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PubMed1987

[Prophylaxis and therapy of the acid aspiration syndrome].

The best prevention of the aspiration syndrome begins with early identification of any patient at risk. Reduction of gastric volume and elevation of gastric pH can be achieved by premedication with glycopyrrolate (0.3 mg i.m.) and preoperative administration of H2-receptor antagonists (150 mg ranitidine p.o. 6-8 h and 80 mg i.m./i.v. 60 min before induction). Transportation of stomach contents into the duodenum can further be accelerated by 10 mg metoclopramide i.v. 20-40 min before induction. Metoclopramide will also elevate lower esophageal sphincter tone. Rapid elevation of gastric pH can be achieved by oral administration of 15-30 ml 0.3 mol sodium citrate. Induction of anesthesia should be performed as a "rapid sequence induction". Manual compression of the esophagus (Sellick manoever) may prevent gastric regurgitation. In cases of pulmonary aspiration, consequent therapy has to be initiated as soon as possible to limit broncho-alveolar damage. After endotracheal intubation the upper respiratory tract should be cleared of stomach contents by suction. Further efforts should include artificial ventilation with a high FiO2 and low PEEP (5-10 cm H2O) as well as vigorous volume substitution to maintain cardiovascular stability. Corticosteroids (200 mg Hydrocortisone i.v. may have a beneficial effect if given within 5 min after aspiration. Severe bronchospasm may respond to aminophylline (5 mg/kg i.v. as an initial bolus) or inhalation of beta-adrenergics (terbutaline 0.75-1.5 mg/inh). Bronchial lavage will rather damage than improve broncho-alveolar integrity and cannot be recommended.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia↗

PubMed1986

Pharmacokinetics of atropine in children.

The serum concentration of atropine was determined both by radioreceptor assay (RRA) and by radioimmunoassay (RIA) following a single 0.02 mg/kg i.v. injection of 7 girls (age 6-15 years) and 16 boys (age 4-15 years) at the beginning of a combination anesthesia. RIA appeared to be useful in the clinical kinetic studies of this alkaloid, but RRA determined the whole antimuscarinic activity produced by atropine plus glycopyrrolate when the latter agent was used as an anticurarizing component together with neostigmine at the end of anesthesia. A biexponential serum decay curve of atropine was demonstrated by RIA with a very rapid distribution phase (t1/2 = 1-2 min) and a quite high tissue distribution (mean Vd beta = 2.6 l/kg), but due to the effective clearance of the drug (mean Cl total = 0.310-0.384 l/kg/h) the mean elimination phase half-life was around 6.5 hours. No age or gender dependency was found in the pharmacokinetics of atropine.

Adolescent↗

PubMed1985

Infusion of propofol ('Diprivan') as sedative technique for colonoscopies.

Sixty male and female patients, scheduled for colonoscopy were premedicated with glycopyrrolate 0.4 mg intramuscularly. Anaesthesia was induced with 2 mg/kg propofol ('Diprivan') and maintained with a continuous infusion of propofol at a rate of 3, 6 or 9 mg/kg/h randomly allocated. Patients lost consciousness within 60.6 +/- 18.7 (s.d.) s. Preservation of the hypnotic effect was infusion-rate dependent as 15, 40 and 85% of the patients were unconscious on infusion rates of 3, 6 or 9 mg/kg/h propofol, respectively. A high degree of sedation was observed in the remaining patients with an incidence of 40, 35 and 0% in the different series. Sedation was light in the remainder of the patients. To increase the acceptability of the procedure, a supplemental bolus of propofol and/or an increase in the infusion rate were required in 40, 15 and 10% of the 3, 6 and 9 mg/kg/h infusion rate groups, respectively. The incidence of amnesia was similar in all three groups (80, 90 and 95%, respectively). Recovery was significantly longer with increasing infusion rate, but remained rapid. The longest time was 7.3 +/- 4.0 min to open eyes on command and 10.6 +/- 4.6 min to answer correctly. The most important side effects were pain on injection (50%) and some restlessness during maintenance (25%). Blood pressure decreased, but heart rate was unaffected. Patients breathed room-air spontaneously. Respiratory rate slowed after induction then increased rapidly above baseline values. The incidence of apnoea was 48% with a mean duration of 51 +/- 22s (s.d.). The technique was evaluated as good or adequate in 95% of the cases. We suggest than an analgesic premedication followed by an average of 6 mg/kg/h propofol by infusion might be a simple and convenient method of achieving good conditions for colonoscopy.

