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Biomedical subjects

M Tryba

Publications and source records attributed to M Tryba.

At least 127 records · Page 7Linked to original sources
PubMed1984

[Prevention of anaphylactoid reactions using intramuscular promethazine and cimetidine. Studies of a histamine infusion model].

The effect of combined intramuscular premedication with H1 + H2-receptor-antagonists on histamine-induced cardiovascular and cutaneous reactions was studied in 8 volunteers in a randomized placebo-controlled double-blind crossover trial and compared with premedication with H1-receptor antagonist alone and with the histamine-induced effects without premedication. As H1-receptor antagonist the volunteers received 0.5 mg/kg promethazine i.m. 45 min before the start of histamine infusion; as H2-receptor antagonist we used 400 mg cimetidine i.m. 120 min before application of histamine. While the premedication with promethazine alone could prevent histamine-induced tachycardia, fall of blood pressure and cutaneous reactions only partially, these reactions were almost completely prevented by combined premedication. Like intravenous application of H1 + H2-receptor antagonists shortly injected before induction of anesthesia, intramuscular premedication with promethazine and cimetidine can prevent anaphylactoid reactions. In contrast to intravenous application, the latter application is also effective in reducing the risk of acid aspiration syndrome and as a sedative.

Adult↗
PubMed1983

[Effectiveness of cimetidine in the prevention of aspiration pneumonia in obstetrics].

In a prospective controlled study 30 parturients provided for elective cesarean section were premedicated either with no specific medication for prophylaxis of aspiration pneumonia or 400 mg cimetidine orally at the evening and 400 mg intramuscularly two hours prior to induction of anesthesia. In the cimetidine treated group only one patient had a gastric pH below 2.5, while in the control group 11 patients had a pH below this limit. The gastric volume in the cimetidine treated group also was significantly reduced. No side effects could be observed in mothers and children. Application of intramuscularly cimetidine seems to be an effective method for prophylaxis of aspiration pneumonia in obstetric anesthesia.

Anesthesia, Obstetrical↗
PubMed1983

[Sublingual buprenorphine tablets: initial clinical experiences in long-term therapy of cancer pain].

Buprenorphine sublingual tablets (0.2 mg) were investigated in therapy of cancer pain. In 67 patients there was a good analgetic effect in 60%, even in those cases treated with other opiates before. The induction time was quite long (60 min.) but is no problem in chronic administration. Effective pain relief was obtained even in final stages of cancer. The mean daily dose of buprenorphine had been 1.2-1.7 mg, the mean duration of analgesia being 6-8 hours with a single dose of 0.2-1.0 mg buprenorphine. Typical opiate-side-effects were registered and well tolerated after some days' treatment. There was no respiratory depression. Buprenorphine sublingual tablets are certainly a good alternative in orally available opioids.

Administration, Oral↗
PubMed1983

Prolonged analgesia after cuff release following i.v. regional analgesia with prilocaine.

In a prospective randomized study, 60 outpatients received 0.8%, 1.5% or 2% prilocaine (4 mg/kg body weight) as i.v. regional anaesthesia for operations in the carpal region. The latent period, quality and duration of analgesia after release of the tourniquet were analysed. The latent period was shortest with 2% prilocaine. The duration of analgesia after tourniquet release increased from 5.7 min with 0.8% to 15.6 min with 2% prilocaine. The plasma concentrations after 1.5% prilocaine were significantly less than with 0.8% prilocaine.

Analgesia↗
PubMed1983

Rectal and oral cimetidine for prophylaxis of aspiration pneumonitis in paediatric anaesthesia.

In a prospective randomized study, 60 children between 1 and 8 years of age in three groups received no premedication, 10 mg kg-1 cimetidine orally or 40 mg kg-1 cimetidine rectally for prophylaxis of acid aspiration syndrome 120-180 min before induction of anaesthesia. The pH of the stomach contents was above 2.5 in both cimetidine groups. The aspirated gastric volume was significantly reduced with rectal cimetidine compared to the other groups. Rectal cimetidine proved to be the more effective drug for prophylaxis of acid aspiration syndrome in paediatric anaesthesia.

Administration, Oral↗
PubMed1983

Single-drug and combined medication with cimetidine, antacids and pirenzepine in the prophylaxis of acute upper gastrointestinal bleeding.

For an analysis of the risk factors for stress bleeding, 24 risk factors selected from 202 clinical parameters were analysed, and their values determined in 586 medical and surgical intensive-care patients treated for at least six days between 1975 and 1980, who received no prophylactic medication. In 420 patients who received a prophylactic treatment with 800 mg or 1200 mg cimetidine, 2-hourly 30 ml antacids or 30 mg pirenzepine individually or in combination, the total risk scores were determined as the sum of the risk factors. This risk score served as the unit for comparison of the prophylaxis groups. Combined medication with two or three drugs proved to be significantly superior to treatment with either of the medicaments given alone.

