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T Lindeburg

Publications and source records attributed to T Lindeburg.

11 recordsLinked to original sources

Perivascular axillary block IV: blockade following 40, 50 or 60 ml of mepivacaine 1% with adrenaline.

Perivascular axillary blockade was performed on 90 patients with the aid of a catheter technique. The patients were randomly allocated to receive either 40, 50 or 60 ml of 1% mepivacaine with adrenaline 1:200,000. Blood concentrations of mepivacaine were measured up to 90 min after injection in seven, eight and ten of the patients from the three groups. Sensory and motor blockade was evaluated 20, 30 and 40 min after injection. All groups showed the same temporal development of the blockade, i.e. improval of the blockade during the period from 20 to 40 min after injection, but no difference was found in the sensory or motor blockade between the three groups. However, a further analysis of the incomplete blockades showed a better quality of the sensory blockade in the groups given 50 and 60 ml than in the group given 40 ml. None of the 90 patients showed any signs of systemic toxic reactions. The mean peak values of blood concentrations were 0.5-1.0 microgram/ml higher in the groups given 50 ml and 60 ml than in the group given 40 ml. On the basis of the present and two previous investigations on the dose response in perivascular axillary blockade, a dose of 50 ml 1% mepivacaine with adrenaline or another equivalent drug with vasoconstrictor is recommended.

Adult↗

Perivascular axillary block V: blockade following 60 ml of mepivacaine 1% injected as a bolus or as 30 + 30 ml with a 20-min interval.

Perivascular axillary blockade was performed on 60 patients with the aid of a catheter technique. The patients were randomly allocated to two groups. All patients received the same dose of local anaesthetic: 60 ml of mepivacaine 1% with adrenaline, but one group received the dose as a bolus injection, whereas the other group received the dose as fractional injections of 30 + 30 ml with an interval of 20 min. Blood concentrations of mepivacaine were measured up to 90 min after injection of local anaesthetic. Sensory and motor blockade were evaluated 20, 30 and 40 min after injection. Forty minutes after the last injection of local anaesthetic, there was no difference between the blockades of the two groups, except for the sensory blockade of the lower lateral cutaneous nerve of the arm, in which the frequency of analgesia was 90% after bolus injection and 63% after fractional injections. There was no difference in blood concentrations of mepivacaine between the two groups. None of the 60 patients showed any sign of systemic toxic reactions. Fractional injection of local anaesthetic in perivascular axillary blockade does not offer any advantage over bolus injection with regard to the resulting blockade.

Adult↗

Analgesic, respiratory and endocrine responses in normal man to THIP, a GABA-agonist.

In a controlled study, the effects of THIP (a synthetic gamma-aminobutyric-acid-agonist) on respiratory function (ventilatory response to CO2), first detection of stimulation (electrical stimulation of a tooth), pain threshold, magnitude of maximal tolerated pain stimulation, and plasma cortisol, prolactin and glucose were investigated in six normal men. Intramuscular injection of THIP in dosages of both 10 mg and 20 mg increased the magnitude of stimulus before first detection, and the pain threshold as well as the maximal tolerance of pain stimulation. THIP did not lead to changes in respiratory function, or in plasma cortisol, prolactin or glucose, suggesting an analgesic action independent of opiate receptors.

Adult↗

Pharmacokinetics of the gamma-aminobutyric acid agonist THIP (Gaboxadol) following intramuscular administration to man, with observations in dog.

The pharmacokinetics of the gamma-aminobutyric acid (GABA) agonist, THIP (Gaboxadol) has been studied following intramuscular administration of 10 or 20 mg THIP-monohydrate to six healthy human volunteers. Additional experiments with special reference to the possible occurrence of non-linear kinetics and to estimation of the efficiency of absorption were carried out in three beagle dogs. As estimated from the dogs, absorption of THIP from the site of injection was efficient (F = 0.94 +/- 0.16, mean +/- S.D., in 8 experiments). The time course of the THIP serum concentration was in all experiments adequately described by an open 1-compartment linear model. In most individual experiments a near maximum concentration was present at 15 or 10 min. after the administration to man and dog, respectively. In some subjects and dogs an uncertain relation was found between dose and the time integral of the THIP serum concentration, but the mode of variation did not suggest deviations from first-order kinetics at high doses or concentrations. The rate constant of elimination was estimated to 0.50 +/- 0.13 hr-1 and 0.52 +/- 0.13 hr-1 following injection of a 10 or 20 mg dose, respectively, to man (mean +/- S.D., n = 6), and similar values were obtained from the dogs.

Absorption↗

Cardiovascular effects of etomidate used for induction and in combination with fentanyl-pancuronium for maintenance of anaesthesia in patients with valvular heart disease.

The effects of induction of anaesthesia by etomidate 3 mg kg-1 followed by continuous infusion of etomidate 2 mg min-1, fentanyl 0.01 mg.kg-1 and pancuronium 0.1 mg.kg-1 were studied in ten patients with valvular heart disease. No haemodynamic changes were seen injection of etomidate, but after fentanyl was given there was a significant decline in cardiac index (10%), in mean arterial systemic pressure (20%), in systemic vascular resistance (14%), in left ventricular minute work index (27%) and in right ventricular minute work index (21%) compared to the control values. After supplementing with pancuronium, no further significant changes were seen. There was no significant change in the pulmonary vascular resistance during the whole study. In conclusion, it appears that etomidate is a safe intravenous agent, and is worth further study, in particular in patients with minimal cardiac reserve requiring high inspired oxygen tension.

Adult↗

Respiratory, analgesic and endocrine responses to an enkephalin analogue in normal man.

In a controlled study, the effect of a new enkephalin analogue (FW 34-569, Sandoz) on respiratory function (ventilatory response to CO2), pain threshold (hot plate technique), and plasma cortisol, prolactin, growth hormone, luteinizing hormone (LH) and follicle-stimulating hormone (FSH) was investigated in six normal subjects. One milligram of enkephalin, but not 0.5 mg, resulted in a significantly decreased ventilatory response to CO2, although mean values were not significantly different from saline control values (0.05 less than P less than 0.1). Neither 0.5 mg nor 1.0 mg enkephalin influenced pain threshold, but doses stimulated growth hormones and prolactin release and inhibited the release of cortisol and LH, while FSH remained unchanged.

Adult↗

Effect of epidural analgesia on muscle amino acid pattern after surgery.

Free amino acids in muscle were studied before and 96 hours after skin incision in 14 patients undergoing elective hip replacement and allocated to general anesthesia or epidural analgesia (T10-S5) effective before incision and maintained with intermittent 0.5% bupivacaine during the first 24 postoperative hours. The general anesthesia group (n = 8) showed the characteristic changes in muscle amino acids, with increase of branched chain amino acids and phenylalanine and decreased glutamine, arginine and lysine, as well as raised plasma levels of cortisol and glucose. The epidural group (n = 6), contrastingly, showed no significant changes in plasma cortisol and glucose and an attenuated postoperative response in all amino acids, without significant difference from the preoperative values. Differences in postoperative muscle amino acid concentrations between the epidural and the general anesthesia group were significant as regards glutamine, valine and asparagine. These results suggest that post-trauma changes in muscle amino acids are predominantly mediated by afferent neurogenic stimuli and the secondary increase in catabolic hormones.

Aged↗