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Biomedical subjects

A Doenicke

Publications and source records attributed to A Doenicke.

At least 19 recordsLinked to original sources
PubMed1992

Onset and recovery of rocuronium (Org 9426) and vecuronium under enflurane anaesthesia.

We have studied the onset, duration of action and recovery index of twice the ED90 of rocuronium (Org 9426) (0.6 mg kg-1) and of vecuronium (0.08 mg kg-1) in patients during enflurane anaesthesia. Rocuronium had a significantly shorter mean onset time of 1.8 (SD 0.4) min, compared with vecuronium 3.4 (0.8) min. Clinical duration (time for the first twitch in the train-of-four to recover to 25% of control) was similar for both drugs (29 (10) min vs 31 (12) min). Spontaneous recovery times (TOF ratio 70%) did not differ significantly between rocuronium (47 (10) min) and vecuronium (44 (11) min).

Adolescent↗
PubMed1992

[Histamine release during induction of combination anesthesia using nalbuphine or fentanyl. Modulation of the reaction by premedication with promethazine/pethidine].

In a controlled clinical trial in patients admitted for general surgery (mainly abdominal and thyroid), histamine release following nalbuphine 1 mg/kg i.v. versus fentanyl 5 micrograms/kg i.v. was studied in the course of an otherwise routine induction with promethazine/pethidine as premedication 30 min before the opioids and alcuronium-flunitrazepam-thiopental 5 min later. Succinylcholine was given before intubation and further analgesia was obtained by repeated administration of either nalbuphine or fentanyl. Plasma histamine levels were measured by a specific fluorometric assay, heart rate and blood pressure were measured for assessing hemodynamics, and clinical signs of anaphylactoid reactions such as skin eruptions and arrhythmias were registered. RESULTS. Nalbuphine and fentanyl both released histamine with an incidence of more than 40%. In addition, nalbuphine potentiated the histamine release evoked by the sequential administration of alcuronium-flunitrazepam-thiopental in one complex of application. The incidence of histamine release in the nalbuphine group was 6/13 = 46%, in the fentanyl group only 1/11 = 9% (chi2 test, P less than 0.05). Furthermore, this study showed high histamine levels after succinylcholine and intubation in a relation to time of administration that suggested histamine release as a stress response to intubation. Finally, the incidence of histamine release after a second injection of the opioids was still 30%. A direct correlation between plasma histamine levels, hemodynamic changes, and skin reactions could not be shown. A detailed causality analysis with histamine release as a contributory determinant showed histamine release less detrimental to hemodynamic stability than the opposite, which had been expected. However, the promethazine administered 30 min before induction of anaesthesia had strong H1- and H2-receptor antagonistic activity and was given with optimum timing for H1- and H2-prophylaxis. CONCLUSION. The study demonstrated that histamine release during anaesthesia and surgery depends strongly on the time sequence of drugs and measures used. Histamine release is not predictable from studies in human volunteers alone; studies in patients have to be added. Histamine release is not always detrimental. H3-receptor-mediated effects after H1- and H2-prophylaxis may help patients to counteract the effects of a series of vasoactive drugs given during induction of anaesthesia.

Adult↗
PubMed1979

[Lormetazepam in preoperative sleeplessness. Dose dependance of the effect and comparison with 100 mg pentobarbital (author's transl)].

Lormetazepam (0.5, 1, 2, 4, 8 mg)--a new benzodiazepine--was tested versus Pentobarbital (100 mg) under double blind conditions on 240 preoperative inpatients for night-time sedative and side effects after acute oral intake. Results are based on p less than 0.05. Additionally p less than 0.125 in binomial-two-sample-tests was accepted. Lormetazepam shows dose dependent increase in hypnotic effects (e.g. reduction in sleep latency and number of awakenings, increase of total sleep duration), and side effects (e.g. dopiness, dizziness), but no relevant change in vital signs. About 0.5 mg of Lormetazepam are equivalent to 100 mg of Pentobarbital. 2 mg of Lormetazepam seem to be the optimum dose regarding the relation between hypnotic and side effects. In the view of anaesthesists Lormetazepam is preferable to Pentobarbital because of more favorable safety aspects.

Adult↗
PubMed1979

[The hypnotic effect of the new benzodiazepine derivative lormetazepam when given intravenously (author's transl)].