Anesthesia Recovery Period↗

PubMed1985

Bradycardia associated with meningioma in a dog.

Clinical signs of bradycardia and syncope, associated with intracranial meningioma, were observed in a 4-year-old female Irish Setter. Electrocardiographic abnormalities confirming bradycardia and suggestive of sinoatrial arrest were demonstrated. Return to a normal heart rate and sinus rhythm after administration of atropine IV indicated that increased vagal tone was responsible for the observed abnormalities. Neither glycopyrrolate nor propantheline bromide therapy was successful in controlling bradycardia and syncope. Necropsy findings included the demonstration of a 3 X 2 X 2-cm mass on the ventral aspect of the right half of the brain. This mass covered half of the mammillary body and extended as a thick reddish brown membrane extending over the piriform lobe of the cerebrum, optic chiasm, and longitudinal fissure. Histologically, the mass was identified as a meningotheliomatous meningioma.

Animals↗

PubMed1983

Succinylcholine-vecuronium (Org NC 45) sequence for cesarean section.

Vecuronium (Org NC 45) was used in 27 parturients undergoing elective cesarean section under general anesthesia. One of the parturients had a twin pregnancy. Neuromuscular transmission was assessed clinically by stimulating the ulnar nerve and observing the contraction of the fingers. An initial bolus of 0.05 mg . kg-1 of vecuronium was injected after recovery from succinylcholine block. Complete neuromuscular block resulted in all cases and lasted for a mean duration of 19.3 +/- 6.02 min. Muscular relaxation was maintained by incremental doses of 0.01 mg . kg-1 of vecuronium. Administration of vecuronium did not cause significant changes in blood pressure, pulse rate, or plasma cholinesterase activity. Also, there was no correlation between the plasma cholinesterase activity and the duration of neuromuscular block of vecuronium. The residual neuromuscular block could be antagonized at the end of the procedure by a mixture of 0.005 mg . kg-1 of glycopyrrolate and 0.025 mg . kg-1 of neostigmine. In all parturients, antagonism was adequate as evidenced by maintained tetanic response (50 Hz for 5 sec) and sustained head lift. Nine infants were delivered before the injection of vecuronium; 19 infants were delivered after its injection. There was no significant difference between the Apgar scores in the two groups, suggesting that vecuronium does not cross the placenta in concentrations that affect the newborn. Vecuronium may be advantageous in parturients undergoing cesarean section under general anesthesia because it maintains cardiovascular stability, is noncumulative, is readily antagonized by neostigmine, has no effect on the plasma cholinesterase activity, and has no deleterious effect on the newborn.

Anesthesia, General↗

PubMed1984

Anesthesia for cesarean section in large animals.

Respiratory minute volume, blood volume, RBC mass and cardiac output increase while the functional residual capacity decreases during late pregnancy. General anesthetics reach the fetus in high concentrations and tend to persist in the fetus after delivery. Use of small doses of a combination of anesthetics is recommended. Ephedrine increases vascular tone and cardiac output. Glycopyrrolate and fentanyl-droperidol are used to restrain sows for cesarean section. Morphine alone or with acepromazine works well in depressed sows. Acepromazine or xylazine, used with ketamine, is good in restraining small ruminants. A sedative and local blocks can be used in standing cows. Anesthesia in mares is induced with xylazine, guaifenesin and ketamine and maintained with halothane, guaifenesin or thiopental. Large doses of xylazine should be avoided. Lidocaine toxicity can result from overuse in local blocks.

Anesthesia↗

PubMed1995

Evaluation of stress response to surgery under general anesthesia combined with spinal analgesia.

