PubMed Health⌕ Search

Biomedical subjects

S Fitzal

Publications and source records attributed to S Fitzal.

At least 37 records · Page 2Linked to original sources
PubMed1982

Relative roles of heart rate and ventricular stroke volume for the regulation of cardiac output during controlled hypotension with sodium nitroprusside in man.

The effects of N-allyl clonidine (St 567, alinidine), (0.5 mg/kg i.v.) a substance with specific bradycardic action at the sinus node, were studied on a total of thirteen patients in neuroleptanaesthesia and during controlled hypotension with sodium nitroprusside (SNP). Invariably, the fall in blood pressure was associated with an increase in heart rate (20.0 +/- 4.3+; P less than 0.01), presumably due to an activation of the arterial baroreceptor reflex. Alinidine decreased heart rate to the original level but no fall in cardiac output occurred a ventricular stroke volume and the calculated left ventricular stroke work were increased compensatorily (35.9 +/- 7.2% and 35.9 +/- 6.7%, P less than 0.01, respectively). In patients who received alinidine before the onset of controlled hypotension (n = 5) SNP failed to elicit an increase in heart rate. It is concluded that in patients under neuroleptanaesthesia tachycardiac does not play an important role for the maintenance of an adequate cardiac output during controlled hypotension with SNP.

Adult↗
PubMed1982

[Neuromuscular and cardiovascular effects of Duador, a new short-acting nondepolarizing muscle relaxant].

The neuromuscular blocking and circulatory effects of a recently synthesized relatively short acting nondepolarizing muscle relaxant, Duador, have been investigated in anaesthetized patients. Duador appears to be a potent muscle relaxant with intermediate duration of action. It had no cumulative effects even after as many as five maintenance doses. Doses of 0.4 mg/kg provided ideal intubating conditions in 2 min, though maximal blockade only developed in about 6 min. Duador was easily antagonized by edrophonium and no signs of recurarisation have been observed. The initial dose of Duador caused a mean 28% increase in heart rate. The increase in heart rate was inversely proportional to the control rate. Repeat doses did not cause further elevation in frequency. Duador had no effect on mean blood pressure.

Adult↗
PubMed1982

Cardiovascular effects of N-allyl clonidine (ST 567, alinidine): a substance with specific bradycardiac action during neuroleptanesthesia in humans.

The cardiocirculatory effects of N-allyl clonidine (ST 567, alinidine), a substance with specific bradycardiac action at the sinus node [Kobinger et al. 1979], were studied in 30 patients undergoing noncardiac surgery in neuroleptanesthesia. Alinidine (0.5 mg/kg i.v.) alleviated both spontaneous and reactive tachycardia, i.e., in response to deliberate hypotension with sodium nitroprusside (3.0 +/- 1.8 micrograms/kg i.v.), (decrease in heart rate from control: 20.7 +/- 5.7% and 25.4 +/- 3.2%, respectively), without affecting mean arterial blood pressure substantially. The slight but significant reduction in cardiac output can be explained, at least in part, by the decrease in heart rate, since the left ventricular stroke volume showed a tendency to increase and the mean pulmonary artery pressure failed to change significantly. Thus, alinidine may be useful for reducing heart rate and myocardial oxygen consumption in patients under neuroleptanesthesia.

Adult↗
PubMed1981

Plasma catecholamines, plasma renin activity and haemodynamics during sodium nitroprusside-induced hypotension and additional beta-blockage with bunitrolol.

The effects of beta-blockade on certain physiological and haemodynamic responses to sodium nitroprusside-induced hypotension have been studied in 5 patients, aged 18--54 years, undergoing inner ear surgery. Samples of blood were collected under premedication, following induction of anaesthesia, during neuroleptanalgesia, during a sodium nitroprusside infusion adjusted to produce a 40% fall in blood pressure, during superimposed beta-blockage with bunitrolol and under stable haemodynamic conditions after discontinuation of sodium nitroprusside. The sodium nitroprusside-induced reduction in blood pressure led to a massive increase in plasma noradrenaline and adrenaline and in plasma renin activity. beta-blockade with bunitrolol did not affect the increased catecholamine concentrations, the increase in plasma renin activity was significantly reduced, the increase in heart rate was reversed, and total peripheral resistance and diastolic blood pressure were further reduced. These changes can be attributed to the intrinsic beta-synmpathomimetic activity of bunitrolol in addition to its beta-blocking effect. Since no adverse effect was observed in this study, combined therapy with sodium nitroprusside and beta-receptor blockade should be employed if the effects of increased sympathetic tone are considered to be undesirable.

Adolescent↗
PubMed1981

Verapamil as a hypotensive agent during neuroleptanaesthesia.

