden.
Inhalation Anesthetics, Carbon Dioxide and Glucose Transport Across Red Cell Membranes
Authors: Greene Nicholas M. , Cervenko Frank W. 
Published: December 2008

SUMMARYThe increase in permeability of human erythrocytes to glucose produced by carbon dioxide was confirmed. The effect of certain membrane inhibitors was studied. It was found that while mercuric chloride inhibited the effect of carbon dioxide, ouabain and butanol did not. Inhalation anesthetics in therapeutic concentrations were found to inhibit the stimulatory effect of carbon dioxide. It was concluded that while the means by which carbon dioxide stimulates glucose entry into red cells remains undefined, the inhibitory effect of anesthetics is not related to their ability to “stabilize” membranes, to their effects on energy‐linked metabolic processes, or to their interactions with sulfhydryl or amino groups in cell membranes. The inhibitory effect of anesthetics on carbon dioxide‐stimulated glucose entry is compatible with the hypothesis that they act as competitive penetrating inhibitors of glucose transport mechanisms in human red cell membranes. The depressant effect of anesthetics on carbon dioxide‐induced increases in respiration resemble their depressant effects on carbon dioxide‐induced increases in glucose transport. This raises the possibility that anesthetics have as a common property inhibition of normal responses to carbon dioxide, including responses other than those involving pulmonary ventilation.
A New Circle System for Paediatric Anaesthesia
Authors: Holm H. H. , Secher O. 
Published: December 2008

SUMMARYA new paediatric circle system is described. It has been used for 232 anaesthetics over a wide range of procedures, lasting up to 9 hours. The ages of the children ranged from 19 hours to 14 years.This system has worked well except in relatively few cases of sticking of the valve mechanism. In children weighing less than 4000 g, the respiratory tidal volume was usually so small that the valve did not function properly.The advantages of the closed system over non‐rebreathing or open systems are:‐

The ability of delivering inspiratory gases with high humidity to avoid drying of the respiratory tract.
Special advantages of the system:‐

Small dead space.
Small amount of gases contained in the circle.
Light weight.
Easy and effective ventilation control.
Firm attachment to operating table, but free positioning of the patient still possible.

It is concluded that the circle system described is especially suitable for anaesthesia of children between 4000 g and 48 kg.ZUSAMMENFASSUNG UND SCHLUSSFOLGERUNGENEs wird ein neues pädiatrisches Kreissystem beschrieben. Bisher wurde es für 232 Narkosen für die verschiedensten operativen Eingriffe bis zu 9 Studen Dauer verwendet. Das Alter der Kinder lag zwischen 19 Stunden und 14 Jahren.Das System hat sich gut bewährt, wenn man von den relativ wenigen Fällen von Verklebung des Ventilmechanismus absieht. Bei Kindern mit einem Körpergewicht von unter 4000 g ist das Atemvolumen gewöhnlich so klein, dass das Ventil nicht ordentlich funktionieren kann.Die Vorteile des geschlossenen Systems gegenüber der Nicht‐Rückatmung oder einem offenen System sind:

Die Möglichkeit, die Einatmungsgase mit hohem Feuchtigkeitsgehalt zu liefern und dadurch Austrocknung des Respirationstraktes zu verhindern.
Besondere Vorteile des Systems:

Kleiner Totraum.
Geringe Gasmenge im Kreissystem.
Leichtes Gewicht.
Leichte und wirksame Kontrolle der Ventilation.
Sichere Befestigung am Operationstisch bei freier Beweglichkeit für die Lagerung des Patienten.

Wir kommen zu dem Schluss, dass das beschriebene Kreissystem für Narkosen bei Kindern zwischen 4000 g und 48 kg besonders geeignet ist.