BACKGROUND: Each type of anesthesia has varying influence on the amount of catecholamine secretion during surgery. Epidural or spinal anesthesia can markedly suppress the increase of many of the stress hormones. Our purpose of this study is to evaluate metabolism change during surgery under anesthesia and to see whether general anesthesia combined with intraspinal anesthetic and narcotic is a better way to suppress such stress response. METHODS: Seventeen patients in fit physical condition (ASA class I) with normal biochemical screening scheduled for radical gastrectomy were studied. All patients were premedicated with diazepam and glycopyrrolate and an indwelling catheter was inserted into a radial artery under local anesthesia for monitoring blood pressure and obtaining blood samples for glucose and hormonal assays. A CVP line was set up via the right internal jugular vein for the administration of fluid (free of sugar). In the study group, a 32-G intraspinal catheter was placed via lumbar interspaces. Spinal blockade up to T4 by titrating 0.25% marcaine. Then anesthesia in both groups was induced with thiopental 5 mg/kg, followed by succinylcholine 1.5 mg/kg for intubation. Anesthesia was maintained with isoflurane, N2O, O2 and pancuronium. Blood samples for measurement cortisol, catecholamine and sugar were taken after induction and 30 min after surgical incision. Thirty min after skin incision all patients were subjected to glucose tolerance test, accomplished by giving 50% dextrose at 0.33 g/kg in 3 min. Arterial blood samples were then obtained at 1, 3, 5, 7, 10, 20, 30, 45 and 60 min intervals for plasma glucose determination. RESULTS: No difference was evident in cortisol values, baseline, before and after surgical incision (p > 0.05) either intragroup or inter-group. Catecholamine and glucose were significantly higher in control group after surgical incision (p < 0.05, intra-gr and inter-gr). Following a glucose load the decay of plasma glucose was similar in both groups but glycemic level was higher in the control group. CONCLUSIONS: Better control of stress response by general anesthesia combined with subarachnoid block was disclosed in this study.

Aged↗

PubMed1994

Evaluation of fentanyl and sufentanil on the diameter of the common bile duct by ultrasonography in man: a double blind, placebo controlled study.

Narcotic mu-agonists have been shown to increase the common bile duct pressure. With a recently introduced non-invasive ultrasonographic technique, we have demonstrated that morphine caused constriction of the common bile duct. We have now investigated the effect of highly potent, widely used mu-agonists, fentanyl and sufentanil on the diameter of the common bile duct using this technique in a double-blind, randomized study in 17 patients undergoing cholecystectomy. After premedication with midazolam and glycopyrrolate, anesthesia was induced by midazolam, 50 micrograms.kg-1 and thiopental, 3.0-5.0 mg.kg-1. Tracheal intubation was facilitated by succinyl-choline, 1.0 mg.kg-1 and muscle relaxation maintained with vecuronium. Anesthesia was maintained with enflurane or isoflurane and nitrous oxide in oxygen. The diameter of the common bile duct was determined before and at 4 and 8 minutes after the administration of the study drugs. One way analysis of variance and paired t-test were used for statistical analysis. P < 0.05 was considered significant. No significant change in common bile duct diameter was observed after i.v. placebo, nor were there any significant changes after fentanyl or sufentanil administration. Since the baseline common bile duct diameters were not significantly different among the three groups, fentanyl or sufentanil in the doses used had no more effect than a placebo on common bile duct diameter. It is concluded that fentanyl and sufentanil caused no effect on the common bile duct, therefore, these mu-agonists seem to be safe in patients in whom spasm of the common bile ducts should be avoided.

Adult↗

PubMed1994

Anesthesia for electroconvulsive therapy: effects of propofol and methohexital on seizure activity and recovery.

The influence of methohexital and propofol on seizure activity and recovery profiles was assessed in a randomized, crossover study involving 13 adult outpatients undergoing electroconvulsive therapy (ECT). Arterial blood pressure, heart rate, hemoglobin oxygen saturation, and electroencephalogram (EEG) activity were monitored during the ECT procedure. After premedication with glycopyrrolate, 0.2 mg intravenously (i.v.), and labetalol 20-30 mg i.v. hypnosis was induced with a bolus injection of either methohexital or propofol, 0.75 mg/kg. Muscle paralysis was achieved by administering succinylcholine, 1.4 mg/kg i.v. Ventilation was assisted using a face mask while administering 100% oxygen. Thereafter, an electrical stimulus was administered and the length of the resulting motor and EEG seizures was measured. Mood level and cognitive function were assessed prior to induction of anesthesia and after ECT. A total of 72 treatment sessions were evaluated. Each patient underwent a minimum of four treatments and received both induction drugs equally. Although the use of propofol was associated with significantly shorter motor and EEG seizure durations (mean +/- SEM) compared with methohexital (34 +/- 1.6 s and 52 +/- 2.9 s vs 39 +/- 1.5 s and 61 +/- 3.0 s, respectively), this difference was not clinically significant because the durations exceeded 30 s in both groups. Although awakening times were similar, both hemodynamic stability and cognitive recovery were more favorable after propofol. Compared with methohexital, the use of propofol was associated with a clinically insignificant decrease in seizure duration. However, propofol was associated with improved hemodynamic stability and an earlier return of cognitive function after ECT.

