Biomedical subjects

B J Gesink-van der Veer

Publications and source records attributed to B J Gesink-van der Veer.

5 recordsLinked to original sources

PubMed1994

[Nitric oxide to combat pulmonary hypertension in an infant following heart surgery for septum defect].

A 5-month-old female infant with Down syndrome underwent surgical repair of a complete atrioventricular septal defect and a patent ductus arteriosus. The postoperative course was complicated by life-threatening pulmonary hypertensive crises which did not respond to conventional vasodilating therapy. Nitric oxide inhalation resulted in rapid decrease in pulmonary artery pressure and improvement of haemodynamics and oxygenation without causing any untoward side effects. Inhalation of NO was continued over the next 4 days, with a maximum NO concentration of 20 ppm during a period of 12 hours. The subsequent postoperative course was uneventful and the patient was discharged from the hospital in good health on the 23rd postoperative day.

Down Syndrome↗

PubMed1994

Efficacy of epidurally administered sufentanil versus bupivacaine during thoracic surgery. A randomised placebo-controlled double-blind study.

The efficacy of thoracic epidural sufentanil 50 micrograms was compared with bupivacaine 0.5% with adrenaline 5 micrograms.ml-1 (dose 40 mg) or saline, in 30 patients (n = 10 in each group) undergoing lateral thoracotomy. Sufentanil, bupivacaine or saline was administered epidurally after induction of anaesthesia with sufentanil 1 microgram.kg-1 and thiopentone 2-5 mg.kg-1. Anaesthesia was maintained with nitrous oxide 66% and halothane 0.3%. Supplementary sufentanil 25 micrograms was given whenever the systolic arterial blood pressure increased more than 15 mmHg above the pre-operative value, whenever heart rate exceeded 90 beat.min-1 in the absence of hypovolaemia, or when other autonomic or somatic signs occurred. Fewer patients in the epidural sufentanil (n = 4, p < 0.005) and bupivacaine (n = 1, p < 0.001) groups required supplementary sufentanil compared to the placebo group, in which all patients needed supplementary sufentanil, but there was no statistical difference between the sufentanil and bupivacaine groups. One or more hypotensive episodes occurred in five patients in the sufentanil group, in all patients in the bupivacaine group and in no patient in the placebo group, and the differences were significant (p < 0.02).

Adolescent↗

PubMed1993

Influence of Crohn's disease on the pharmacokinetics and pharmacodynamics of alfentanil.

We have compared the dose requirements, pharmacokinetics and pharmacodynamics of alfentanil in 12 patients with Crohn's disease and 10 control patients undergoing abdominal surgery. Plasma concentrations of alpha 1-acid glycoprotein (AAG) and alfentanil protein binding were also measured. Anaesthesia was induced with alfentanil 100 micrograms kg-1 and thiopentone, and maintained with nitrous oxide in oxygen and alfentanil 25-200 micrograms kg-1 h-1. Arterial blood samples were obtained before and after each change in the alfentanil infusion rate and for 6 h after stopping the infusion. Pharmacokinetic data were derived using non-compartmental methods. Alfentanil concentration-effect data were evaluated by non-linear regression, where effect was either response or no response to surgical stimulation. Mean intraoperative alfentanil requirement was greater in patients with Crohn's disease (2.48 micrograms kg-1 min-1) than in control patients (1.35 micrograms kg-1 min-1) (P < 0.01). Mean elimination half-life, total plasma clearance and steady state distribution volume in patients with Crohn's disease were comparable to those in control patients (80 vs 81 min, 5.7 vs 6.4 ml kg-1 min-1 and 0.70 vs 0.68 litre kg-1, respectively). Mean plasma concentration at which the probability of no response was 50% for the intra-abdominal period of surgery was greater in the Crohn group (359 ng ml-1) than in the control group (199 ng ml-1) (P < 0.02). Plasma AAG concentrations were greater in the Crohn group, but the free fraction of alfentanil was similar in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1989

Alfentanil requirement in Crohn's disease. Increased alfentanil dose requirement in patients with Crohn's disease.

The dose requirement of alfentanil as a supplement to nitrous oxide anaesthesia was studied in 13 patients with Crohn's disease and seven control patients all of whom underwent laparotomy. Alfentanil was administered as a variable rate infusion with supplemental bolus injections titrated to the patient's needs. The alfentanil requirement was independent of the duration of surgery and was significantly higher in patients with Crohn's disease than in control patients. The results indicate that Crohn's disease alters the dose requirement of alfentanil.

Adjuvants, Anesthesia↗

PubMed1983

[Cave fungos!].

Explore the source record for details and available documents.

Adult↗