[EDTA therapy of arteriosclerosis].
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Arteriosclerosis↗
Biomedical subjects
N C Ahn
Publications and source records attributed to N C Ahn.
[Stimulants].
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Central Nervous System Stimulants↗
Skeletal muscle circulation during sufentanyl and morphine anesthesia in propranolol treated dogs.
Sufentanyl is a new, potent, short-acting, fentanyl-like morphinomimetic. In the present study we compared the effects of high doses of sufentanyl and morphine on the peripheral circulation in beta-blocked dogs. Skeletal muscle surface pH (m-pH) was recorded continuously as an index of the microcirculation. Sufentanyl (0.01 mg/kg) had no adverse effects on the peripheral perfusion. Morphine (4 mg/kg) caused a severe and rapid fall in m-pH from 7.34 to 7.14 during the 30-min experimental period. At the same time calculated blood volume decreased by 20%. This hypovolemic deterioration of the circulation was probably caused by a histamine-mediated increase in capillary pressure and filtration of plasma from the intravascular space to the interstitial space. As sufentanyl could be safely administered to beta-blocked dogs, we recommend human studies. On the other hand, we discourage the use of high-dose morphine anesthesia until human studies have proved that the collapse of the peripheral perfusion seen in this study is species specific.
Adrenergic beta-Antagonists↗
Early response in central hemodynamics to high doses of sufentanil or morphine in dogs.
The hemodynamic effects of high doses of sufentanil, a newly synthetized highly potent analgesic, were investigated in dogs. This study compared the early (30 min) cardiovascular effects of sufentanil 0.01 mg . kg-1 and morphine 4 mg . kg-1. Sufentanil caused a moderate and insignificant decrease in mean arterial pressure (MAP). A 30% decrease in cardiac index (CI) was almost outbalanced by an increased systemic vascular resistance (SVRI). The lowering of CI was due to a more than 50% decrease in heart rate (HR) which was partly compensated for by a greater stroke volume index (SVI). In the first 5 min after morphine injection, MAP fell significantly to about 50 mmHg (below 50% of the control value). CI was reduced to about 50% of the control value because of significant decreases in both SVI and HR. The calculated SVRI was unchanged after morphine. Within 30 min some of the initially changed parameters had returned to control levels. Central venous pressure (CVP) and pulmonary capillary wedge pressure (PCWP) increased immediately after sufentanil, but decreased after morphine. With time, both parameters returned towards control values. Peak left ventricular dP/dt decreased by about 25-50% after both analgesics. The rate-pressure products (RPP) were significantly decreased to less than one half of the control values after both analgesics. Mixed venous oxygen tension (PVO2), oxygen transport and oxygen consumption were significantly lowered in the sufentanil group, whereas immediate decreases after morphine were followed by gradual increases towards control values. We conclude that the use of high doses of sufentanil in dogs is safe. Apart from initial, transient changes, a stable cardiovascular state characterizes the high-dose sufentanil anesthesia, while morphine causes fluctuations in several hemodynamic parameters. Compared to morphine anesthesia, sufentanil anesthesia appears to be an attractive alternative which deserves further evaluation in humans.
Analgesics, Opioid↗
Preanaesthetic medication with rectal diazepam in children.
With the purpose of avoiding injections to children, the quality of rectal premedication with a solution of diazepam (Apozepam) was investigated in a double-blind study. Compared with a lytic cocktail (containing pethidine, promethazine and chlorpromazine), adequate preanaesthetic sedation was obtained with rectally administered diazepam in a dose of 0.75 mg kg-1. However, following rectal diazepam, the majority of the children were very restless during recovery, but the combination of diazepam premedications and a small dose of lytic cocktail given i.m. during anaesthesia secured a smooth recovery in practically all children. The proportion of cases classified as "unsatisfactory' was higher in children below the age of 5 years than in the older children.
Child↗
Peripheral circulation during sufentanyl and morphine anesthesia.
Sufentanyl is a newly developed potent, short-acting fentanyl-like morphinomimetic. No independent studies of the peripheral circulation during sufentanyl anesthesia are available. In the present study we compared the effects of sufentanyl and morphine on the peripheral perfusion in dogs. The effects of total beta-blockade during sufentanyl and morphine anesthesia were also evaluated. We elected to record skeletal muscle surface pH (m-pH) continuously as an index of the microcirculation and cellular fractions. Arterial and mixed venous blood gases and acid-base status were measured to determine the respiratory component of changes in m-pH. Hematocrits, plasma electrolytes and plasma proteins were analyzed in order to permit calculations of fluid-shifts between the blood and the interstitial fluid. Sufentanyl (0.01 mg/kg) had no adverse effects on the peripheral perfusion. Morphine (4 mg/kg) caused a severe and rapid fall in m-pH from 7.29 to 7.11 during the 30-min experimental period. At the same time, calculated blood volume decreased by 20%. This hypovolemic deterioration of the circulation was probably caused by a histamine-mediated increase in capillary pressure with filtration of plasma from the circulation to the interstitial fluid. Calculated systemic vascular resistance was not correlated to the quality of the peripheral perfusion. Propranolol administered during sufentanyl and morphine anesthesia did not influence the peripheral perfusion. On the basis of the present study we recommend human studies on sufentanyl, and discourage the use of high-dose morphine anesthesia.
Anesthesia, Intravenous↗
Results after meniscectomy in 147 athletes.
The object of this study was to ascertain the consequences of meniscectomy performed because of meniscus injury sustained during sports. Out of 147 athletes meniscectomized from 1964 to 1973 a total of 142 were seen at follow-up. The median follow-up period was 4.25 (range 2.25-11.0) years. During the follow-up period 8 per cent (11/142) had further surgical treatment because of new knee injuries. At the time of follow-up, 15 per cent (20/131) of the patients who had undergone operation solely for the primary meniscus injury had given up sports because of knee complaints and 12 per cent (16/131) had restricted their sporting activities. There were no complaints in 46 per cent (60/131). In 79 per cent (56/71) of the patients who had complaints, these had started immediately after operation. The main trouble was a feeling of instability and pain on weight-bearing. The complaints correlated with the physical findings at follow-up. In 14 per cent (18/13) there was increased collateral instability of the knee. Considering also previous experimental studies, it is concluded that meniscectomy causes immediate functional changes in the knee which explain the complaints. There was no correlation between complaints and radiological osteoarthrosis.
Adolescent↗