[Awakening in spite of narcosis--psychological trauma for many years after].
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Biomedical subjects
Publications and source records attributed to L Westermark.
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In nine elderly (mean age 60, rang 42-74 years) cardiovascular pressures and cardiac output have been measured by catheterization of the pulmonary and brachial artery during spinal anaesthesia without and with dihydroergotamine (DHE) and during an added slight head-up (10-15 degrees). Spinal anaesthesia lowered arterial pressure and also stroke volume. After DHE arterial pressures as well as stroke volume were normalized. Tilting before spinal anaesthesia lowered stroke volume but arterial pressures were maintained. During spinal anaesthesia, tilting lowered arterial pressures as well as filling pressures of the heart. After administration of DHE during spinal anaesthesia the pressures were unaffected by tilting. It is concluded that in elderly men, unlike the young men previously studied, spinal anaesthesia decreases arterial blood pressures by a combination of reduced peripheral resistance and decreased stroke volume. The decreases in stroke volume and cardiac output were most pronounced in those patients with a reduced blood volume. DHE also prevents arterial pressure fall with head-up tilt during spinal anaesthesia.
In order to establish whether methoxyflurane causes any change in renal vascular resistance, the renal venous flow was measured by means of a drop recording technique in six cats under methoxyflurane anaesthesia. Arterial pressure was recorded simultaneously, and the renal vascular resistance was calculated. Methoxyflurane caused a significant reduction of the renal vascular resistance to about 85% of control value at an anaesthetic depth characterised by loss of the corneal reflex. At a deeper anaesthetic stage characterised by steady state circulation and absence of any reflexes, no further significant fall in renal vascular resistance occurred. Autoregulation and depression of the sympathetic activity are assumed to explain the reduction of the renal vascular resistance.
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