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At least 19 recordsLinked to original sources
PubMed1977

[Epidural anesthesia: indications and limitations (author's transl)].

The effectiveness and indications for epidural anesthesia have progressed in the last two decades. Better techniques, new long-acting local anesthetics, and better understanding of pathophysiologic changes after epidural block made this technique widely used and rather safe. Nowadays, limitations of epidural block include the absolute and relative contraindications, the lack of pharmacologic and pathophysiologic knowledge, and insufficient techniques and equipment. In experienced hands, epidural block is one of the safest techniques for surgical anesthesia.

Anesthesia, Epidural↗
PubMed1991

[Temporary pacing in connection with anesthesia. Indications and methods].

The indications for permanent pacing are, by and large, established. Considerable uncertainty still exists about when temporary pacing should be initiated not least in connection with anaesthesia and surgery. The indications for temporary pacemaker treatment are reviewed and, in addition, the two methods of temporary pacemaker treatment are discussed, viz the transvenous and the transcutaneous method.

Anesthesia, General↗
PubMed1990

[Is epidural buprenorphine with nitrous oxide-oxygen-enflurane anesthesia indicated for surgery of short-duration?].

The effects of duration of surgeries on epidural buprenorphine (Bn) with nitrous oxide-oxygen enflurane anesthesia were examined. The subjects were 64 patients who underwent upper abdominal surgery. The patients were divided into two groups in terms of the time required for surgery: i.e., group I (surgery of short duration, n = 18) and group II (surgery of long duration, n = 46). They were given 0.2 mg epidural Bn just before induction and then general anesthesia with nitrous oxide-oxygen-enflurane was performed. The patients were rated with intraoperative anesthetic dosage, time required for arousing from anesthesia, postoperative respiratory depression and postoperative analgesia. There was no significant difference between groups I and II with regard to the dose of Bn, maximum concentration of inhaled enflurane and time required for arousal from anesthesia. There were, however, significant differences in postoperative respiratory state between the two groups. The mean tidal volume was 307.6 ml in group I, which is lower than the corresponding value, 429.5 ml in group II (P less than 0.01), and PaCO2 was higher in group I (mean 44.9 mmHg) than in group II (42.3 mmHg) (P less than 0.05). Although no difference was found in the time from Bn administration to the first analgesic supplement between the two groups, the postoperative analgesic time was longer in group I than in group II (P less than 0.05). From these results we conclude that considerable care should be taken for surgery of short duration under epidural buprenorphine with nitrous oxide-oxygen-enflurane anesthesia.

Abdomen↗
PubMed1977

[Regional anesthesia today--possibilities and limits: introduction (author's transl)].

The various procedures of regional anesthesia were widely used before the introduction of intratracheal anesthesia; thereafter, it was replaced by the today commonly used general anesthesia. Regional anesthesia nonetheless plays an important role, primarily in outpatient treatment, because a large number of surgical departments still have no anesthesiologist on the staff. Often the surgeon is responsible for both the operation and the anesthesia. Indications, risks, and complications including legal problems related to regional anesthesia are discussed.

Anesthesia, Conduction↗
PubMed1986

Osmosensitive vagal receptors in the small intestine of the cat.

In anesthetized cats, the unitary activity of 66 sensory vagal neurones was recorded with extracellular glass microelectrodes implanted in the nodose ganglia. These neurones had non-medullated afferent fibres with conduction velocities between 0.8 and 1.2 m/s, as do most of the intestinal vagal fibres, and were silent or fired at low frequencies before any simulation. They were activated by perfusion of the small intestine (duodenum and first part of jejunum) with tap water and various solutions (glucose, NaCl and mannitol, in particular) having osmotic pressures ranged between 4 and 1100 mOsm. In general, hypotonic solutions and tap water induced the more marked responses, but differences were observed according to the solution used. Most of these neurones were also excited by other forms of stimulation including stroking of the mucosa and perfusion with warm (39-55 degrees C) and acid (HCl at pH 1) solutions. Therefore they must be considered to be polymodal receptors sensitive to osmotic pressure. The short latency of responses elicited by osmotic stimulations, the marked sensitivity to mucosal stroking and the disappearance of nervous activity after local anesthesia indicate that these receptors are located close to the epithelium. The role of these osmosensitive endings is discussed. Analysis of their general characteristics suggests that they may be involved in the inhibitory entero-gastric reflex modulating gastric emptying.

Action Potentials↗
PubMedDate not supplied

Effects of chloral hydrate, pentobarbital, ketamine, and curare on the auditory middle latency response.

