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Biomedical subjects

H K King

Publications and source records attributed to H K King.

At least 19 recordsLinked to original sources
PubMed1995

BMY 7378 is a selective antagonist of the D subtype of alpha 1-adrenoceptors.

BMY 7378 (8-[2-[4-(2-methoxyphenyl)-1-piperazinyl]ethyl]-8- azaspiro[4.5]decane-7,9-dione dihydrochloride), a 5-HT1A receptor partial agonist, also binds to alpha 1-adrenoceptors. Competition assays were performed using (+/-)-beta-([125I]iodo-4-hydroxyphenyl)-ethyl-aminomethyl-tetralone ([125I]HEAT), and membranes prepared from Rat-1 fibroblasts expressing hamster alpha 1b-, bovine alpha 1c-, or rat alpha 1d-adrenoceptor, or their respective human homologues. Results indicate that BMY 7378 is selective for the alpha 1D-adrenoceptor subtype (pKi: hamster alpha 1b-adrenoceptor 6.2 +/- 0.03, human alpha 1b-adrenoceptor 7.2 +/- 0.05; bovine alpha 1c-adrenoceptor 6.1 +/- 0.02, human alpha 1c-adrenoceptor 6.6 +/- 0.20; rat alpha 1d-adrenoceptor 8.2 +/- 0.06, human alpha 1d-adrenoceptor 9.4 +/- 0.05) and has high affinity (pA2, 8.9 +/- 0.1) for rat aorta alpha 1-adrenoceptor.

Adrenergic alpha-1 Receptor Antagonists↗
PubMed1992

[Emergency translaryngeal ventilation].

Every anesthesia providers is aware of the serious consequences of anoxia subsequent to acute airway obstruction, and is trained to manage such situations when they occur. Nonetheless, a patent airway is not always attainable. Percutaneous needle laryngostomy with translaryngeal ventilation has been widely advocated for emergency ventilation in desperate situations in which other efforts, including intubation have failed. A review of literature suggested that using a large bore (> 18 Ga) needle/catheter with a jet ventilator, or alternatively connecting it to an oxygen source of high pressure (40-50 psi; i.e. anesthesia machine, wall outlet etc.) via a low compliance tubing will effectively resuscitate an animal or patient. However, this method may expose the patients to the risk of barotrauma which has inhibited its widespread adoption. In order to assess this risk, we have conducted an in vitro study employing a simple lung simulator and an anesthesia machine. Variables of the experiment included the make of the anesthesia machine, size of the needle/catheter, degree and duration of depression of the flush valve, as well as the size of the pop-off valve opening. Based on the data obtained from our study as well as others by an extensive literature review, we have proposed some guidelines for this technique when a jet ventilator is not available.

Airway Obstruction↗
PubMed1992

[Epidural administration of bupivacaine in glycerine solution can prolong analgesia].

Glycerine has long been used with phenol as a drug depot in control of intractable pain. However, through our literature review, glycerine has never been used to prolong the pharmacological effects of a local anesthetic, such as bupivacaine. Our study is an attempt to use the same mechanism to further extend the pharmacologic effects of a popular long lasting anesthetic in a commonly used technique. Fifteen adult patients with cancer pain received 0.125% bupivacaine via a chronically implanted epidural catheter. In a blind study of pain control: Group I, consisting of 8 patients, received 5 ml 0.125% bupivacaine in normal saline; group II, consisting of 7 patients, received the same amount of the same strength anesthetic dissolved in 50% glycerine. The pharmacological effect was assessed by evaluation of intensity and duration of sensory as well as motor blockade. Our preliminary experimental experience revealed that significant prolongation (11.8 +/- 2.3 h vs 7.6 +/- 1.8 h, p less than 0.01) of analgesia was observed with the glycerine solution as compared to the saline solution. There was no motor blockade or other adverse effects or complications. This markedly prolonged analgesic effect is attributed to the slow release of the local anesthetic agent from the glycerine base which functions as a drug depot. Other clinical applications of this novel approach in pain relief are currently under investigation.

Adult↗
PubMed1991

[Effects of drug dose on spinal anesthesia with isobaric tetracaine].