Anesthesia↗

PubMed1994

[Alternative one lung ventilation anesthesia for bilateral thoracoscopic sympathectomy].

Palmar hyperhidrosis (PH) is a common disorder in the oriental subtropical area. There have been many therapeutic methods, such as: oral medication, local treatment and traditional surgical operation, but none of them has proved entirely satisfactory. Since the development of video endoscopic surgery, transthoracic endoscopic sympathectomy has been increasing day by day. This study consisted of 124 PH patients under alternative one lung ventilation anesthesia for bilateral thoracoscopic laser sympathectomy. The age of patients ranged from 13 to 64 years, male 45 and female 79. The average anesthesia duration was 60 min. We used glycopyrrolate 0.03 mg/kg, decardon 1 mg/10 kg for premedication. Induction was with fentanyl 0.07 ml/kg, atracurium 0.6 mg/kg and thiopental 4 mg/kg. Maintenance was with isoflurane in 3L/min. oxygen inhalation. The alternative one lung ventilation anesthesia was achieved with double-lumen endobronchial tube. Fr 37, Fr 35, Fr 28 Sheridan Lt. double-lumen bronchial tube were used depending upon the sex and fudgement of the individual patient. All patients tolerated the procedure well so that sympathectomy could be performed smoothly and uneventfully. Immediately after the operation, a transient mild to moderate degree of difficult breathing and substernal discomfort were experienced in the majority of patients. These suffering often relieved spontaneously or with some common analgesic.

Adolescent↗

PubMed1993

Effect of preanesthetic medication on ease of endoscopic intubation of the duodenum in anesthetized dogs.

The effects of preanesthetic medication on ease of duodenal endoscopic intubation in dogs was evaluated. One of 12 combinations of preanesthetic medications (using atropine, glycopyrrolate, morphine, meperidine, acepromazine, and 0.9% NaCl solution) was administered IM to each of 12 dogs in a trial. Twelve endoscopic trials were performed so that each dog received each treatment combination once. Anesthesia was induced with thiamylal administered IV and maintained with halothane vaporized in oxygen. Electrocardiographic recordings, indirect blood pressure measurements, end-tidal carbon dioxide partial pressures, and halothane concentrations were monitored during the anesthetic period. The ease with which the fiberoptic endoscope was passed into the proximal portion of the duodenum was qualitatively score on the basis of time and maneuvering effort. None of the preanesthetic combinations made intubation of the duodenum significantly easier than that with 0.9% NaCl solution (control). Only the combination of morphine and atropine induced gastro-pyloric conditions that resulted in significantly higher (more difficult) endoscopic scores than those after preanesthetic medication with 0.9% NaCl solution.

Animals↗

PubMed1993

Double-blind placebo-controlled ultrasonographic confirmation of constriction of the common bile duct by morphine.

Although the increase in the common bile duct pressure in response to morphine has been repeatedly reported in experimental animals and humans, this is the first double-blind non-invasive, ultrasonographic study designed to demonstrate constriction of the common bile duct caused by i.v. administration of morphine in surgical patients. In a double-blind, placebo-controlled, randomized study, 12 patients undergoing open cholecystectomy were enrolled. No opioids were allowed for 12 hours prior to the study. After premedication with midazolam and glycopyrrolate, anesthesia was induced by midazolam, 50 micrograms/kg-1 and thiopental, 3.0-5.0 mg/kg-1. Tracheal intubation was facilitated by succinylcholine, 1.0 mg/kg-1 and muscle relaxation was maintained with vecuronium. Anesthesia was maintained with enflurane and nitrous oxide in oxygen. After imaging the common bile duct by ultrasonography, placebo or morphine, 0.2 mg/kg-1 was injected intravenously. The diameter of the common bile duct was measured before and 4 and 8 minutes after the drug. Student t-test was utilized for statistical analysis. P < 0.05 was considered significant. No significant change in common bile duct diameter was observed after placebo administration. Morphine caused a significant reduction in the diameter of the common bile duct. Before morphine, the mean +/- SD diameter was 9.5 +/- 3.3 mm; after morphine at 4 and 8 minutes, 7.2 +/- 2.1 and 5.8 +/- 2.1 mm, respectively. It is concluded that ultrasonography in a double-blind placebo-controlled design has proven to be a valid method for the evaluation of the effect of drugs on the common bile duct.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1993

Double-blind comparison of butorphanol and nalbuphine on the common bile duct by ultrasonography in man.