Changes in threshold, latency, and amplitude of the auditory middle latency response (MLR) with anesthesia and neuromuscular paralysis were studied in guinea pigs. Although each component of the surface-recorded MLR was altered by barbiturate and nonbarbiturate agents, the early positive wave (wave A) was always present, and the later waves were generally identifiable at moderate levels of anesthesia. MLR threshold was not affected by anesthesia or curare. Pentobarbital, chloral hydrate, and ketamine each caused an increase in the latency of all MLR components, with increases progressively marked for later waves. Amplitude changes were more complex. Wave A increased in amplitude with anesthesia, while wave C decreased or disappeared temporarily. Wave B showed mixed amplitude changes. Changes in MLR associated with anesthesia were generally more pronounced at a stimulation rate of 10/sec as compared to 4/sec. No changes in waveform morphology or latency were seen with neuromuscular paralysis. The results provide evidence in support of separate neurogenic substrates for the different components of the guinea pig temporal lobe MLR. The presence of the MLR with moderate levels of anesthesia indicates that this animal is an appropriate model for studying the MLR in experiments requiring anesthesia and immobilization.

Animals↗
PubMed1975

Systemic and regional blood-flow changes during spinal anesthesia in the rhesus monkey.

The radioactive microsphere technique was used to determine the distribution of cardiac output and regional blood flow in rhesus monkeys before and 10,20,40, and 80 minutes after induction of spinal anesthesia. Five monkeys were studied during low spinal anesthesia (sensory level T10) and five other monkeys were studied during high spinal anesthesia (sensory level T1). Each monkey served as its own control. There was no significant change in regional blood flow during T10 spinal anesthesia. During T1 spinal anesthesia, blood flow (per 100 g of tissue) to kidneys was significantly reduced at 20, 40, and 80 minutes, blood flows to liver and carcass were significantly reduced at 20 and 40 minutes and blood flows to miscellaneous organs (lymph nodes, salivary glands, etc.) were significantly reduced throughout anesthesia. Blood flows to heart, brain, and lower extremity during T1 spinal anesthesia showed only non-significant changes. Vascular resistance in the lower extremity was significantly reduced during both levels of spinal anesthesia, indicating arteriolar dilatation. Also, during both levels of anesthesia, the lungs received an increased proportion of the radioactive microspheres, suggesting increased peripheral arteriovenous shunting of microspheres due to the arteriolar dilatation.

Anesthesia, Spinal↗
PubMed1976

Systemic and regional blood flow during epidural anesthesia without epinephrine in the rhesus monkey.

The radioactive-microsphere technique was used to determine distribution of cardiac output and regional blood flow in rhesus monkeys before and 10, 20, 40, and 80 minutes after induction of epidural anesthesia with lidocaine (1 per cent) without epinephrine. Four monkeys were studied during low epidural anesthesia (sensory level T10) and five other monkeys were studied during high epidural anesthesia (sensory level T1). During T10 epidural anesthesia. During T1 epidural anesthesia, blood flow (per 100 g tissue) to the lower extremity was significantly increased 10 minutes after induction of anesthesia. There was no other significant change in regional blood flow during T10 epidural anesthesia. During T1 epidural anesthesia, blood flow to the heart was significantly reduced at 10 minutes, blood flow to the liver was significantly reduced at 10 and 40 minutes, blood flows to kidneys and miscellaneous organs (lymph nodes, salivary glands, etc.) were significantly reduced at 10, 20, and 40 minutes, and blood flow to the brain was significantly reduced throughout anesthesia. Vascular resistance in the lower extremity was reduced in each monkey following epidural anesthesia, indicating arteriolar dilatation. Also, during both levels of anesthesia, the lungs received an increased proportion of the microspheres, suggesting an increased periopheral arteriovenous shunting of microspheres due to the arteriolar dilatation.

Anesthesia, Epidural↗
PubMed1985

Intestinal circulation during inhalation anesthesia.

This study was designed to evaluate the influence of inhalational agents on the intestinal circulation in an isolated loop preparation. Sixty dogs were studied, using three intestinal segments from each dog. Selected intestinal segments were pumped with aortic blood at a constant pressure of 100 mmHg. A mixture of 86Rb and 9-microns spheres labeled with 141Ce was injected into the arterial cannula supplying the intestinal loop, while mesenteric venous blood was collected for activity counting. A very strong and significant correlation was found between rubidium clearance and microsphere entrapment (r = 0.97, P less than 0.0001), suggesting that the shunting of 9-microns spheres through the intestines reflects the arteriovenous shunting of blood. Nitrous oxide anesthesia was accompanied by a higher vascular resistance (VR), lower flow (F), rubidium clearance (Cl-Rb), and microspheres entrapment (Cl-Sph) than pentobarbital anesthesia, indicating that the vascular bed in the intestinal segment was constricted and flow (total and nutritive) decreased. Halothane, enflurane, and isoflurane anesthesia were accompanied by a much lower arteriovenous oxygen content difference (AVDO2) and oxygen uptake than pentobarbital or nitrous oxide. Compared with pentobarbital, enflurane anesthesia was not accompanied by marked differences in VR, F, Cl-Rb, and Cl-Sph; halothane at 2 MAC decreased VR and increased F and Cl-Rb while isoflurane increased VR and decreased F. alpha-Adrenoceptor blockade with phentolamine (1 mg . kg-1) abolished isoflurane-induced vasoconstriction, suggesting that the increase in VR was mediated via circulating catecholamines.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia, Inhalation↗
PubMed1992

