WorldWideScience

Sample records for anaesthetics

  1. Alleged allergy to local anaesthetics.

    Science.gov (United States)

    Fisher, M M; Bowey, C J

    1997-12-01

    The aim of this study was to determine the incidence of true local anaesthetic allergy in patients with an alleged history of local anaesthetic allergy and whether subsequent exposure to local anaesthetics is safe. Two hundred and eight patients with a history of allergy to local anaesthesia were referred over a twenty-year period to our Anaesthetic Allergy Clinic. In this open study, intradermal testing was performed in three patients and progressive challenge in 202 patients. Four patients had immediate allergy and four patients delayed allergic reactions. One hundred and ninety-seven patients were not allergic to local anaesthetics. In 39 patients an adverse response to additives in local anaesthetic solutions could not be excluded. In all but one patient local anaesthesia has been given uneventfully subsequently. A history of allergy to local anaesthesia is unlikely to be genuine and local anaesthetic allergy is rare. In most instances LA allergy can be excluded from the history and the safety of LA verified by progressive challenge.

  2. Adverse responses to local anaesthetics.

    Science.gov (United States)

    Fisher, M M; Graham, R

    1984-11-01

    Progressive challenge was used to investigate twenty-seven patients with a history of an adverse response to local anaesthesia. True allergy was detected in only one patient. The method does not exclude reactions to additives and preservatives in local anaesthetics. If preservative-free local anaesthetics are used for subsequent exposure in patients with no response to progressive challenge, subsequent exposure is safe. The possibility that some of these patients may be reacting to preservatives in the solutions cannot be excluded by such testing. Where possible preservative-free local anaesthetic preparations should be used for subsequent anaesthesia.

  3. Lateral Thoracic Maningocele : Anaesthetic Implications

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    Nazeer Ahmed K

    2008-12-01

    Full Text Available Meningomyelocele is a broad term representing herniation of extracranial contents through a congenital defect in the vertebral column. If only cerebrospinal fluid (CSF and meninges herniate, it is termed as a meningocele. A meningoencephalocele is herniation of neural elements along with meninges. Anaesthetic challenges in management of thoracic meningomyelocele include securing the airway with intubation in lateral or supine position, intraoperative prone position with its associated complications and accurate assessment of blood loss and prevention of hypothermia. We report a case of a thoracic meningocele posted for resection and discuss its anaesthetic implications

  4. Inhalation anaesthetics and climate change

    DEFF Research Database (Denmark)

    Andersen, Mads Peter Sulbæk; Sander, S P; Nielsen, O J

    2010-01-01

    Although the increasing abundance of CO(2) in our atmosphere is the main driver of the observed climate change, it is the cumulative effect of all forcing agents that dictate the direction and magnitude of the change, and many smaller contributors are also at play. Isoflurane, desflurane......, and sevoflurane are widely used inhalation anaesthetics. Emissions of these compounds contribute to radiative forcing of climate change. To quantitatively assess the impact of the anaesthetics on the forcing of climate, detailed information on their properties of heat (infrared, IR) absorption and atmospheric...

  5. New Zealand's first general anaesthetic.

    Science.gov (United States)

    Newson, A J

    1975-08-01

    The administration of New Zealand's first general anaesthetic took place at the Colonial Gaol, Wellington, on the morning of Monday, September 27th, 1847. The agent used was sulphuric ether which was administered by Mr. Marriot, the manufacturer of the Herapath-type inhaler used on this occasion. The operation, a dental extraction, was performed by the Colonial Surgeon, Dr. J. P. Fitzgerald.

  6. [Pharmaceutical chemistry of general anaesthetics].

    Science.gov (United States)

    Szász, György; Takácsné, Novák Krisztina

    2004-01-01

    The paper represents the first part of a planned series of reviews about pharmaceutical chemistry of drugs acting on the central nervous system. The authorial aim and editorial concepts are the same were followed in a former series of papers about pharmaceutical chemistry of agents effecting the heart, blood circulation and vegetative nervous system. Consequently, general anaesthetics are discussed in the present paper through the chapters "history, preparation; structure-properties-activity; application; analysis".

  7. Analysis of cricoid pressure application: anaesthetic trainee doctors vs. nursing anaesthetic assistants

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    Nurul Haizam Yahaya

    2016-06-01

    Full Text Available ABSTRACT BACKGROUND AND OBJECTIVE: To evaluate the ability of anaesthetic trainee doctors compared to nursing anaesthetic assistants in identifying the cricoid cartilage, applying the appropriate cricoid pressure and producing an adequate laryngeal inlet view. METHODS: Eighty-five participants, 42 anaesthetic trainee doctors and 43 nursing anaesthetic assistants, were asked to complete a set of questionnaires which included the correct amount of force to be applied to the cricoid cartilage. They were then asked to identify the cricoid cartilage and apply the cricoid pressure on an upper airway manikin placed on a weighing scale, and the pressure was recorded. Subsequently they applied cricoid pressure on actual anaesthetized patients following rapid sequence induction. Details regarding the cricoid pressure application and the Cormack-Lehane classification of the laryngeal view were recorded. RESULTS: The anaesthetic trainee doctors were significantly better than the nursing anaesthetic assistants in identifying the cricoid cartilage (95.2% vs. 55.8%, p = 0.001. However, both groups were equally poor in the knowledge about the amount of cricoid pressure force required (11.9% vs. 9.3% respectively and in the correct application of cricoid pressure (16.7% vs. 20.9% respectively. The three-finger technique was performed by 85.7% of the anaesthetic trainee doctors and 65.1% of the nursing anaesthetic assistants (p = 0.03. There were no significant differences in the Cormack-Lehane view between both groups. CONCLUSION: The anaesthetic trainee doctors were better than the nursing anaesthetic assistants in cricoid cartilage identification but both groups were equally poor in their knowledge and application of cricoid pressure.

  8. Pre-anaesthetic screening of geriatric dogs

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    K.E. Joubert

    2007-05-01

    Full Text Available Pre-anaesthetic screening has been advocated as a valuable tool for improving anaesthetic safety and determining anaesthetic risk. This study was done determine whether pre-anaesthetic screening result in cancellation of anaesthesia and the diagnosis of new clinical conditions in geriatric dogs. One hundred and one dogs older than 7 years of age provided informed owner consent were included in the study. Each dog was weighed, and its temperature, pulse and respiration recorded. An abdominal palpation, examination of the mouth, including capillary refill time and mucous membranes, auscultation, body condition and habitus was performed and assessed. A cephalic catheter was placed and blood drawn for pre-anaesthetic testing. A micro-haematocrit tube was filled and the packed cell volume determined. The blood placed was in a test tube, centrifuged and then analysed on an in-house blood analyser. Alkaline phosphatase, alanine transferase, urea, creatinine, glucose and total protein were determined. A urine sample was then obtained by cystocentesis, catheterisation or free-flow for analysis. The urine specific gravity was determined with a refractometer. A small quantity of urine was then placed on a dip stick. Any new diagnoses made during the pre-anaesthetic screening were recorded. The average age of the dogs was 10.99+2.44 years and the weight was 19.64+15.78 kg. There were 13 dogs with pre-existing medical conditions. A total of 30 new diagnoses were made on the basis of the pre-anaesthetic screening. The most common conditions were neoplasia, chronic kidney disease and Cushing's disease. Of the 30 patients with a new diagnosis, 13 did not undergo anaesthesia as result of the new diagnosis. From this study it can be concluded that screening of geriatric patients is important and that sub-clinical disease could be present in nearly 30 % of these patients. The value of screening before anaesthesia is perhaps more questionable in terms of

  9. [Anaesthetic management of Stiff Man syndrome].