Butorphanol and nalbuphine, narcotic agonist-antagonists were shown to cause no increase in biliary pressure in contrast to morphine in dogs or men. A non-invasive, ultrasonographic technique confirmed that morphine caused constriction of the common bile duct while placebo caused no effect. To prove the lack of constrictive effect of butorphanol and nalbuphine on the common bile duct, the changes in its diameter were measured following placebo or the two agonist-antagonists by ultrasonography. In a double-blind, randomized study, 17 patients undergoing open cholecystectomy were evaluated. No morphine or opioids were allowed for 12 hours prior to the study. After premedication with midazolam and glycopyrrolate, anesthesia was induced by midazolam, 50 micrograms.kg-1 and thiopental, 3.0-5.0 mg.kg-1. Tracheal intubation was facilitated by succinylcholine 1.0 mg.kg-1 and muscle relaxation was maintained with vecuronium. Anesthesia was maintained with isoflurane or enflurane and nitrous oxide in oxygen. After imaging the common bile duct by ultrasonography, placebo, nalbuphine 0.3 mg.kg-1 or butorphanol 40 micrograms.kg-1 were injected intravenously. The diameter of the common bile duct was measured before and at 4 and 8 minutes after drug administration. One-way analysis of variance and paired t-test were utilized for statistical analysis. P < 0.05 was considered significant. No significant changes in the common bile duct diameter was observed after placebo administration, nor was any change observed after either nalbuphine or butorphanol as compared to the baseline. The comparison of three groups of patients showed no statistically significant difference.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1995

[Sedation and anesthesia in dogs and cats with cardiovascular disease. II. Anesthesia planning with respect to pathophysiology, heart arrhythmia].

The purpose of this study was to review the incidence of cardiac arrhythmias in 137 anesthetized dogs and 13 anesthetized cats with congenital or acquired heart disease that were referred for correction of following procedures: patent ductus arteriosus (PDA-ligation, 28%), cardiac catheterization with angiogram and angioplasty (22%), pacemaker implantation (18%), exploratory lateral thoracotomy (8.7%), correction of right aortic arch (ring anomaly, 3.3%), correction of subvalvular aortic stenosis (2.7%), correction of PDA with coil in patients with mitral regurgitation and congestive heart failure (2%), pericardectomy and removal of heart base tumor (2%), and palliative surgery for ventricular septal defect (VSD, 0.7%). The anesthetic plan considered the risks of anesthesia based upon the pathophysiology of cardiac lesions and the anesthetic drug effects on the cardiovascular system. Recommendations are made for dogs with decreased cardiac contractility, cardiac disease with volume overload, cardiac disease with pressure overload, and pericardial tamponade. The percentages of animals and their associated cardiac arrhythmias after premedication and during and after anesthesia were: sinus bradycardia (15.3%), sinus tachycardia (3.3%), atrial flutter (0.7%), atrial fibrillation (0.7%), premature ventricular contraction (14%), and ventricular tachycardia (1.3%). Prompt therapy was given to a percentage of animals in order to control arrhythmia and support cardiovascular system, by using atropine or glycopyrrolate (14%), lidocaine (17.3%), and dopamine (14.7%).(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia↗

PubMed1996

Hyperkalemic periodic paralysis episode during halothane anesthesia in a horse.

A 7-month-old Quarter Horse filly was admitted for surgical repair of a right olecranon fracture. Anesthesia was achieved with xylazine hydrochloride, guaifenesin, ketamine hydrochloride, and halothane. Two and a half hours after induction of anesthesia, myotonia, muscle fasciculations, and sweating, concurrent with high serum potassium concentration and associated electrocardiographic changes consistent with hyperkalemic periodic paralysis, were observed. Treatment included intermittent positive-pressure ventilation, changing intravenous administration of fluids from lactated Ringer's solution to 0.9% NaCl solution, and administration of calcium gluconate, glycopyrrolate, dopamine, and sodium bicarbonate. Clinical signs resolved with the return of serum potassium concentrations to the reference range. The horse was confirmed to be heterozygous for hyperkalemic periodic paralysis by DNA testing.

Anesthesia, General↗

PubMed1996

Determination of the lifespan of erythrocytes from greyhounds, using an in vitro biotinylation technique.