A protocol similar to that established in our previous reports was used in the current study. A total of 128 demographically compatible patients were studied using various tetracaine dosages in 2 ml isobaric solution; fifty patients (group I) received 10 mg, 46 patients (group II) received 15 mg, and 32 patients (group III) received 20 mg. Except for the drug dosage, an identical technique was employed for every patient in the study. The highest sensory levels were T7 (median, range T5-12) for group I, T5 (median, range T3-8) for group II, and T4 (median, range C8-T5) for group III, with an onset time of 7.08 +/- 1.16, 10.37 +/- 1.69 and 11.14 +/- 1.85 min respectively. The above differences are statistically significant (p less than 0.05). However the differences between their onset times to the T10 level were not statistically significant (p greater than 0.05). The 2-segment regression times were 180.5 +/- 53.44 min for group I, 216.4 +/- 37.3 min for group II and 248.7 +/- 38.6 min for group III. The difference between group I and group II as well as group I and group III were statistically significant (p less than 0.01) but not significant between group II and group III (p greater than 0.05). The onset times of maximum motor blockade assessed by modified Bromage scale were 5.42 +/- 1.59, 5.28 +/- 1.36 and 5.37 +/- 1.42 min.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

[Effects of the specific gravity on spinal anesthesia with 0.5% tetracaine].

In a double-blind study, 0.5% tetracaine 10 mg in hyperbaric or isobaric solution was administered intrathecally at random to 102 adult patients. Except the variable under study, identical technique was used for every patient enrolled. Other influential factors were also under careful control. The extent and pattern of anesthesia were compared. The time for maximal spread was short, the mean times was 7.74 min and 7.8 min for hyper-and isobaric groups respectively, there was no differences statistically. (P less than 0.05). The maximum cephalad spread was T5 (mean, range T12-T3) for the hyperbaric solution and T7 (mean, range T10-T3) for the isobaric solution. The difference was 2 dermatomes and was statistically significant (P less than 0.01). Forty three patients (86%) in the hyperbaric group and 16 patients (30%) in the isobaric group had a sensory blockade higher than T6 level. The hyperbaric group has a much higher percentage of high blockade. The isobaric group has a more predictory lower blockade, but occasionally blockade up to T3 did occur. The 2-segment regression times were also statistically significant. That of hyperbaric group was 88.9 min (mean, range 60-150 min) and 180.5 min (mean, 75-270 min) in isobaric group with a P value less than 0.01. Statistically significant differences in regard to maximum motor blockade and its onset times were found between the two groups. Maximum motor blockade assessed by modified Bromage scale was degree 2 (mean, range 1-3) for the hyperbaric group and degree 3 (mean, range 2-3) for the isobaric group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

Translaryngeal guided intubation solved a critical airway problem.

Airway obstruction during the induction of general anesthesia remains a persistent problem in modern anesthesia practice, particularly in obstetric patients. Generally, a careful preoperative airway evaluation uncovers most abnormalities that might make intubation difficult. The planning and preparation for additional intubation equipment facilitate an anticipated difficult intubation. However, situations may arise in which unanticipated airway obstruction occurs requiring prompt management. Although every anesthesia provider is trained to manage such acute airway problems, the provision of a patent airway is not always possible, particularly when repeated attempts at endoscopic or blind intubation have failed, leaving a bloody field that prevents optimal visualization, or when time does not allow to wake up the patient. In this article a difficult airway problem is reported in which translaryngeal guided intubation was lifesaving.

Abruptio Placentae↗
PubMed1987

Translaryngeal guided intubation for difficult intubation.

Airway obstruction remains a constant problem in acute care. This is particularly true when there are anatomical or pathological abnormalities, trauma, or when repeated failed attempts at endoscopic or blind intubations have left a bloody field, preventing clear visualization of the vocal cords. Our refinement of translaryngeal guided intubation (TLI) uses a spring guidewire accompanied by a plastic sheath protector. The wire is introduced percutaneously via a cricothyroid puncture and passed cephalad into the oropharynx or nasopharynx and out through the mouth or one of the nostrils. The plastic sheath is slid over the wire into the trachea. A well-lubricated endotracheal tube is then inserted to the desired position using the plastic sheath as a stylet. This technique works very well, and we are convinced that TLI is one of the most effective emergency techniques to secure an airway. It can be performed quickly with inexpensive equipment and is a promising addition to the currently recommended alternatives.

Airway Obstruction↗