[Anesthetic implications of amyloidosis].
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Adult↗
Biomedical subjects
J C Luis-Navarro
Publications and source records attributed to J C Luis-Navarro.
[Adrenergic response during general anesthesia with propofol as maintenance agent].
To determine plasma catecholamine levels during the use of propofol for maintenance of anesthesia. We studied 20 randomly chosen patients undergoing elective orthopedic surgery under general intravenous anesthesia with propofol as the agent of maintenance along with pancuronium and fentanyl. Plasma concentrations of dopamine, noradrenalin and adrenalin were measured at the following times: baseline, after intubation and every 15 min during surgery. The levels obtained for the different samples were compared with baseline levels. At the doses used in our study, there were no significant differences in the way dopamine plasma levels varied. This was not the case with the other two hormones, however. Adrenalin levels were significantly higher at the first 3 extractions (post-intubation, 15 min and 30 min), and noradrenalin was significantly higher (p < 0.05) at all extraction times. Total intravenous anesthesia with propofol is associated with a significant increase in plasma concentrations of adrenalin and noradrenalin. Adrenalin returns to baseline levels 45 min after induction.
Adult↗
[Utility of premedication with different regimens of omeprazole and ranitidine in the prevention of acid broncho-aspiration syndrome].
OBJECTIVE: To study the usefulness of several omeprazole regimens on gastric fluid volume and pH in patients undergoing elective surgery. MATERIAL AND METHODS: We analyzed 105 patients undergoing to elective surgery who received prophylactic treatment for the acid aspiration syndrome. They were randomly allocated into 7 homogeneous groups according to the therapeutic regime. Placebo (group 1), oral omeprazole (20 mg) the night prior to surgery (group 2), oral ranitidine (150 mg) the night before (group 6), two doses (the previous night and before surgery) in the remaining three groups: 20 mg of omeprazole (group 4), 40 mg of omeprazole (group 5) or 150 mg of ranitidine (group 7). In all patients we measured pH and volume of the gastric content after induction of anesthesia and one hour thereafter. RESULTS: There were no statistically significant differences in mean pH values and gastric volume content among groups 1.2,3, and 6 (2.1 (pH) and 27 ml (gastric volume) in group 1, 2.1 and 23 ml in group 2, 2.6 and 19 ml in group 3, and 2.2 and 32 ml in group 6). With repeated doses of 40 mg omeprazol (group 5), mean pH values were comparable to those found with the two doses of ranitidine (4.1 +/- 1.8 vs 4.1 +/- 3.6) although gastric volumes were significantly less (12 +/- 2.6 ml vs 20 +/- 4.8 ml). These two groups showed significantly greater mean pH values and less gastric volumes than the remaining patients. CONCLUSIONS: The incidence of patients with gastric content deemed at risk for acid aspiration (pH less than 2.5 and gastric volume greater than 25 ml) was less after premedication with two oral doses of omeprazole (40 mg) than either two doses of ranitidine (150 mg) or smaller doses of both drugs.
Adult↗
[Body temperature variations during laparoscopic cholecystectomies].
OBJECTIVE: To study changes over time in body temperature related to insufflation of CO2. PATIENTS AND METHOD: Fifty patients were randomly assigned to 2 groups of 25 to undergo cholecystectomy by either laparoscopy or laparotomy. Total intravenous anesthesia with propofol, pancuronium and fentanyl was used in both groups. Ventilation was maintained at 0.5 FiO2. Central temperature was continuously measured by a distal esophageal thermometer and results were recorded every 10 minutes in both groups. All operations lasted approximately 80 min. RESULTS: We found that temperature gradually decreased over time in both groups. In the laparotomy group the decrease reached 0.20 degree C (SD 0.03) at 80 min. During laparoscopy the temperature decrease was 0.43 degree C (SD 0.04) for the same time period. The differences were statistically significant. We observed no pathophysiologic repercussions associated with these results. CONCLUSIONS: Laparoscopic surgery, even when the abdominal cavity is not exposed to room air, induces a loss of temperature that is greater than that of laparotomy, because of insufflation of CO2 at 4 degrees C. The decrease was 0.4 degree C for every 50 l of CO2 insufflated during the study.
Anesthesia, Intravenous↗