    Science.gov (United States)

    Marín, T; Hernando, D; Kinast, N; Churruca, I; Sabate, S

    2015-04-01

    Stiff Man syndrome or stiff-person syndrome is a rare autoimmune disorder. It is characterized by increased axial muscular tone and limb musculature, and painful spasms triggered by stimulus. The case is presented of a 44-year-old man with stiff-person syndrome undergoing an injection of botulinum toxin in the urethral sphincter under sedation. Before induction, all the surgical team were ready in order to minimise the anaesthetic time. The patient was monitored by continuous ECG, SpO2 and non-invasive blood pressure. He was induced with fractional dose of propofol 150 mg, fentanyl 50 μg and midazolam 1mg. Despite careful titration, the patient had an O2 saturation level of 90%,which was resolved by manual ventilation. There was no muscle rigidity or spasm during the operation. Post-operative recovery was uneventful and the patient was discharged 2 days later. A review of other cases is presented. The anaesthetic concern in patients with stiff-person syndrome is the interaction between the anaesthetic agents, the preoperative medication, and the GABA system. For a safe anaesthetic management, total intravenous anaesthesia is recommended instead of inhalation anaesthetics, as well as the close monitoring of the respiratory function and the application of the electrical nerve stimulator when neuromuscular blockers are used.

  10. Anaesthetic Management of Conjoined Twins′ Separation Surgery

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    Kolli S Chalam

    2009-01-01

    Full Text Available Anaesthesia for conjoined twins, either for separation surgery, or for MRI or other evaluation procedures is an enormous challenge to the paediatric anaesthesiologist. This is an extra challenging surgery because we the anaesthesiologists need to care for two patients at the same time instead of just one. Anaesthesia for conjoined twins ′separation surgery mainly centered on the following concerns: 1.Conjoined Twins′ physiology like crossed circulation. distribution of blood volume and organ sharing with their anaesthetic implications. 2.Long marathon surgery with massive fluid shifts and loss of blood & blood components and their rapid replenishment. 3.Meticulous planning for organized management of long hours of anaesthetic administration in two paediatric subjects simultaneously with multi surgical specialties involvement and their unique requirements.We report the anaesthetic and intensive care management of one pair of Pygopagus separation surgery and also the review of literature and world statistics.

  11. Local anaesthetics and chondrotoxicty: What is the evidence?

    LENUS (Irish Health Repository)

    Baker, Joseph F

    2012-11-01

    Recent reports have suggested that local anaesthetic agents have a toxic effect on articular chondrocytes. This is despite the widespread intra-articular use of local anaesthetic agents following arthroscopic procedures for a number of years.

  12. Periodic Classification of Local Anaesthetics (Procaine Analogues

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    Gloria Castellano

    2006-01-01

    Full Text Available Algorithms for classification are proposed based on criteria (information entropyand its production. The feasibility of replacing a given anaesthetic by similar ones in thecomposition of a complex drug is studied. Some local anaesthetics currently in use areclassified using characteristic chemical properties of different portions of their molecules.Many classification algorithms are based on information entropy. When applying theseprocedures to sets of moderate size, an excessive number of results appear compatible withdata, and this number suffers a combinatorial explosion. However, after the equipartitionconjecture, one has a selection criterion between different variants resulting fromclassification between hierarchical trees. According to this conjecture, for a given charge orduty, the best configuration of a flowsheet is the one in which the entropy production is mostuniformly distributed. Information entropy and principal component analyses agree. Theperiodic law of anaesthetics has not the rank of the laws of physics: (1 the properties ofanaesthetics are not repeated; (2 the order relationships are repeated with exceptions. Theproposed statement is: The relationships that any anaesthetic p has with its neighbour p 1are approximately repeated for each period.

  13. Outpatient laser tonsillar ablation under local anaesthetic.

    Science.gov (United States)

    Andrews, Peter J; Latif, Abdul

    2004-11-01

    Outpatient laser ablation of the palatine tonsils under local anaesthetic is an alternative technique to capsular tonsillectomy for recurrent tonsillitis under general anaesthetic. Laser tonsillotomy ablates up to 70% of the tonsillar tissue and is performed when patients choose not to have a conventional tonsillectomy, or are unfit for a general anaesthetic. The technique described here is an adaptation of Krespis' laser-assisted serial tonsillectomy (LAST) whereby only one sitting is required. Krespis' technique effectively eliminates recurrent tonsillitis in 96% of the cases over a 4-year follow-up period and represents the only substantial study looking at treating recurrent tonsillitis with outpatient laser ablation. This study is a retrospective postal survey of 19 patients who underwent laser tonsillar ablation under local anaesthetic for recurrent chronic tonsillitis from 1997 to 2001 and was performed in liaison with the clinical audit department at Basildon Hospital. We had a response rate of 74% and an admission rate of 0%, which compares favourably with day case tonsillectomy surgery. Of the patients, 75% did not experience further episodes of tonsillitis 12 months after the procedure and 77% of the patients were glad they had the operation. Although this technique does not completely eliminate tonsillitis, it offers an alternative for those patients who prefer a procedure that is done quickly in an outpatient setting without the additional problems of general anaesthesia, overnight hospital admission and long waiting lists.

  14. Do fish perceive anaesthetics as aversive?

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    Gareth D Readman

    Full Text Available This study addresses a fundamental question in fish welfare: are the anaesthetics used for fish aversive? Despite years of routine general use of many agents, within both scientific research and aquaculture, there is a paucity of information regarding their tolerance and associated behavioural responses by fish. This study examined nine of the most commonly used fish anaesthetic agents, and performed preference tests using adult mixed sex zebrafish (Danio rerio, the most commonly held laboratory fish. Video tracking software quantified swimming behaviour related to aversion for each anaesthetic at 50% of its standard recommended dose compared with clean water in a flow-through chemotaxic choice chamber. Results suggest that several commonly used anaesthetics were aversive, including two of the most commonly recommended and used: MS222 (ethyl 3-aminobenzoate methanesulphate and benzocaine. For ethical best practice, it is recommended that compounds that are aversive, even at low concentration, should no longer be used routinely for anaesthesia or indeed the first step of humane euthanasia of adult zebrafish. Two agents were found not to induce aversive behavioural responses: etomidate and 2,2,2 tribromoethanol. For the millions of adult zebrafish used in laboratories and breeding worldwide, etomidate appears best suited for future routine humane use.

  15. Therapeutic coma or neuroprotection by anaesthetics

    NARCIS (Netherlands)

    Mortier, E; Struys, M; Herregods, L

    2000-01-01

    Some surgical patients are at an increased risk for developing cerebral ischaemia. A subset of these patients is believed to benefit from putative cerebroprotective effects of anaesthetic agents. Therefore, in this setting these drugs could have therapeutic modalities, besides their auxiliary functi

  16. ANAESTHETIC MANAGEMENT OF BILATERAL PHEOCHROMOCYTOM A

    OpenAIRE

    Joginder Pal; Veena; Ranjana; Gurmeet Kaur; Anju

    2012-01-01

    A 27 year old female patient with bilateral pheochrom ocytoma presented with hypertension. Confirmation of diagnosis was done by CT scan and raised 24 hour urinary vanillylmandelic acid levels. Preoperative BP was co ntrolled with prazosin, labetolol, indapamide and clonidine. The anaesthetic technique used was general anaesthesia with epidural analgesia.

  17. ANAESTHETIC MANAGEMENT OF BILATERAL PHEOCHROMOCYTOM A

    Directory of Open Access Journals (Sweden)

    Joginder Pal

    2012-11-01

    Full Text Available A 27 year old female patient with bilateral pheochrom ocytoma presented with hypertension. Confirmation of diagnosis was done by CT scan and raised 24 hour urinary vanillylmandelic acid levels. Preoperative BP was co ntrolled with prazosin, labetolol, indapamide and clonidine. The anaesthetic technique used was general anaesthesia with epidural analgesia.

