PubMed · 8129136
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J P Warwick, D Blake. 1994. Drawing up propofol.. https://doi.org/10.1111/j.1365-2044.1994.tb03389.x
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Citrinin's nephrotoxicity was examined in pentobarbital-anesthetized dogs under conditions that minimized or avoided significant changes in a number of its actions that could indirectly and adversely affect renal function and ultrastructure, such as, (i) major acute reductions in blood pressure and renal blood flow and, (ii) emesis and diarrhea that could lead to dehydration and electrolyte imbalances, especially hypokalemia. Slow intravenous injection of 20 mumol citrinin/kg to pentobarbital-anesthetized dogs did not induce any alterations in renal tissue ultrastructure or in any of the 23 whole blood, plasma or renal function parameters that were monitored over a 6-h post-citrinin period. On the other hand, 80 mumol citrinin/kg produced significant increases in the hematocrit and in the renal excretion rates of protein and glucose; modest reductions were noted in CIN, RBF and excretion rate of inorganic phosphorus. In addition, 80 mumol citrinin/kg induced ultrastructural lesions in the cells of the S2 proximal tubular segment, the thick ascending limb, the distal convoluted tubule and the collecting ducts. The glomeruli, S1 and S3 cells of the proximal tubule and the thin descending and ascending limbs of Henle's loop were unaffected by both citrinin doses. The location and nature of the adverse ultrastructural lesions were most likely the result of the direct actions of citrinin (or a citrinin metabolite) since the effects of citrinin that could lead to indirect adverse renal effects were totally avoided or greatly minimized.
The dependence of functional MRI contrast on the repetition rate (1.5-9 Hz) of a sensory stimulus was investigated with a T2*-weighted gradient echo method during forepaw stimulation of alpha-chloralose anesthetized rats (n = 5). An activation area was observed in the left or right somatosensory cortex dependent on the stimulation of the right or left forepaw, respectively. The activation intensity decreased for stimulation frequencies above 3 Hz, and was negligible at 9 Hz. The interpretation is that at low stimulation rates the neurons can respond to each stimulus, but at higher rates there is insufficient recovery time so that the response is progressively occluded.
PURPOSE: High-dose thiopentone has been reported to reduce the incidence of neurological dysfunction after open-chamber cardiac surgery. However, this technique delays tracheal extubation and increases requirements for inotropic support after cardiopulmonary bypass. As a quality assurance measure to determine the safety of high-dose thiopentone, we reviewed the records of all patients undergoing elective, open-chamber surgery at our institution between 1st March, 1987 and 31st Dec, 1989. METHODS: The charts of 236 patients were reviewed retrospectively, and 227 met our inclusion criteria. The perioperative characteristics of patients anaesthetized with thiopentone (Group T, n = 80) were compared with those of patients anaesthetized with opioids (Group O, n = 147). RESULTS: Anaesthetic technique was chosen by the attending anaesthetist. in Group T (n = 80) thiopentone 38.1 +/- 11.8 mg.kg-1 was infused to produce electroencephalographic burst-suppression during bypass. Moderate hypothermia and arterial line filtration were used during bypass. The groups did not differ with respect to demographics, type of surgery, or conduct of bypass. There were no strokes in Group T and 4 in Group O (P = NS). The time to extubation was prolonged in Group T compared with Group O (39 +/- 51 vs 27 +/- 24 h, P = 0.014), as was the duration of stay in intensive care (66 +/- 56 vs 51 +/- 29 h, P = 0.010). Thiopentone did not increase the need for inotropic or mechanical support after bypass. In-hospital mortality was lower in Group T than in Group O (1.2% vs 9.5%, P = 0.034). CONCLUSION: High-dose thiopentone delays extubation after open-chamber procedures. However, the technique appears safe, and further prospective investigation is justifiable.