[Propofol and pain caused by the injection].
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Biomedical subjects
Publications and source records attributed to C Melloni.
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The pharmacokinetics and placental transmission of fazadinium (0.75-0.80 mg kg-1) were studied in seven pregnant women undergoing elective caesarean section. Plasma levels of the drug were determined by a spectrofluorimetric method and pharmacokinetics were derived according to a 2-compartment open model. Distribution and elimination half-lives averaged 0.07 +/- 0.03 (t1/2 alpha) and 1.24 +/- 0.34 (t1/2 beta) h; the volume of distribution was 20.75 +/- 5.81 1, and the plasma clearance was 202.33 +/- 39.2 ml min-1 1.73 m2. The ratio between umbilical venous blood and maternal blood at delivery ranged from 2.57 to 17.5%. Urinary elimination accounted for 37% of the injected dose within 24 h. It is concluded that because of early good intubating conditions and favourable pharmacokinetics with a modest placental passage, fazadinium might be particularly useful in obstetrics.
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ORG NC45 was compared with succinylcholine to produce muscle relaxation for short, intra-abdominal operations in 40 patients during nitrous oxide-oxygen-enflurane anaesthesia. Intubating conditions after ORG NC45, 100 micrograms/kg, were similar to those after succinylcholine 1 mg/kg, although this was achieved at a mean time of 229.9 +/- 10.8 sec compared with 129.8 +/- 14.2 sec after succinylcholine. Muscle relaxation during surgery, mean duration 32.5 minutes, was provided in the succinylcholine group with an infusion and in the ORG NC45 group by repeated boluses, 10 micrograms/kg, which were required in four patients. At the end of surgery ORG NC45 was antagonized with atropine, 17 micrograms/kg, and neostigmine, 36 micrograms/kg, which were repeated in two patients. Postoperative recovery of neuromuscular function was indistinguishable between the two groups. We conclude that ORG NC45 is a suitable relaxant for short, intra-abdominal operations if sufficient time, three to four minutes, is allowed to produce good intubating conditions.
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The neuromuscular effects of ORG NC45, used as the sole muscle relaxant, were compared with a succinylcholine-pancuronium sequence in patients during nitrous oxide-fentanyl anaesthesia. The subjects were divided into four groups with ten in each group. After induction of anaesthesia they received either succinylcholine, 1 mg . kg-1 or ORG NC45 in doses of 50, 70 or 90 micrograms . kg-1 and tracheal intubation was done 90 seconds later. Neuromuscular transmission was monitored using train-of-four stimulation. Succinylcholine produced 100 per cent block with uniformly excellent intubating conditions whereas the three doses of ORG NC45 were associated with blocks of 7.5, 18.7 and 30.7 per cent and acceptable conditions in only 30 per cent of subjects. Muscle relaxation was maintained in the NC45 groups with increments of 10 micrograms . kg-1 and in the succinylcholine group with pancuronium, initially as a bolus of 40 micrograms . kg-1, followed by increments of 5 mg . kg-1. All increments were given at 10 per cent recovery of twitch height. The overall requirement to maintain 90 per cent block with pancuronium was 1.1 microgram/kg-1 . min-1 compared with 1.28 microgram . kg-1 . min-1 with ORG NC45. No cumulative effects were seen with either drug during the first hour of neuromuscular blockade. At the end of the operation the neuromuscular block was antagonized with atropine 18 micrograms . kg-1, and neostigmine 36 micrograms . kg-1 and recovery was significantly more rapid with NC45 than pancuronium. We conclude that the lack of cumulation, easy reversibility and lack of cardiovascular effects suggest that NC45 has advantages over currently available non-depolarizing muscle relaxants but that its onset of action is too slow for rapid intubation.
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