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Biomedical subjects

J B Eck

Publications and source records attributed to J B Eck.

6 recordsLinked to original sources
PubMed2000

Neuromuscular effects of rapacuronium in pediatric patients during nitrous oxide-halothane anesthesia: comparison with mivacurium.

PURPOSE: To describe neuromuscular effects of rapacuronium in pediatric patients during N2O-halothane anesthesia and compare them with mivacurium in children. METHODS: 103 pediatric patients, seven days -12 yr, received rapacuronium or mivacurium during N2O-halothane anesthesia. Onset and recovery of block were measured using EMG (Datex). Block was compared between groups based on drug treatment and age. Children < two years received 1 or 2 mg x kg(-1) rapacuronium: 2-12 yr received either 2 mg x kg(-1) or 3 mg x kg(-1) rapacuronium, or 0.2 mg x kg(-1) mivacurium. RESULTS: There were no differences in onset (1.7+/-1.8 min) or maximum block (T1 2.4+/-8%) among neonates, infants, and toddlers after either dose of rapacuronium. There was no difference between 1 and 2 mg x kg(-1) of rapacuronium block at 60 sec. Train-of-four ratio (T4/T1) >0.7 occurred later after 2 mg x kg(-1) than 1 mg x kg(-1) in these patients (P<0.05). There was no difference in T25 among neonates, infants and toddlers for 1 mg x kg(-1) or 2 mg x kg(-1) doses. Rapacuronium, 3 mg x kg(-1), produced maximum block 1.5 min earlier than did mivacurium, 0.2 mg x kg(-1) (P<0.001). There was no difference in block at 60 sec, maximum block or time to maximum block between 2 and 3 mg x kg(-1) rapacuronium for children > two years of age. Maximum block occurred 1.0+/-0.5 min after 2 or 3 mg x kg(-1) when T1 was 0.2+/-1.1% of baseline. T25 and T4/T1 >0.7 occurred 10 to 11 min later after this dose of rapacuronium than after mivacurium. CONCLUSION: Rapacuronium produces block earlier than mivacurium. Recovery from rapacuronium block is dose related and slower than that following mivacurium during halothane anesthesia.

Anesthesia, Inhalation↗
PubMed1998

Teaching successful central venous cannulation in infants and children: audio Doppler versus anatomic landmarks.

OBJECTIVE: To determine if vein localization with an audio Doppler increases successful central venous cannulation and decreases complications in infants and children when performed by inexperienced operators, compared with vein localization by anatomic landmarks (ALs). DESIGN: A prospective cohort of infants and children undergoing central venous cannulation for cardiac surgery. SETTING: A university-affiliated children's hospital with a pediatric anesthesia fellowship program. PARTICIPANTS: All infants and children undergoing cardiac surgery between July 1, 1996, and January 1, 1997. INTERVENTIONS: Subjects had central venous catheters (CVCs) placed by an anesthesia fellow by either ALs or audio-Doppler localization of the veins. MEASUREMENTS AND MAIN RESULTS: Eighty-four children were studied. Internal jugular vein (IJV) cannulation was attempted in 71 (85%) children and femoral vein cannulation in 13 (15%) children. Time to catheter insertion, number of needle passes, and artery puncture were noted. Sixty-one of 63 (97%) children had successful central venous cannulation by an anesthesia fellow using audio-Doppler vein localization. This was significantly greater than the 13 of 21 (62%) successful cannulations among children who had veins localized by ALs. Time to insertion did not differ by method of vein localization; however, the number of needle passes was significantly greater in the AL group. Artery puncture did not differ significantly by method of vein localization. CONCLUSION: Vein localization by audio Doppler significantly increases the rate of successful central venous cannulation and decreases the number of needle passes in pediatric patients when used by inexperienced operators.

Adolescent↗
PubMed1998

Use of remifentanil in infants.

We describe the use of remifentanil in three infants with complex medical issues (hepatic failure, cyanotic heart disease and renal compromise). The short duration of opioid effect even after a long period of drug infusion (18 h) suggests this drug may be useful in some infants. Continued study is warranted.

Analgesics, Opioid↗
PubMed1992

Effect of ether stress on growth hormone during development in the neonatal rat.

Stress in adult rats causes an inhibition of growth hormone (GH) secretion which might be mediated by corticotropin-releasing factor (CRF). The response of neonates to stress differs from that observed in adults, including changes in GH secretion that are independent of CRF. The present study examines the effects of ether exposure, a stress known to elicit CRF release, on serum GH in the neonatal period. Preliminary experiments indicated that ether elicits increases in serum adrenocorticotropic hormone and corticosterone, and that the latter response is blocked by pretreatment with dexamethasone. Corticosterone was measured as an indicator of hypothalamo-pituitary-adrenal (HPA) axis stimulation for subsequent studies. Rat pups of 5, 8, 10, 15, 18 or 30 days were divided into three groups. Baseline animals were taken for decapitation directly from the mother. Ether animals were exposed to ether fumes for 1 min, returned to the mother after a brief recovery period, and killed 30 min later. Handled control animals were removed from the mother briefly, returned, and similarly killed at 30 min. Blood was assayed for GH and corticosterone. Handling itself stimulated both GH and corticosterone on postnatal days 10 and 15 and suppressed GH and corticosterone on days 5 and 30. Ether significantly lowered GH and increased corticosterone when compared to this handling control from day 8 to 18, but values in ether-treated animals were different from baseline animals only at 5 and 30 days of age. These results indicate that ether stress produces a mild decrease in GH by day 5 postnatally and throughout the neonatal period which is only apparent in relation to 'handled' controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenal Glands↗