Spectral analysis of heart rate variability during isoflurane anesthesia.

The autonomic nervous system is an important neural control system for maintaining cardiovascular stability in humans. Analysis of heart rate variations may provide important clinical information on the influence of anesthesia on the autonomic nervous system and the central nervous system. Therefore, the effects of 1.0, 1.5, and 2.0 minimum alveolar concentrations of isoflurane anesthesia on beat-to-beat heart rate variations were studied in ten patients (ASA Physical Status 1). Spectral analysis was used to determine the intensity of the variations. For each power spectrum, the frequency components were identified as follows: 1) the parasympathetically mediated respiratory component (0.15-0.4 Hz) and 2) both parasympathetically and sympathetically mediated components (0.04-0.15 Hz). The latter was subdivided into the low-frequency component (0.04-0.09 Hz) of vasomotor origin and the mid-frequency component (0.09-0.15 Hz) of baroreceptor origin. Marked reductions in the power of heart rate variations, at all frequencies, were found during isoflurane anesthesia, indicating isoflurane decreased total autonomic nervous system activity. Isoflurane decreased the high-frequency and mid-frequency components in a concentration-dependent manner. The low-frequency component increased transiently at 1.5 minimum alveolar concentrations concomitant with the burst suppression in the electroencephalogram. The ratio of mid-frequency to high-frequency components did not change significantly during isoflurane anesthesia compared with the awake period. These frequency characteristics of heart rate variations during isoflurane anesthesia suggest there are dose-related decreases in autonomic nervous system activity in both the vagus and the cardiac sympathetic nerves.

Adult↗
PubMed1976

Relative hypoxemia during rhytidoplasty.

The results of blood gas analyses in 24 patients who had a rhytidoplasty under local anesthesia indicated that a moderate degree of hypoxemia can be elicited in these patients when they have had standard doses of the usual sedatives. While the acid-base abnormalities were generally corrected spontaneously, the extent of the hypoxemia can be aggravated further by the additional use of diazepam during the operation. Therefore, over-sedation of such a patient during the operation, without a secured airway, must be avoided. Additionally, we recommend deep breathing at frequent intervals, with or without supplemental oxygen through a high flow system.

Adult↗
PubMed1988

Nerve root infiltration in the diagnosis of radicular pain.

Clinical and standard radiographic evaluation of patients with lumbosacral radicular symptoms may, on occasion, fail to delineate a cause. This study retrospectively reviews 62 patients who had undergone nerve root infiltration (NRI) and assesses the accuracy and indications for this diagnostic study. Surgical exploration of patients with a Group 1 response (typical pain reproduced by needle placement and then relieved by NRI) confirmed local root pathology in all. Exclusive of patients with arachnoiditis, a Group 1 response showed 85% accuracy in identifying a single symptomatic root. A Group 2 response (typical pain reproduced by needle placement but not relieved by local anesthesia) indicated multiple root involvement. Patients with a Group 3 or Group 4 response (typical pain not reproduced by needle insertion, with or without relief of pain by local anesthesia) were seldom relieved of radicular pain. NRI was most useful in investigation of patients with radicular symptoms in whom other investigations were 1) normal, 2) showed multiple level involvement, or 3) were difficult to interpret because of previous surgery.

Back Pain↗
PubMed1977

Systemic and regional blood flow during epidural anesthesia with epinephrine in the Rhesus monkey.

Hemodynamic and regional blood flow measurements were made in five rhesus monkeys before and 10, 20, 40 and 80 min after induction of high epidural anesthesia (T1) with lidocaine (1%) containing 1:200,000 epinephrine. Following induction of epidural anesthesia with epinephrine, there were significant decreases in heart rate, mean arterial pressure, cardiac output and myocardial and renal blood flow. The percentage of cardiac output received by the brain was significanly increased following epidural anesthesia with epinephrine, thus evidencing autoregulation to maintain cerebral blood flow. Vascular resistance in the lower extremity was significantly decreased during anesthesia, indicating arteriolar dilatation. Also, during anesthesia, the lungs received a significantly increased proportion of the microspheres, suggesting an increased peripheral arteriovenous shunting of microspheres due to the arteriolar dilatation.