The haemodynamic effects of verapamil were investigated in 11 patients anaesthetized with thiopentone, fentanyl and dehydrobenzperidol. Suxamethonium and pancuronium bromide were used for muscle relaxation. Verapamil 0.07 mg kg-1 given as a single intravenous bolus decreased mean arterial pressure from 108 +/- 18 mm Hg to 84 +/- 20 mm Hg (P less than 0.001) and total peripheral resistance by 29 +/- 10% from 1662 +/- 399 dyne s cm-5 (P less than 0.001) while heart rate and mean pulmonary artery pressure showed only minor changes. The decrease in arterial pressure was caused by reduction in total peripheral resistance while cardiac output was increased.

Aged↗
PubMed1981

[Haemodynamic changes during intracoronary infusion of norepinephrine. A study of the halothane-induced circulatory depression (author's transl)].

The haemodynamic effects of halothane (0.9 vol% = 1 MAC) and of intracoronary infusion of norepinephrine (14.28 +/- 3.28 ng/kg/min) were investigated in anesthetized dogs (n=6). During inhalation of halothane the left ventricular (LV) stroke volume was diminished while heart rate and total peripheral resistance exhibited no significant changes. In spite of this cardiodepressive action, by means of a decrease in both LV-end-diastolic pressure and LV-end-diastolic volume, a backward heart failure could be excluded. Intracoronary infusion of norepinephrine increased the contractility of the left ventricle leading to an increase in LV-dP/dtmax to control values. However, in comparison to the original level, cardiac output and mean arterial blood pressure remained decreased. Thus, selective inotropic stimulation failed to antagonize the halothane-induced circulatory depression. In a second series of experiments performed on chronically instrumented dogs (n=5) the haemodynamic effects of piritramide (0.3 mg/kg/h i.v.), i.e. the anaesthetic used for preparation of the animals in the acute experiments, were studied during anaesthesia with halothane (1 MAC). While dipidolor failed to elicit significant changes under these conditions, haemodynamic side effects cannot generally be excluded since there is evidence that narcotic analgesics interfere with the neural control of the cardiovascular system.

Anesthesia↗
PubMed1981

[The clinical application of the "locus of resistance" method for axillary plexus block (author's transl)].

We describe a new method of axillary brachial plexus block, the principle of which is to verify the position of the needle in the perivascular tissue not by paraesthesia but by the "loss of resistance" measured when penetrating the perivascular sheath. This method has been developed from the well known "loss of resistance" technique used in epidural anaesthesia and has been tested in practice as well as in theory. This technique not only guarantees greater accuracy in locating the perivascular tissue, but also opens the possibility of decreasing the incidence of lesions of nerves and vessels.

Anesthesia, Epidural↗
PubMed1981

[Analgesics].

Explore the source record for details and available documents.

Analgesics↗
PubMed1980

[Cardiovascular effects of two synthetic enkephalin analogues following intracoronary administration in dogs (author's transl)].

Haemodynamic changes following intracoronary injection of two synthetic Met5-enkephalin analogues (FK 33-824 and DALA) with prolonged action as compared with "natural" enkephalines were investigated in anaesthetized dogs (n = 5; dosage; 200, 400, 600 micrograms of both substances i. cor.). DALA led to a shortlasting (5 minutes) rise in heart rate associated with an increase in cardiac output and left ventricular dp/dt max. Besides, a fall in mean arterial blood pressure was noted. No alterations in the pulmonary circulation were encountered. FK 33-824 elicited similar, but unpronounced changes. Direct influences on baroreceptor activity or endogenous release of vasoactive substances as the cause of circulatory effects occuring primarily under DALA were discussed. It is concluded that the cardiovascular effects of synthetic opioids resemble those of morphine and its related compounds.

Animals↗
PubMed1980

[Steal-induction with ketamine in childhood: comparison of the postanaesthetic period (author's transl)].

The behaviour of 48 children ranging from weeks to eight years was observed and compared after four different anaesthesia methods. Either ethrane or halothane was used with or without induction with ketamine i.m. (5 mg/kg bodyweight). Restlessness, the depth of postanaesthetic sleep, shivering, muscle rigidity and vomiting were evaluated every 15 min. up to one hour postoperatively using a graduation from 1--4. Ketamine combined with halothane showed significantly less postoperative restlessness than all other methods. No statistically proven differences were seen in the other criteria, which were noticed more than once. The psychic effects as well as the practical clinical application of this method are discussed.

Anesthesia, Inhalation↗
PubMed1979

[Abolition of hypotension following spinal anaesthesia by dihydroergotamine (DHE) (author's transl)].