Acute Disease↗
PubMed1983

[Efficacy of cimetidine in the prevention of aspiration pneumonia in paediatric anaesthesia].

In a prospective controlled study 63% of 150 children without prophylaxis were at risk of aspiration pneumonia in case of aspiration or regurgitation. In a second trial 10 mg/kg cimetidine orally 120 to 180 minutes prior to induction of anaesthesia proved to be a very effective prophylaxis. In small children up to 15 kg rectal application of 40 mg/kg cimetidine was even more effective than 10 mg/kg orally in reducing gastric volume. Premedication with cimetidine may be a practicable method for reducing the risk of aspiration pneumonia in paediatric anaesthesia.

Adolescent↗
PubMed1983

[Peridural opiate analgesia. Clinical results of a 2-year study].

Postoperative pain relief, consumption of analgesics and the incidence of postoperative complications were investigated in a retrospective cohort-study on 470 patients following abdominal surgery. 221 of these patients received epidural morphine or buprenorphine for postoperative pain relief (Group I). Another group of 249 patients received conventional opiate analgesics intravenously or intramuscularly (Group II). On average the analgesia lasted 14 h after epidural morphine and 11 h after epidural buprenorphine. The overall amount of morphine in the postoperative period was 13.3 +/- 14.9 mg and 0.89 +/- 0.55 mg buprenorphine respectively. 5 cases of pneumonia (2.3%) were seen in the epidural group (Group I). 22 pneumonia cases (8.8%) were registered in the group with conventional analgesics (Group II). Besides the advantage of stronger and longer duration, small dosage and minor central depressive side effects, epidural opiate analgesia has proven to result in positive clinical consequences. The low incidence of postoperative pneumonia is due to the strong regional pain relief, which improves mechanical pulmonary function and gas exchange.

Adult↗
PubMed1983

[Does a stomach tube enhance regurgitation during general anaesthesia?].

The effect of a gastric tube on the competence of the lower esophageal sphincter was studied in 7 patients who underwent gastric resection. In 6 patients the maximal gastric volume until occurrence of regurgitation was lower in the presence of a gastric tube compared with the measurement without a tube. This shows the necessity to remove a gastric tube prior to induction of anaesthesia.

Adult↗
PubMed1983

[Controlled study on intravenous regional anesthesia using high and low concentration prilocaine].

In a prospective randomised study, 20 out-patients in each group received 0.8%, 1.5% or 2% prilocaine (4 mg/kg body weight) as intravenous regional anaesthesia for operations in the carpal region. The latency time, quality of analgesia and recurrence of pain after the tourniquet release rose with increasing prilocaine concentration from 5.7 min on average at 0.8% to 15.6 min on average at 2%. The latency time was shortest with 2% prilocaine. The blood plasma levels using the highly concentrated prilocaine were significantly lower than with 0.8% prilocaine.

Anesthesia, Conduction↗
PubMed1982

[Toxicity of prilocaine and bupivacaine in intravenous regional anesthesia].

In a prospective randomized study plasma levels of prilocaine and bupivacaine were analyzed after intravenous regional analgesia (IVRA). 20 patients respectively received either 1 mg/kg bupivacaine or 4 mg/kg prilocaine in an equipotent dosis. Prilocaine proved to be significantly less toxic than bupivacaine. Plasma levels of bupivacaine, expressed as percentage of the toxic limit, were threefold higher than those of prilocaine. In one case the maximum level of bupivacaine reached even 85% of the toxic limit. This demonstrates the possibility of dangerous side effects when exceeding the bupivacaine dose of 1 mg/kg. Methaemoglobin formation following use of prilocaine was of no clinical importance. Prilocaine is the agent of choice for intravenous regional analgesia. The use of bupivacaine for IVRA should be limited to special indications.

Adult↗
PubMed1982

[Sonographic studies for optimizing the cannulation of the internal jugular vein].

The increasing use of cannulation of the internal jugular vein led to an increase of complications associated with this procedure. In most cases the reason is incorrect puncture. Functional sonographic studies of the internal jugular vein have demonstrated the anatomical conditions for safe cannulation. The optimal site of puncture was detected with a sector scan by measuring volumes in both internal jugular veins in 12 patients dependent on the position and rotation of the head. As a result of our study we propose a modification in the cannulation technique with a headdown position and 45 degrees rotation of the head to the opposite site without palpating the carotid artery.

Catheterization↗
PubMed1982

[Prevention of aspiration pneumonia with cimetidine].

Aspiration of gastric acid is one of the most feared narcosis complications. The currently practiced methods of prophylaxis did not reduce the frequency of aspiration pneumonitis. In a prospective randomised study orally and intramuscularly given Cimetidine significantly reduced the toxicity of stomach contents. The intramuscular route proved to be superior. Preoperative prophylactic use of Cimetidine can be a useful method to reduce the frequency of Mendelson's syndrome without disadvantages.

Administration, Oral↗