  18. Anaesthetic agents for advanced regional anaesthesia: a North American perspective.

    Science.gov (United States)

    Buckenmaier, Chester C; Bleckner, Lisa L

    2005-01-01

    Interest in the use of regional anaesthesia, particularly peripheral nerve blocks (PNBs) and continuous PNBs, has increased in recent years. Accompanying this resurgence in interest has been the development of new local anaesthetics and additives designed to enhance block duration and quality. This manuscript provides a literature-based review on accepted uses of local anaesthetics and adjuncts for a variety of regional anaesthesia techniques. A brief review of local anaesthetic pharmacodynamics describes the action of these drugs in preventing nerve depolarisation, thus blocking nerve impulses. Toxic adverse effects of local anaesthetics, specifically CNS and cardiac manifestations of excessive local anaesthetic blood concentrations and the direct neurotoxic properties of local anaesthetics, are discussed generally and specifically for many commonly used local anaesthetics. Clinically useful ester and amide local anaesthetics are evaluated individually in terms of their physical properties and toxic potential. How these properties impact on the clinical uses of each local anaesthetic is explored. Particular emphasis is placed on the long-acting local anaesthetic toxic potential of racemic bupivacaine compared with levobupivacaine and ropivacaine, which are both levorotatory stereoisomers. Guidelines for using ropivacaine and mepivacaine, based on the authors' experience using advanced regional anaesthesia in a busy practice, is provided. Finally, epinephrine (adrenaline), clonidine and other local anaesthetic additives and their rationale for use is covered along with other future possibilities.

  19. Inaccurate reporting of simulated critical anaesthetic incidents.

    Science.gov (United States)

    Byrne, A J; Jones, J G

    1997-06-01

    Eleven anaesthetists completed a simulated anaesthetic which was deliberately complicated by a slow progressive bradycardia followed by an episode of severe bronchospasm. After the simulation, each anaesthetist was asked to complete an anaesthetic chart and a critical incident report. Considerable discrepancies were found between the anaesthetists' written accounts, a videotape of their performance and actual data from the simulator. During the simulations, all of the anaesthetists reacted appropriately and treated their "patient" successfully but their written accounts showed a tendency to record "typical" rather than actual events and to ignore events not consistent with their final diagnosis. Only four anaesthetists mentioned bradycardia in their written description and none accurately described the changes in arterial pressure during the episode of bronchospasm. The findings are in keeping with other studies which suggest that people record events as "schemata" rather than as collections of discrete facts. These results have significant implications for those involved in the teaching of anaesthesia and in the analysis of critical incidents.

  20. Tachyphylaxis to local anaesthetics. What is the clinical evidence?

    DEFF Research Database (Denmark)

    Kongsgaard, U E; Werner, M U

    2016-01-01

    : We performed a systematic review of the literature utilising the databases PubMed and Embase employing the search terms [Tachyphylaxis AND Local Anaesthetics AND Human] AND [Tolerance AND Local Anaesthetics AND Human]. RESULTS: A total of 66 records were identified. Thirty-four articles were assessed...

  1. Chirality and anaesthetic drugs: A review and an update.

    Science.gov (United States)

    Mitra, Sukanya; Chopra, Puneet

    2011-11-01

    Many molecules can exist as right-handed and left-handed forms that are non-superimposable mirror images of each other. They are known as enantiomers or substances of opposite shape. Such compounds are also said to be chiral (Greek chiros meaning 'hand'). Such chiral molecules are of great relevance to anaesthetic theory and practice. This review summarizes the basic concepts, pharmacokinetic and pharmacodynamic aspects of chirality, and some specific examples of their application in anaesthesia, along with recent advances to elucidate the anaesthetic mechanisms. Chirality is relevant to anaesthesia, simply because more than half of the synthetic agents used in anaesthesia practice are chiral drugs. Almost all these synthetic chiral drugs are administered as racemic mixture, rather than as single pure enantiomers. These mixtures are not drug formulations containing two or more therapeutic substances, but combination of isomeric substances, with the therapeutic activity residing mainly in one of the enantiomer. The other enantiomer can have undesirable properties, have different therapeutic activities or be pharmacologically inert. Specific examples of application of chirality in anaesthetic drugs include inhalational general anaesthetics (e.g. isoflurane), intravenous anaesthetics (e.g. etomidate, thiopentone), neuromuscular blocking agents (e.g. cisatracurium), local anaesthetics (e.g. ropivacaine and levobupivacaine) and other agents (e.g. levosimendan, dexmedetomidine, L-cysteine). In the recent advances, chirality study has not only helped new drug development as mentioned above, but has also contributed in a more profound way to the understanding of the mechanism of anaesthesia and anaesthetic drugs.

  2. Anaesthetic gardens. On Metaphysics by Lech Majewski

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    Marta Baron

    2010-06-01

    Full Text Available Interpretation of Metaphisics – the novel written by Lech Majewski, is the subject matter of theoretical, aesthetic and antropological considerations. Synthesis of arts: literature, film, painting and theatre, which occur in the novel, opens a perspective of intertextuality and provokes questions about ekphrasis, varied materials, ways of experience mediated by dispositives and reflections on humans among other problems. The crucial point in both: Majewski’s novel and this dissertation, is a triptych painted by Hieronymus Bosch – The Garden of Earthly Delight, which gradually annexes the featured world – becomes a basic figure in trying to show, how the aesthetization of reality brings Wolfgang Welsch’s cahegory of an(aesthetics.

  3. Interactions between diltiazem and inhalation anaesthetics in the isolated heart.

    Science.gov (United States)

    Carceles, M D; Miralles, F S; Laorden, M L; Hernandez, J

    1989-09-01

    It has been postulated that inhalation anaesthetics may interfere with calcium movement across cell membranes. We have evaluated the interaction between diltiazem and the inhalation anaesthetics halothane and isoflurane on sinus automaticity in the isolated right atrium (SAIRA). Isoflurane significantly reduced atrial rate at all concentrations tested. However, halothane produced only a small but significant decrease at the higher concentrations used (1-2 v/v%). Diltiazem modified the maximal negative chronotropic response to inhalation anaesthetics. Maximum depression of SAIRA was significantly greater in the presence of two different doses of diltiazem compared with exposure to halothane and isoflurane alone. These results suggest that inhalation anaesthetics may block the influx of extracellular calcium through voltage-dependent calcium channels inhibited by diltiazem.

  4. Anaesthetic consideration during laparoscopic bilateral simultaneous nephrectomy

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    Manisha P Modi

    2014-01-01

    Full Text Available Study Objective: To assess outcome from anaesthesia during laparoscopic bilateral simultaneous nephrectomy. Design: Retrospective study. Measurements: Preoperative Hb%, serum potassium, coagulation profile electrocardiography (ECG changes, 2D Echography, x-ray chest, haemodynamic changes, end-tidal carbon dioxide (EtCO 2 , fluid management and postoperative analgesia. Results: The mean age was 24.75 ± 14.35 years. The mean duration of surgery was 120 ± 80 minutes. The Hb%, serum creatinine and serum potassium were 9.4 ± 1.04%, 6.79 ± 4.91 meq/L and 3.61 ± 0.51 meq/L, respectively. Pulse rate mean blood pressure and EtCO 2 were recorded after creation of pneumoperitoneum and at 15, 30, 45 and after exsufflation of pneumoperitoneum. After pneumoperitoneum, there was increase in pulse rate, systolic blood pressure, diastolic blood pressure and EtCO 2 . After 30 minutes and throughout the surgery, these variables remained stable. Four patients required nitroglycerine infusion for intraoperative hypertention. Only one patient required packed cell volume (PCV transfusion and total intravenous fluid was 1 ± 0.5 L. At the time of exsufflation, there was decrease in pulse rate, systolic and diastolic blood pressure and EtCO 2 . Conclusion: Because of advancement in anaesthetic agents and muscle relaxant, there is safe outcome from anaesthesia during laparoscopic bilateral simultaneous nephrectomy.