The conduction block of the preganglionic sympathetic fibres in spina anaesthesia leads to peripheral vasodilation. Such a loss of tone in blood vessels is also pronounced on the venous side. Therefore the effects of intravenously administered DHE (10 microgram/kg i.v.) on 25 healthy patients undergoing spinal anaesthesia were studied. Though all patients were preinfused with 500 ml Ringer there was a sustained decrease in arterial and pulmonary artery pressures (p less than 0.001). However, the heart rate remained unaffected. After DHE the pressure changes were completely reversed whereas heart rate was significantly decreased (p less than 0.001). The effects of DHE can largely be explained by its powerful and selective action on the capacitance vessels in the peripheral circulation. The increased venous return to the heart augments ventricular filling. Perfusion pressure is increased without any concomitant myocardial stimulation. The results indicate that DHE can have a beneficial effect in patients undergoing spinal anaesthesia.

Adult↗
PubMed1979

[A comparison of two preoperative medications: responses in sedative, psychic and somatic effects (author's transl)].

The influence of two different premedication methods on the psychic reaction of the patient and their somatic-vegetative effect was tested in a controlled double-blind study. 96 patients between the ages of 20 and 40 took part in the study and were divided into two groups. Group 1 (n = 47) received meperidine (Alodan) and promethazine (Phenergan). Group 2 (n = 49) were given thalamonal. All patients underwent a personality test (Cattell 16 PF) a day prior to scheduled surgery. After administration of the respective pre-anaesthetic drugs, three different test methods were applied to determine their subjective state. Simultaneously, independent from the patients, their psychic reactions were determined by the anaesthetist. Premedication 2 effected less calm, i.e. decrease of fear, exhaustion and depression, than premedication 1. The somatic-vegetative region exhibited no significant difference except for increased cardiocirculatory symptoms in group 1. Based on the less favourable psychodynamics in patients who received thalamonal, it is not advised as pre-anaesthetic medication.

Adult↗
PubMed1979

[Loss of resistance in axillary plexus blockade].

The results of the "loss of resistance" method for identification of the perivascular space are demonstrated. The axillary plexus with its accompanying structures is embeded in the perivascular space. 20 pressure readings were performed with a special transducer. A statistically significant pressure loss was demonstrated after passing the vascular and nerve sheath. The distinct pressure differences during the tissue penetration are recognized with the finger guiding the syringe, similar to the technique used for peridural anaesthesia. We thus believe that we can offer an exact method for blocking the axillary plexus with maximum safety which does not rely on the cooperation of the patient.

Axilla↗
PubMed1978

[The continuous perivascular axillary plexus block in hand replantation surgery (author's transl)].

A modified techniques of axillary plexus block is described which enables prolonged analgesia. The main principle of this techniques is to insert an indwelling canula into the perivascular tissue of the plexus brachialis. A cold local anaesthetic (4 degrees) is injected for controlling the canula site. The indications for this technique are all corrective and reconstructive operations of the upper extremity and the postoperative alleviation of pain. Twenty cases with different indications are discussed in this paper. No allergic, toxic or inflammatory reactions were seen in our patients. They were satisfied with this method of analgesia. The easy application, absence of time limiting factors and suitable intraoperative monitoring are the advantages of the method.

Brachial Plexus↗
PubMed1977

[Control of respiratory therapy by means of rheography (author's transl)].

Rheography measures changes in electrical conductivity. In measurements taken at the thorax it was appeared that the changes in conductivity caused by breathing are superimposed by the changes caused by circulatory factors and exceed them in amplitude quite far. This makes the expansion of rheography for electrical respiration control possible. The changes in electrical conductivity are explained by inspiration into the alveoles, by the increase in the distance of the electrodes on thoracic expansion, and by the change in the intrathoracic blood volume. When using respiratory therapy the physiotherapist must pay great attention how the patient reacts to respiratory therapy and whether he is adapted correctly to the mechanical respiratory support devices. The method of "rheospirography" was tested as to whether it allows an objective, direct evaluation of the interplay between respiratory therapy and patient. The method appears to be able to control respiratory therapeutic measures as it allows an evaluation of the respiratory type, the regional ventilation, and the adaption of the patient to the device.

Adult↗
PubMed1977

[Rheographic monitoring of lung ventilation (author's transl)].

Electrical conductivity changes are measured with rheography. Changes of conductivity on the thorax caused by respiration, superimpose and exceed those caused by different circulatory conditions. Therefore rheography was adapted for monitoring of respiration. Changes in electric conductivity can be explained by the inflow of air to the alveoli, by increase of the distance between electrode, and by changes of the intrathoracic blood volume. Rheography developed by Polzer and Schuhfried was tested in the intensive care unit and the respiration therapy department. It was shown that this method is suitable for control of respiration, for demonstrating regional differences of pulmonary ventilation, for checking of respiration therapy and for monitoring the ventilated patient.

Asthma↗