1. 7 groups of 3 healthy male volunteers each, at the age of 21--27 years received various doses of Lormetazepam (0.0635 to 4.0 mg/70 kg). -- 2. The drug was injected intravenously during 60 s. Before, during and up to 4 hours after the injections the EEG, eye-movements, ECG and respiration was recorded and blood pressures measured at given time intervals. -- 3. The vigilo-somnograms showed after the injections a change in the EEG-stages, indicating a reduction of alertness, transitions into reduced wakefulness or beginning stages of sleep. Corresponding to clinical signs one can speak with i.v. applied doses of 0.0635 to 0.5 mg/70 kg of tranquilizing, with 1 mg/70 kg of sedative and with 2--4 kg of hypnotic effects. There has been a good dosage-efficiency relation. -- 4. Side-effects or unwarranted symptoms have not been seen during the clinical observations.

Adult↗
PubMed1978

[The effect of domperidone and metoclopramide on antral motility (author's transl)].

The effect of domperidone and metoclopramide on antral motility was studied by measuring the intraluminal pressure in the antrum of 10 normal persons and of 8 patients suffering from duodenal ulcer. Both drugs stimulated the rhythmic activity of the antrum. The antiemetic effect and the therapeutic effect of domperidone on complaints by gastrointestinal retention was the result of the influence on gastrointestinal motility, which is similar to that of metoclopramide.

Antiemetics↗
PubMed1978

[The effect of the morphine antagonist naloxone on the effect of fentanyl].

1. In healthy volunteers fentanyl (0.15 mg i.v.) induces a reduction of awareness and vigilance and in some persons a transition to sleepiness or sleep stages. The course of these changes with time can be shown in narcograms, consisting of vigilance indices which correspond to the different EEG-stages. 2. Naloxon (0.4--1.6 mg i.v.) reduces the hypnotic effect of fentanyl or antagonizes it completely. 3. Index values of rapid eye movements in wakefulness measured oculographically indicate a reduction of motor activity after administration of fentanyl, when stages of reduced vigilance appear. Injections of naloxone following later on diminish this effect of fentanyl or antagonize it completely, not so does levallorphan.

Arousal↗
PubMed1978

[Etomidate].

Explore the source record for details and available documents.

Etomidate↗
PubMed1978

[The effect of naloxone and levallorphane following fentanyl on the blood gases, EEG and psychodiagnostic tests (author's transl)].

After administration of fentanyl, 0.15 mg naloxone or levallorphan or placebo were given several times and in increased doses and at same intervals of time to six volunteers. The experiment has been done after the rules of a double blind study. Naloxone has shown its superiority to levallorphan. The study demonstrated a faster and better action of naloxone in the way of a return to initial conditions of respiratory frequency, blood gases, and EEG. The concentration and attention faculties after naloxone have become clearly better in contrary to the results after levallorphan. At the end of an anaesthetic procedure, the greatest care should be given to the patient. First of all effective antagonism of the respiratory depression should be obtained without concomitant sedative and psychomimetic effects. The use of antagonists with agonist properties to reverse respiratory depression due to a morphinomimetic drug is not justified and so naloxone should supplant levallorphan.

Adult↗
PubMed1977

Quantitative analysis of trifluoroacetic acid in body fluids of patients treated with halothane.

A simple procedure for the quantitative analysis of trifluoroacetic acid (TFA) in urine and serum from patients narcotized with halothane is described. This involves addition of sodium hydroxide to the body fluid, evaporation of the aqueous phase and esterification of TFA in concentrated sulphuric acid with 2,2,2-trichloroethanol. The gaseous phases above the reaction mixture were then analyzed by gas chromatography with a nickel-63 electron-capture detector. The detection limit was 1 microgram of TFA per mililitre of body fluid (200 microgram of body fluid are analysed) and the relative standard deviation was +/-6%. Patients treated with ethrane, another commercial anaesthetic, did not produce any detectable TFA.

Anesthesia↗
PubMed1977

Histamine release in dogs by Cremophor E1 and its derivatives: oxethylated oleic acid is the most effective constituent.

Several preparations of Cremophor E1, several of other non-ionic detergents and several components of Cremophor E1 were tested for their histamine-releasing capacity in dogs. Lutensol AP 10 and a derivative of 1,2-propylenglycol were ineffective, but showed excellent properties as detergents. Thus the histamine-releasing capacity was not necessarily combined with the tenside effect of the surfactants. Oleic acid found in Tween 80 as well as in Cremophor E1 seems to be the most effective constituent, but the alcohol seems also to be important for the histamine-releasing capacity. The development of a non-toxic solubilizer for lipophilic drugs seems of considerable clinical interest.

Animals↗