  5. Chirality and anaesthetic drugs: A review and an update

    Directory of Open Access Journals (Sweden)

    Sukanya Mitra

    2011-01-01

    Full Text Available Many molecules can exist as right-handed and left-handed forms that are non-superimposable mirror images of each other. They are known as enantiomers or substances of opposite shape. Such compounds are also said to be chiral (Greek chiros meaning ′hand′. Such chiral molecules are of great relevance to anaesthetic theory and practice. This review summarizes the basic concepts, pharmacokinetic and pharmacodynamic aspects of chirality, and some specific examples of their application in anaesthesia, along with recent advances to elucidate the anaesthetic mechanisms. Chirality is relevant to anaesthesia, simply because more than half of the synthetic agents used in anaesthesia practice are chiral drugs. Almost all these synthetic chiral drugs are administered as racemic mixture, rather than as single pure enantiomers. These mixtures are not drug formulations containing two or more therapeutic substances, but combination of isomeric substances, with the therapeutic activity residing mainly in one of the enantiomer. The other enantiomer can have undesirable properties, have different therapeutic activities or be pharmacologically inert. Specific examples of application of chirality in anaesthetic drugs include inhalational general anaesthetics (e.g. isoflurane, intravenous anaesthetics (e.g. etomidate, thiopentone, neuromuscular blocking agents (e.g. cisatracurium, local anaesthetics (e.g. ropivacaine and levobupivacaine and other agents (e.g. levosimendan, dexmedetomidine, L-cysteine. In the recent advances, chirality study has not only helped new drug development as mentioned above, but has also contributed in a more profound way to the understanding of the mechanism of anaesthesia and anaesthetic drugs.

  6. Anaesthetic related maternal deaths in Malaysia--a review.

    Science.gov (United States)

    Dalina, A M; Inbasegaran, K

    1996-03-01

    The anaesthetic hazards for the obstetric patient are well known. Based on results of the first two reports on the confidential enquiry into maternal deaths in Malaysia for 1991 and 1992, ten cases of anaesthetic related deaths were analysed. There were 3 in 1991 and 7 in 1992 accounting for 1.34% and 2.8% of maternal deaths respectively. It was estimated that the crude mortality rate for the obstetric patient was 11.4 per 100,000 operative deliveries or a four-fold risk compared to the general surgical patient. One case resulted from administration of intravenous sedation while the rest involved general anaesthesia, seven of which were done under emergency conditions. Inadequate airway management and ventilation in the perioperative period, including during interhospital transfer was the single most important factor causing the majority of these deaths. The use of regional anaesthesia for Caesarean sections is strongly advocated. Substandard care was also present in all cases. Other issues pertinent to improvement of obstetric anaesthetic services are also discussed which include the quality of anaesthetic manpower, upgrading of infrastructure, facilities and staffing of operating and recovery areas, the use of regional anaesthesia, expanding the role of the anaesthetist and the quality of the anaesthetic services in general.

  7. Experimental studies of new topical anaesthetics on the oral mucosa.

    Science.gov (United States)

    Holst, A; Evers, H

    1985-01-01

    In order to reduce pain by injection, a frequently used topical anaesthetic is Xylocaine 5% ointment. This preparation, however, has certain limits in effectiveness. A new topical anaesthetic formulation, EMLA (Eutectic Mixture Local Anaesthetics), has been developed. Promising local anaesthetic properties on intact skin made it interesting to investigate the clinical usefulness of EMLA on mucous membranes and to find a suitable time of application. 30 volunteers, 20-40 yr, took part in the study. In two experimental double blind series, the topical anaesthetic effect was compared for EMLA 5% cream, Xylocaine 5% ointment, placebo cream, dry EMLA emulsion in cellulose discs and placebo discs. Application times were 2 and 5 minutes for the first three preparations, 2 minutes for the cellulose discs. The application areas were the alveolar mucosa in the lower buccal fold and the palatal mucosa. The pain by insertion of 27 or 30 gauge dental needles through the mucosa was registered. Xylocaine 5% and EMLA 5% reduced pain perception compared to placebo. For both Xylocaine 5% and EMLA 5% an application time of 2 minutes was found to be enough to produce a high degree of mucosal analgesia in the lower buccal fold. In the palatal area, however, the pain was not totally blocked by any of the investigated preparations but after 5 minutes of application EMLA showed a higher degree of analgesia. EMLA 5% creams was poorly localized at the applied area while the cellulose EMLA discs seemed to be more useful. No side effects were noticed.

  8. ANAESTHETIC MANAGEMENT OF PERIPARTUM CARDIOMYOPATHY: A CASE REPORT

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    Prabhu

    2016-02-01

    Full Text Available Anaesthetic management for caesarean section of a patient with peripartum cardiomyopathy (PPCM can be challenging. These patients require analgesia/anaesthesia for normal delivery or caesarean section. In this case report we describe the anaesthetic management of a 20-year-old patient at 37 weeks of gestation, with peripartum cardiomyopathy, heart failure and pulmonary oedema. She was scheduled for emergency caesarean section because of a threat to mother’s life and fetal distress. GA was induced with Etomidate and fentanyl safely. No adverse outcome on mother or new born was observed.

  9. Cardiac Arrest after Local Anaesthetic Toxicity in a Paediatric Patient

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    Liana Maria Torres de Araújo Azi

    2016-01-01

    Full Text Available We report a case of a paediatric patient undergoing urological procedure in which a possible inadvertent intravascular or intraosseous injection of bupivacaine with adrenaline in usual doses caused subsequent cardiac arrest, completely reversed after administration of 20% intravenous lipid emulsion. Early diagnosis of local anaesthetics toxicity and adequate cardiovascular resuscitation manoeuvres contribute to the favourable outcome.

  10. [Anaesthesia and vasomotor tone during CPB: intravenous anaesthetics].

    Science.gov (United States)

    Durand, M

    2012-05-01

    Anaesthesia during CBP is frequently provided using intravenous anaesthetic drugs, particularly propofol. The effects of the different drugs have been studied during CPB. These drugs have an arterial and venous vasodilator effect during CPB which is dose dependent and is more pronounced for propofol. High doses of propofol or thiopental reduce cerebral blood flow but provide no additional neurological protection.

  11. Iatrogenic greenhouse gases: the role of anaesthetic agents.

    Science.gov (United States)

    Uzoigwe, Chika E; Sanchez Franco, Luis C; Forrest, Michael D

    2016-01-01

    The contribution of health-care activity to climate change is not negligible and is increasing. Anaesthetic greenhouse gases, in particular the fluranes, have a much more potent global warming capacity, volume for volume, than carbon dioxide, but their emissions remain completely unregulated.

  12. Anaesthetic management of bilateral phaeochromocytoma in a young female patient

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    Mina Basu

    2007-01-01

    The patient was scheduled for excision of tumour. Pre-operative blood pressure was controlled with prazosin and metoprolol, hyperglycemia was controlled with soluble human insulin. The anaesthetic technique used was general anaesthesia with control of blood pressure during operation and manipulation of tumour with sodium nitroprusside (SNP infusion and after removal of tumour with noradrenaline infusion and fluid replacement.