Adjuvants, Anesthesia↗
PubMed1988

Cardiac arrhythmias during arousal from hibernation in three species of rodents.

Cardiac activity was monitored during arousal from deep hibernation in three species of hibernators (Citellus tridecemlineatus, Marmota monax, and Mesocricetus auratus). Individuals of each species showed marked arrhythmias, and these were confined to a body temperature range of between 11 and 20 degrees C, measured orally or rectally. The arrhythmias consisted of intermittent periods of asystole and bradycardia and were sometimes marked by the appearance of premature ventricular contractions and elevated or depressed S-T segments. Surgical manipulation of euthermic M. monax, under pentobarbital sodium anesthesia, indicated that none of the arrhythmias observed was inducible by injections of cold saline into the vena cava.

Animals↗
PubMedDate not supplied

Cardiovascular effects of atropine sulfate preparations in vagotomized dogs under halothane anesthesia.

The cardiovascular effects of 3 preparations of atropine sulfate were studied acutely in open-chest, vagotomized dogs under endotracheal halothane anesthesia. Indices of myocardial performance (LVdp/dt/CPIP and maximum ascending aortic blood acceleration) showed insignificant changes when varying doses of IV atropine (0.04 mg/kg and 0.04 mg/kg) were given. However, mean ascending aortic pressure fell by 20 percent following the larger doses of 2 commercial preparations containing antibacterial preservatives, and only 9 percent following a "pure" (USP) atropine preparation. Calculated changes in systemic vascular resistance closely followed actual pressure values. These results indicate that atropine, even in large doses, causes little or no depression of ventricular function independently of its chronotropic action. However, atropine does cause a fall in blood pressure, seemingly due to peripheral vasodilation, particularly in commercial preparations containing preservatives.

Anesthesia, Endotracheal↗
PubMed1991

Treatment of periodontal defects with an absorbable membrane (polyglactin 910) with and without osseous grafting: case reports.

The purpose of these reports is to illustrate the possible use of polyglactin 910 as an absorbable membrane for periodontal healing. Eleven surgical sites in 10 patients are reported. Vicryl mesh was used on all sites, and osseous allograft material was used in 8 of these sites. Radiographic evaluation and sounding with anesthesia indicate improvement in the treated areas. Few adverse effects were seen at the treated sites. Therefore, polyglactin offers promise as a material for use in periodontal therapy, especially in deep infrabony pockets. Further controlled studies comparing polyglactin 910 and other resorbable materials as barrier membranes are needed to establish their safety and efficacy.

Adult↗
PubMed1987

Effect of clot removal at 24 hours on chronic vasospasm after SAH in the primate model.

The efficacy of complete clot removal 24 hours after subarachnoid hemorrhage (SAH) in the prevention of chronic cerebral vasospasm was evaluated in monkeys in a blind randomized controlled trial. Twenty-four monkeys were randomized to one of three groups to undergo sham-operation (sham-operated group), clot placement only (clot group), or clot placement and removal (clot-removal group). By means of standard microsurgical techniques, the major cerebral vessels bilaterally were dissected free of arachnoid. An autologous hematoma averaging 5 gm was placed around the vessels in the subarachnoid spaces in the clot and clot-removal groups. Saline solution was instilled in the subarachnoid spaces of the sham-operated group. All animals underwent reoperation 24 hours after the first procedure. In the clot-removal group, the hematoma was evacuated. In the sham-operated and clot groups, the incision was simply closed again after 3 hours of anesthesia. Indices monitored before and 7 days after SAH induction included neurological status, angiographic cerebral vessel caliber, and arterial blood pressure. All animals were evaluated with magnetic resonance imaging (MRI); representative animals were evaluated with computerized tomography (CT) brain scans. There were no neurological deficits in either the sham-operated or the clot-removal groups. One animal in the clot group developed a progressive delayed ischemic deficit on Day 5 after SAH. A second animal in this group died suddenly on Day 4 post-SAH. An autopsy revealed a recent infarct in the territory of the superior cerebellar artery. Clinical findings correlated with MRI and CT images. Significant vasospasm (25% to 100% reduction in vessel caliber) was present on Day 7 in 100% of the clot animals (p less than 0.01). There was no significant vasospasm (p greater than 0.05) on Day 7 in either the sham-operated or the clot-removal groups. A large volume of clot placed bilaterally resulted in a 25% incidence of delayed ischemic deficit. Evacuation of subarachnoid hematoma within 24 hours of SAH prevented the development of chronic vasospasm and delayed ischemic deficit in the primate model.

Animals↗