OBJECTIVE: To determine the RBC lifespan of Greyhounds, using an in vitro labeling technique. DESIGN: RBC from dogs were labeled with NHS-biotin and their disappearance measured over time to determine RBC lifespan. SAMPLE POPULATION: 5 Greyhounds that had been vaccinated against distemper, adenovirus 1 and 2 infections, parainfluenza, leptospirosis, parvovirus, and coronavirus infections, Bordetella bronchiseptica infection, and rabies the previous year; 3 sexually intact 14-month-old Beagles served as controls. PROCEDURE: After venipuncture for CBC, catheters were inserted in the cephalic vein of each dog. Butorphanol was then administered to achieve mild sedation and analgesia, and glycopyrrolate was administered to ensure maintenance of adequate heart rate during phlebotomy. Dogs were positioned in lateral recumbency; blood was removed via jugular venipuncture, using a standard laboratory donor blood bag containing citrate-phosphate-dextrose solution. Blood was transferred aseptically into sterile polystyrene containers and NHS-biotin was added. After incubation, the labeled RBC were reinfused into the dogs and the blood was allowed to recirculate for 1 hour before the first postinfusion sample was taken. At frequent intervals, blood to be analyzed was taken by jugular venipuncture, and the percentage of labeled cells was determined by flow cytometry. RESULTS: The mean RBC lifespan of non-Greyhounds was significantly longer than that of Greyhounds (104.3 +/- 2.2 days vs 53.6 +/- 6.5 days; P = 0.001). A negative linear correlation was also found between age of the Greyhounds and their RBC lifespan (P = 0.01, R2 = 0.91). CONCLUSIONS: The shorter RBC lifespan of the Greyhounds may explain the finding of macrocytosis reported in earlier work. The reason for the shorter RBC lifespan in Greyhounds may be caused by differences in Greyhound RBC membrane structure or accelerated RBC removal from the circulation.

Animals↗

PubMed1996

Ability of flumazenil, butorphanol, and naloxone to reverse the anesthetic effects of oxymorphone-diazepam in dogs.

OBJECTIVE: To evaluate the ability of flumazenil (FLU), butorphanol (BUT), and naloxone (NAL) to reverse the anesthetic effects of oxymorphone-diazepam in dogs. ANIMALS: 6 healthy adult mixed-bread dogs. PROCEDURE: Dogs were randomly assigned to each of 6 reversal treatment groups. In each experiment, oxymorphone (0.22 mg/kg of body weight, i.v.) and diazepam (0.22 mg/kg. i.v.) were given sequentially 15 minutes after glycopyrrolate (0.01 mg/kg, i.v.) administration. Physiologic saline solution (SAL; 1 ml), FLU (0.01 mg/kg), BUT (0.44 mg/kg), or NAL (0.06 mg/kg) alone, or FLU-BUT or FLU-NAL (same dosages) was given i.v. as a reversal treatment 15 minutes after oxymorphone-diazepam administration. An individual unaware of the treatment protocol recorded time to extubation, sternal recumbency, and walking. RESULTS: Time to extubation was significantly (P < 0.05) less with BUT, NAL, FLU-BUT, or FLU-NAL treatment, compared with that for SAL treatment. Time to sternal recumbency was less with BUT, NAL, FLU-BUT, or FLU-NAL treatment, compared with that for SAL treatment. Time to walking was less with FLU-BUT or FLU-NAL treatment, compared with that for SAL treatment. CLINICAL IMPLICATIONS: Flumazenil, in combination with BUT or NAL, can be used to reverse the anesthetic effects of oxymorphone-diazepam in dogs.

Adjuvants, Anesthesia↗

PubMed1996

Mechanism of epinephrine-induced dysrhythmias in rat involves local cholinergic activation.

Alterations of autonomic tone can induce cardiac dysrhythmias. In the present experiments intravenous administration of epinephrine (15 micrograms/kg) caused dysrhythmias in rat hearts. Bilateral vagotomy or yohimbine treatment did not suppress the dysrhythmic effects of epinephrine. Atropine, glycopyrrolate, and pertussis toxin reduced the number of premature ventricular contractions and eliminated missed beats caused by epinephrine. Neostigmine increased the number of missed beats but did not change the number of premature ventricular contractions. These results indicate that epinephrine induces cardiac dysrhythmias in part by local release of acetylcholine. Muscarinic receptors and pertussis toxin sensitive G proteins are involved in epinephrine-induced arrhythmogenesis.

Animals↗