  13. POST ANAESTHETIC RECOVERY FOLLOWING DAY-CARE SURGERY: COMPARISON OF TWO ANAESTHETIC TECHNIQUES

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    Dhrubajyoti

    2016-04-01

    Full Text Available BACKGROUND The growing demand for early discharge from hospital, consequent early return to work has resulted in the evolution of concept of “day care surgery.” This has led to development of precise safe anaesthetic techniques and agents as well as a battery of tests of recovery. Day care surgery presents unique challenges for the anaesthetists to produce a ‘street fit’ patient as soon as possible after the surgery with least complications, which can be achieved by both intravenous and inhalational techniques. Thus, an endeavour was made to carry out the present study with the aims and objectives to assess the progress of recovery in patients undergoing day care surgery with two groups of intravenous anaesthetic agents and also to determine the optimum time taken to achieve “home readiness.” METHODS The study included patients of average intelligence of both sexes aged between 15 and 45 yrs. belonging to physical status ASA I and II, undergoing operative procedures less than 30 minutes in our institute over a period of two years. A randomized double blind study was done amongst 80 patients scheduled for day care surgery, where two techniques were compared. Amongst 2 groups [Group I: Propofol (1% and Group II: Thiopentone (2.5% as the intravenous anaesthetic agent]. Recovery was assessed using standard scoring systems. The different variables were evaluated by mean and standard deviation. For comparing two groups, paired ‘t’ test was applied and a p value of ˂0.05 was considered significant. RESULTS The mean total dose requirement in Group-II patients were more than that in Group-I patients (p0.05, but the quality of anaesthesia was excellent in 57.5% in Group-I as compared to 45% in Group-II. After 5 minutes of cessation of anaesthesia, patients in Group-I attained much higher score as compared to Group-II (p<0.001 as assessed by the “Steward scoring system.” More number of patients were “Home ready” in Group-I than in

  14. Malpractice and system of expertise in anaesthetic procedures in Turkey.

    Science.gov (United States)

    Ozdemir, M Hakan; Cekin, Necmi; Can, I Ozgür; Hilal, Ahmet

    2005-10-29

    Deaths which occur during the administration of anaesthetics require medicolegal investigations. The objective of this study is to form a database for future comparisons related to anaesthetic-associated malpractice claims and also to investigate the system of expertise, pertaining to such procedures. The decisions of the Supreme Health Council, whose expert opinion is requested by legal authorities (judges, prosecutors) for health workers brought to trial in a criminal court, were examined retrospectively over the period 1995-1999. In 21 (2.3%) of the 888 decision reports prepared by the council the team members (the anaesthesiologist , the anaesthetic assistant, the anaesthetic technician, the nurse) were directly interrogated. Data concerning these 21 council decisions were evaluated within the scope of this study. It was found that 57% of the 21 decisions were related to medical procedures carried out in state hospitals. Of the 21 cases, 62% were males, 38% females. General anaesthesia was applied to 19 of the cases while one received regional (local) anaesthesia and one axillary blockade. Twenty died of complications associated with anaesthesia. Autopsy was performed on 11 (55%) of the dead. Health workers were found to have different degrees of liability in the 16 (76%) of the 21 decision reports. In their medical practices, anaesthesiologists , like other specialists, are subject to legal procedures in the country where they perform their duties, to national and international principles of ethics, and to diagnostic and curative standards/procedures relevant to the scientific level of the country concerned. In anaesthetic malpractice claims, certain standards need to be followed in inquiries and approaches so as to determine the real reasons behind the disabilities and/or deaths which occur. In order that sound evaluations could be made in such cases, the experts as well as the system of expertise should be efficient and authorized.

  15. 2D3 Pilotstudy: Accelerated learning in anaesthetic training

    DEFF Research Database (Denmark)

    Bisgaard, Claus Hedebo; Holdgaard, Hans Ole; Rubak, Sune Leisgaard Mørck;

    2011-01-01

    Background: With the purpose to elucidate the possibility for accelerated learning, four residents, in their first year of anaesthetic training, followed a revised curriculum. Summary of work: The curriculum consisted of skills training for airway management, spinal anaesthesia and insertion...... increased confidence in relation to insertion of an epidural catheter. Conclusions: Accelerated training in basic anaesthetic procedures may be acquired through skills- and simulation based learning. Further randomised studies needs to be performed....... of an epidural catheter and simulation based training in general anaesthesia. The skill trained for each procedure was performed in 4 sessions on four consecutive days immediately before the beginning of clinical practice. The simulation based course in general anaesthesia was a 1-day course in week three...

  16. Chronic fluorosis: The disease and its anaesthetic implications

    Directory of Open Access Journals (Sweden)

    Madhuri S Kurdi

    2016-01-01

    Full Text Available Chronic fluorosis is a widespread disease-related to the ingestion of high levels of fluoride through water and food. Prolonged ingestion of fluoride adversely affects the teeth, bones and other organs and alters their anatomy and physiology. Fluoride excess is a risk factor in cardiovascular disease and other major diseases, including hypothyroidism, diabetes and obesity. Although anaesthesiologists may be aware of its skeletal and dental manifestations, other systemic manifestations, some of which may impact anaesthetic management are relatively unknown. Keeping this in mind, the topic of chronic fluorosis was hand searched from textbooks, scientific journals and electronically through Google, PubMed and other scientific databases. This article concentrates on the effect of chronic fluorosis on various organ systems, its clinical features, diagnosis and the anaesthetic implications of the disease.

  17. Chronic fluorosis: The disease and its anaesthetic implications

    Science.gov (United States)

    Kurdi, Madhuri S

    2016-01-01

    Chronic fluorosis is a widespread disease-related to the ingestion of high levels of fluoride through water and food. Prolonged ingestion of fluoride adversely affects the teeth, bones and other organs and alters their anatomy and physiology. Fluoride excess is a risk factor in cardiovascular disease and other major diseases, including hypothyroidism, diabetes and obesity. Although anaesthesiologists may be aware of its skeletal and dental manifestations, other systemic manifestations, some of which may impact anaesthetic management are relatively unknown. Keeping this in mind, the topic of chronic fluorosis was hand searched from textbooks, scientific journals and electronically through Google, PubMed and other scientific databases. This article concentrates on the effect of chronic fluorosis on various organ systems, its clinical features, diagnosis and the anaesthetic implications of the disease. PMID:27053777

  18. Pressure and volume controlled mechanical ventilation in anaesthetized pregnant sheep.

    Science.gov (United States)

    Davis, J; Musk, G C

    2014-10-01

    Optimal mechanical ventilation of the pregnant ewe during anaesthesia is of vital importance for maintaining fetal viability. This study aimed to compare peak inspiratory pressure (PIP), oxygenation and cardiovascular parameters with pressure-control (PCV) or volume-control (VCV) mechanical ventilation of anaesthetized pregnant sheep. Twenty ewes at 110 days gestation underwent general anaesthesia in dorsal recumbency for fetal surgery in a research setting. All the sheep were mechanically ventilated; one group with PCV (n = 10) and another with VCV (n = 10) to maintain normocapnia. PIP, direct arterial blood pressure, heart rate, arterial pH and arterial oxygen tension were recorded. PIP was lower in the PCV group (P sheep anaesthetized in dorsal recumbency, though PCV may provide superior oxygenation at a lower PIP.

  19. Chirality and anaesthetic drugs: A review and an update

    OpenAIRE

    Sukanya Mitra; Puneet Chopra

    2011-01-01

    Many molecules can exist as right-handed and left-handed forms that are non-superimposable mirror images of each other. They are known as enantiomers or substances of opposite shape. Such compounds are also said to be chiral (Greek chiros meaning ‘hand’). Such chiral molecules are of great relevance to anaesthetic theory and practice. This review summarizes the basic concepts, pharmacokinetic and pharmacodynamic aspects of chirality, and some specific examples of their application in anaesthe...

  20. Anaesthetic management of bilateral alveolar proteinosis for bronchopulmonary lavage.

    Directory of Open Access Journals (Sweden)

    Dixit R

    1998-01-01

    Full Text Available The most hazardous manifestation of pulmonary alveolar proteinosis is progressive hypoxia for which bronchopulmonary lavage (BPL is the single most effective treatment. Unfortunately this procedure under general anesthesia itself increases the risk of hypoxia due to the need for one lung ventilation. It was therefore considered interesting to report the successful anaesthetic management of a patient with pulmonary alveolar proteinosis for Bronchopulmonary lavage.

  1. Anaesthetic management of a parturient with Laron syndrome.

    Science.gov (United States)

    Bhatia, K; Cockerham, R

    2011-10-01

    We report a case of a parturient with Laron syndrome, a rare form of dwarfism which results from an inability to generate insulin-like growth factor 1. In addition to dwarfism these patients may have craniofacial abnormalities, atlantoaxial instability, spinal stenosis and metabolic, musculoskeletal and genitourinary abnormalities. The patient underwent an urgent caesarean section using combined spinal-epidural anaesthesia. Laron syndrome is reviewed and its anaesthetic implications discussed.

  2. Anaesthetic management of a child with Pallister-Killian syndrome.

    Science.gov (United States)

    Iacobucci, T; Galeone, M; De Francisci, G

    2003-06-01

    Pallister-Killian syndrome is characterized by tetrasomy of the short arm of chromosome 12p, which produces mental retardation of varying degrees and dysmorphic characteristics. We describe anaesthesia in a 2-year-old child affected by this syndrome who underwent surgery for orchidopexy. Anaesthetic consisted of an inhalation mixture of O2, N2O and sevoflurane, together with an inguinal block with ropivacaine and administration of alfentanil plus ketorolac. Tracheal intubation was uneventful. No complications of any type were observed.

  3. Positive inotropic effects of histamine in anaesthetized dogs.

    OpenAIRE

    Einstein, R.; Mihailidou, A. S.; Richardson, D.P.

    1987-01-01

    1 The cardiovascular effects of histamine were examined in dogs anaesthetized with pentobarbitone 2 The effect of histamine on heart rate, blood pressure, left ventricular pressure, dP/dtmax and dP/dt: IIT (integrated isometric tension) was compared in the presence and absence of autonomic reflexes and blood pressure control. 3 In innervated animals with no attempt to control blood pressure, histamine produced dose-dependent decreases in blood pressure and heart rate and either positive or ne...

  4. Effects of sevoflurane on hypoxic pulmonary vasoconstriction in anaesthetized piglets.

    Science.gov (United States)

    Kerbaul, F; Bellezza, M; Guidon, C; Roussel, L; Imbert, M; Carpentier, J P; Auffray, J P

    2000-09-01

    In vitro, halogenated agents reduce the pulmonary vasoconstrictor response to alveolar hypoxia in isolated perfused lungs. However, studies in intact animals have been less convincing. The aim of the present study was to assess the effect of sevoflurane on hypoxic pulmonary vasoconstriction (HPV) in anaesthetized piglets using the pressure/cardiac index relationship (P/Q). Ten large white piglets were anaesthetized and mechanically ventilated, alternately in hyperoxia (FIO2 = 0.4) and hypoxia (FIO2 = 0.12). Multipoint plots of pulmonary arterial pressure (PAP) or differences between PAP and left atrial pressure (LAP) against Q were generated by gradual inflation of a balloon introduced into the inferior vena cava. P/Q relationships were established in hyperoxia and hypoxia at baseline, and then with sevoflurane. In hypoxia, pressure gradients (PAP-LAP) increased at every level of Q, thus demonstrating active pulmonary vasoconstriction. Sevoflurane at 1 MAC did not affect these P/Q relationships in hyperoxia or hypoxia as compared with baseline. Sevoflurane at a clinically relevant concentration (1 MAC) has no significant effect on HPV in anaesthetized piglets.

  5. Can anaesthetic and analgesic techniques affect cancer recurrence or metastasis?

    LENUS (Irish Health Repository)

    Heaney, A

    2012-12-01

    Summary Cancer is a leading cause of morbidity and mortality worldwide and the ratio of incidence is increasing. Mortality usually results from recurrence or metastases. Surgical removal of the primary tumour is the mainstay of treatment, but this is associated with inadvertent dispersal of neoplastic cells into the blood and lymphatic systems. The fate of the dispersed cells depends on the balance of perioperative factors promoting tumour survival and growth (including surgery per se, many anaesthetics per se, acute postoperative pain, and opioid analgesics) together with the perioperative immune status of the patient. Available evidence from experimental cell culture and live animal data on these factors are summarized, together with clinical evidence from retrospective studies. Taken together, current data are sufficient only to generate a hypothesis that an anaesthetic technique during primary cancer surgery could affect recurrence or metastases, but a causal link can only be proved by prospective, randomized, clinical trials. Many are ongoing, but definitive results might not emerge for a further 5 yr or longer. Meanwhile, there is no hard evidence to support altering anaesthetic technique in cancer patients, pending the outcome of the ongoing clinical trials.

  6. Anaesthetic management of peripartum cardiomyopathy for emergency caesarean section: A case report

    Directory of Open Access Journals (Sweden)

    Teena Bansal

    2014-06-01

    Full Text Available Peripartum cardiomyopathy is a rare but life threatening condition. Anaesthetic management of a patient with peripartum cardiomyopathy for caesarean section is a major challenge for anaesthesiologist. Timely diagnosis of the condition, institution of appropriate medication regimen, a carefully chosen anaesthetic technique and vigilant perioperative monitoring are essential for optimizing outcome in these patients. The goals of anaesthetic management include maintenance of optimal ventricular preload and afterload while avoiding any anaesthesia induced myocardial depression.

  7. Ring keratitis due to topical anaesthetic abuse in a contact lens wearer.

    Science.gov (United States)

    Kurna, Sevda Aydin; Sengor, Tomris; Aki, Suat; Agirman, Yasemin

    2012-07-01

    A 38-year-old woman wearing hydrogel coloured contact lenses presented to the clinic with a painful red eye and epiphora. On biomicroscopy, a large corneal epithelial defect and ring infiltrate were observed. She had been using topical anaesthetic drops for 10 days. After cessation of the anaesthetic drops, the corneal lesions resolved completely in two weeks. On evaluation of a contact lens user with atypical keratitis, misuse of topical anaesthetics should also be considered.

  8. Anaesthetic management of a child with massive extracranial arteriovenous malformation

    Directory of Open Access Journals (Sweden)

    Faisal Shamim

    2012-01-01

    Full Text Available Vascular tumors affect the head and neck commonly but arteriovenous malformations are rare. Vascular malformations are often present at birth and grow with the patient, usually only becoming significant later in childhood. Embolization has been the mainstay of treatment in massive and complex arteriovenous malformations. We present a case of massive extracranial arteriovenous malformation in a 7-year-old boy causing significant workload on right heart and respiratory distress. The management of angioembolization under general anaesthesia and anaesthetic concerns are presented.

  9. Reduction in anaesthetic drug consumption is correlated with mean titrated intra-operative Bispectral Index values.

    NARCIS (Netherlands)

    Ellerkmann, R.K.; Kreuer, S.; Wilhelm, W.; Ropcke, H.; Hoeft, A.; Bruhn, J.

    2006-01-01

    BACKGROUND: Several studies have shown a reduction in anaesthetic drug consumption with Bispectral Index (BIS) titration compared with standard clinical practice. However, the amount of reduction varied widely between 1% and 40%. We investigated the correlation between reduction in anaesthetic drug

  10. Tubulo-glomerular feedback response: enhancement in adult spontaneously hypertensive rats and effects of anaesthetics

    DEFF Research Database (Denmark)

    Leyssac, P P; Holstein-Rathlou, N H

    1989-01-01

    Open-loop tubulo-glomerular feedback (TGF) responses were measured in halothane anaesthetized spontaneously hypertensive rats (SHR), in normotensive Wistar Kyoto (WKY) and Sprague-Dawley rats (SPRD), and in inactin anaesthetized SPRD. Proximal intratubular free flow pressures (FFP) (13.8-14.7 mm Hg...

  11. Strain-specific response to anaesthetics and analgesics in rat and rabbit : A pharmacogenetic approach

    NARCIS (Netherlands)

    Avsaroglu, H.

    2008-01-01

    The response of (laboratory) animals to anaesthetics and analgesics is known to show intraspecies variability. Apart from environmental influences, this may also be caused by genetic factors. In this thesis, rabbit and rat inbred strains were used to identify differences in response to anaesthetics

  12. Spinal cord injury caused by direct damage by local anaesthetic infiltration needle

    NARCIS (Netherlands)

    Absalom, AR; Martinelli, G; Scott, NB

    2001-01-01

    We describe a case of spinal cord injury caused by direct trauma from a local anaesthetic infiltration needle. During local anaesthetic infiltration before placement of an epidural catheter, the patient suddenly rolled over onto her back, causing the infiltrating needle to advance all the way to its

  13. Intrathecal Dexmedetomidine for Anaesthetic Management of a Patient with Chronic Inflammatory Demyelinating Polyneuropathy

    Science.gov (United States)

    Srinivasalu, D

    2016-01-01

    Chronic demyelinating disorders have multifactorial origin but common important physiologic and anaesthetic considerations. Choice of anaesthesia technique and the drugs used, undertanding the pros and cons of using central neuraxial blocks will help in successful management of such patients. We describe the anaesthetic management of a 34-year-old male with chronic inflammatory demyelinating polyneuropathy posted for cystolithotripsy. PMID:27790558

  14. Anaesthetic management and implications of a case of chronic inflammatory demyelinating polyneuropathy

    Directory of Open Access Journals (Sweden)

    Babita Gupta

    2011-01-01

    Full Text Available A 60-year-old man with chronic inflammatory demyelinating polyneuropathy (CIDP was posted for surgery of the neck femur fracture and was successfully managed. We discuss the anaesthetic considerations during regional and general anaesthesia of this patient with CIDP. A brief review of the available literature reveals no consensus on the choice of anaesthetic management.

  15. Anaesthetic management of a patient with familial normokalaemic periodic paralysis.

    LENUS (Irish Health Repository)

    Walsh, F

    2012-02-03

    PURPOSE: We describe the anaesthetic management of a patient with the autosomal dominant inherited disease, normokalaemic periodic paralysis. The disease results in intermittent bouts of limb and respiratory muscular weakness in association with hypothermia, stress, prolonged fasting or exercise. Unlike hypokalaemic and hyperkalaemic periodic paralysis, the more common variants of the disease, normokalaemic periodic paralysis is not accompanied by alterations in the plasma potassium concentration. CLINICAL FEATURES: A five-year-old boy presented for emergency scrotal exploration. He had a family history of periodic paralysis and had experienced previous episodes of weakness, two of which had required hospitalization for respiratory distress. On admission there was no evidence of weakness and serum potassium concentration was 4.2 mMol.L-1. A spinal anaesthetic was performed and the procedure was uncomplicated by muscle paralysis above the level of the spinal block. CONCLUSION: Avoidance of known precipitating factors and judicious use of neuromuscular blocking drugs has been advocated in patients with this disorder presenting for surgery. In appropriate circumstances, spinal anaesthesia represents a useful option in patients with normokalaemic periodic paralysis.

  16. Intercostal nerve blockade for evaluation of local anaesthetic agents.

    Science.gov (United States)

    Bridenbaugh, P O

    1975-02-01

    Bilateral intercostal nerve block provides the opportunity to subject as many as 16 separate peripheral nerves in a single subject to known or unknown local anaesthetic agents in a variety of concentrations, volumes, and additives. It permits the observation of local (e.g., neuritis), clinical (e.g., onset and duration), and systemic (e.g., toxicity and blood concentration) effects of these variables. In double-blind studies, bilateral intercostal nerve block allows the use of each side of the trunk for comparison of two experimental drugs, a new drug against a standard, or two new drugs. Subtle differences in clinical properties as well as simultaneous blood concentrations may be detected in these studies. The advantages of this technique in evaluating local anaesthetic agents are primarily the use of a single subject as his own control while studying may separate peripheral nerves. This aids appreciably in limiting the variable of age, temperature, and perfusion, as well as techniques of administration and evaluation. The constancy of the anatomy of the intercostal nerve provides a highly reliable and reproducible block technique.

  17. Genotoxicity and cytotoxicity of cisplatin treatment combined with anaesthetics on EAT cells in vivo.

    Science.gov (United States)

    Brozovic, Gordana; Orsolic, Nada; Knezevic, Fabijan; Horvat Knezevic, Anica; Benkovic, Vesna; Sakic, Katarina; Hrgovic, Zlatko; Bendelja, Kreso; Fassbender, Walter J

    2009-06-01

    In this study, DNA damage in tumour cells, as well as irreversible cell damage leading to apoptosis induced in vivo by the combined application of cisplatin and inhalation anaesthetics, was investigated. The genotoxicity of anaesthetics on Ehrlich ascites tumour (EAT) cells of mice, alone or in combined application with cisplatin, was estimated by using the alkaline comet assay. The percentage of EAT cell apoptosis was quantified by flow cytometry. Groups of EAT-bearing mice were (i) treated intraperitoneally with cisplatin, (ii) exposed to repeated anaesthesia with inhalation anaesthetic, and (iii) subjected to combined treatment of exposure to anaesthetics after cisplatin for 3 days. Sevoflurane, halothane and isoflurane caused strong genotoxic effects on tumour cells in vivo. The tested anaesthetics alone showed no direct effect on programmed cell death although sevoflurane and especially halothane decreased the number of living EAT cells in peritoneal cavity lavage. Repeated anaesthesia with isoflurane had stimulatory effects on EAT cell proliferation and inhibited tumour cell apoptosis (6.11%), compared to the control group (10.26%). Cisplatin caused massive apoptosis of EAT cells (41.14%) and decreased the number of living EAT cells in the peritoneal cavity. Combined cisplatin and isoflurane treatment additionally increased EAT cell apoptosis to 51.32%. Combined treatment of mice with cisplatin and all anaesthetics increased the number of living tumour cells in the peritoneal cavity compared to cisplatin treatment of mice alone. These results suggest that the inhalation of anaesthetics may protect tumour cells from the cisplatin-induced genotoxic and cytotoxic effects.

  18. Optimal volume of local anaesthetic for the adductor canal block

    DEFF Research Database (Denmark)

    Jæger, P.; Jenstrup, M. T.; Lund, J.;

    2015-01-01

    Background: Theoretically, the ideal volume of local anaesthetic for adductor canal block (ACB) would ensure sufficient filling ofthe canal and avoid proximal spread to the femoral triangle. In this dose-finding study, we aimed to investigate the minimaleffective volume for an ACB needed to fill...... the adductor canal distally in at least 95% of patients (ED95). Methods: We performed a blinded trial, enrolling 40 healthy men. All subjects received an ACB with lidocaine 1%. Volumes wereassigned sequentially to the subjects using the continual reassessment method followed by Bayesian analysis to determine...... theED95. Distal filling of the adductor canal was assessed by magnetic resonance imaging (primary outcome). Secondary outcomeswere the effect of volume on proximal spread to the femoral triangle (also assessed by magnetic resonance imaging), quadricepsmuscle weakness (decrease by ≥25% from baseline...

  19. Umbilical hernia in adults: day case local anaesthetic repair.

    Directory of Open Access Journals (Sweden)

    Menon V

    2003-01-01

    Full Text Available INTRODUCTION: The waiting times for elective surgery of Umbilical hernia (UH in adults are unacceptably long in some cases. During this period, irreducibility and strangulation are possible. We operate on adult patients under local anaesthesia (LA as day cases to avoid this delay and describe our experience in this paper. AIMS: The aims of our study were to look at the age and sex distribution, body weight, type and amount of local anaesthetic used, morbidity, admission and readmission rates, and waiting times of adult patients operated on for UH under LA. MATERIALS AND METHODS: It was a retrospective study covering a 4 year period from July 1996 to June 2000 including all adult patients undergoing the above procedure under the care of a single consultant general surgeon. A standard Mayo repair using non absorbable material was used without a mesh or a drain. RESULTS: 32 patients with UH were operated on under LA, 23 males and 9 females with a median age of 51 years (range 20 to 86 years. The body weight ranged from 63 to 120 (median 87 kg. The average duration of the procedure was 30 (range 22-40 minutes. Sedation was needed in 4 patients. Two patients developed wound infections, one superficial and one deep. There was no mortality. The median period of follow-up was 24 (range 4-48 months and there was no recurrence. The median waiting time for the operation was 6 weeks. CONCLUSIONS: Day case local anaesthetic repair of UH in adults seems to be safe and feasible with an acceptable morbidity. Suture repair in the right patient has excellent results and the waiting times are acceptable.

  20. The development of a system to guide volatile anaesthetic administration.

    Science.gov (United States)

    Kennedy, R R; French, R A

    2011-03-01

    We have developed and deployed within our operating rooms a system which provides real-time estimates of effect-site levels of inhalational anaesthetic agents along with forward predictions of end-tidal and effect-site concentrations. The initial aim of this project was to provide users of inhalational agents with tools similar to those available in target-controlled infusion systems. This paper describes the development and implementation of the system and outlines evaluation and uses of the system. The prototype was developed by combining a locally developed data logging and trend display system with a model of uptake developed as a teaching tool in 1982. This uptake model performs as well as contemporary models of propofol uptake and distribution. Following initial evaluation, the system has been deployed in over half our operating rooms and uses data gathered from the Datex/GE Anaesthesia Delivery Unit anaesthetic machines. We have conducted a number of studies of the system itself explored aspects of the underlying models, and used the system to investigate effect-site guided anesthesia and as a tool for data collection in other studies. The system has been well accepted locally and has been shown to facilitate faster changes in inhalational levels. We have also seen a significant decrease in fresh gas flow rates over recent years and attribute this in part to the predictive system, which simplifies the task of determining the appropriate combination of gas flow and vapour dial setting. The system also provides a useful platform for a range of research projects.

  1. ANAESTHETIC MANAGEMENT OF A CASE OF HEREDITARY SPHEROCYTOSIS FOR SPLENECTOMY AND CHOLECYSTECTOMY.

    Directory of Open Access Journals (Sweden)

    Jyotsna

    2012-11-01

    Full Text Available ABSTRACT: We report successful anaesthetic management of a pat ient with hereditary spherocytosis who underwent laproscopic splenectomy, ch olecystectomy and appendioectomy. Hereditary spherocytosis is a familial hemolytic di sorder with marked heterogeneity of clinical features, ranging from asymptomatic condition to a f ulminant hemolytic anaemia. Commonly recommended perioperative management in these patien ts includes preemptive erythrocyte transfusion, aggressive hydration and avoidance of hypoxia, aplastic crisis, hypothermia and acidosis. The management of such a case is challeng ing from anaesthetic point of view because of sickling oriented anaesthetic approach. Key words: Hereditary spherocytosis, splenectomy, cholecystectomy, perioperative management.

  2. Anaesthetic management of an adult patient with DOOR syndrome: a case report.

    Science.gov (United States)

    Michalek, Pavel; Donaldson, William; Abraham, Alexander

    2009-05-18

    We report the anaesthetic management of a 48-year-old male patient with Deafness, Onycho-Osteodystrophy and mental Retardation syndrome, epilepsy and cerebral palsy who had two dental procedures under anaesthetic care. For the first short examination sedoanalgesia was employed and the second, longer, procedure was performed under general anaesthesia. His airway management was moderately difficult and the postoperative period was complicated by partial seizures involving the upper extremity and a short period of decreased oxygen saturation. The potential anaesthetic implications of Deafness, Onycho-Osteodystrophy and mental Retardation syndrome are highlighted.

  3. Mechanism of inhibitory action of the local anaesthetic trimecaine on the growth of algae (Chlorella vulgaris).

    Science.gov (United States)

    Sersen, F; Král'ová, K

    1994-08-01

    Using the model compound trimecaine, it was found that algicidal effects exhibited by the local anaesthetics of the acetanilide type were caused by two different mechanisms. The first inhibitory mechanism occurring at low concentrations of the anaesthetic is connected with the uncoupling of the photophosphorylations in algal chloroplasts and is accompanied by the enhancement of the oxygen evolving rate in algal photosynthesis. The second mechanism of inhibition of the photosynthesis in algae, taking place at higher concentrations of the anaesthetic, is connected with the damaging of the manganese containing protein on the donor side of photosystem 2 and is accompanied by a decrease of the oxygen evolving rate in algal photosynthesis.

  4. Innovations in existing routes and novel drug delivery systems for local anaesthetics

    Directory of Open Access Journals (Sweden)

    Diwanshu Sharma

    2016-06-01

    Full Text Available New drug delivery systems (NDDS are developed for improvement in efficacy of the drugs, provide maximum benefit to the patient and to minimize the adverse drug reactions. For local anaesthetics (LAs, the development of new effective delivery systems modulate the release rate, extend their anaesthetic effect , and helps to enhance their localisation as desired. The various routes of local anaesthetic delivery (epidural, peripheral, wound catheters, intra-nasal, intra-vesical, intra-articular, intra-osseous are under innovation these days. Different methods such as include iontophoresis, electroporation, sonophoresis, and magnetophoresis are being used to enhance local anaesthetic permeation. Adjuvants are added to potentiate drug effects. The use of different delivery systems should help to keep the LA at the target site for longer periods prolonging the anesthetic or analgesic effect with an extended range of agents. [Int J Basic Clin Pharmacol 2016; 5(3.000: 566-572

  5. In vitro toxicity of local anaesthetics and corticosteroids on supraspinatus tenocyte viability and metabolism

    Directory of Open Access Journals (Sweden)

    Clayton W. Nuelle

    2017-01-01

    Conclusion: This data confirms that peritendinous injection of commonly used local anaesthetics and corticosteroids results in significant supraspinatus tenotoxicity in vitro. Further in vivo studies are required before making definitive clinical recommendations.

  6. The effects of some carbamate local anaesthetics on the guinea-pig ileum.

    Science.gov (United States)

    Bezeková, M; Bauer, V

    1986-01-01

    The action of some carbamate local anaesthetics, pentacaine, BK-52 and heptacaine, was compared in the guinea-pig ileum with that of classic local anaesthetics, procaine and trimecaine. Contractions of the ileum were evoked by transmural stimulation, nicotine, acetylcholine, noradrenaline, histamine, K+ and Ba++. Although the evoked contractions were inhibited by all the local anaesthetics, there was a marked difference in their ability to influence the smooth muscle activation induced by different stimuli. The differences among the IC50 values were slight in the case of pentacaine, moderate in the case of trimecaine and BK-52 and large in the case of procaine and heptacaine. It is suggested that besides their effects on the unmyelinated autonomic nerves, the carbamate local anaesthetics studied can also affect the smooth muscle membrane, similarly to the classic agents. The mechanism of their direct effect is discussed.

  7. 1-Phenoxy-2-propanol is a useful anaesthetic for gastropods used in neurophysiology.

    Science.gov (United States)

    Wyeth, Russell C; Croll, Roger P; Willows, A O Dennis; Spencer, Andrew N

    2009-01-30

    Anaesthesia is often used in neurophysiological, surgical, and neuroanatomical protocols. Several anaesthetics, including magnesium chloride, volatiles (halothane, etc.), and barbiturates, have been used in gastropod neurobiology. 1-Phenoxy-2-propanol (PP) is another anaesthetic option that has not yet been used extensively. We provide an analysis of the neural, muscular and behavioural effects of PP in gastropods. PP eliminates action potentials and reduces muscular contraction force in Hermissenda crassicornis, and eliminates behavioural activity in Tritonia diomedea. Our results show these effects are reversible, with complete action potential recovery, at least partial muscular recovery, and full behavioural recovery. Survival after surgery in T. diomedea was longer with PP than without anaesthetic, and PP also reduced contraction during tissue fixation in Lymnaea stagnalis. Moreover, PP can be bath applied, has low toxicity, and is biodegradable. Thus, PP is an effective anaesthetic in three species of gastropods, and useful in neurophysiological dissection, surgical, and fixation protocols.

  8. Anaesthetic management of an adult patient with DOOR syndrome: a case report

    OpenAIRE

    Michalek, Pavel; Donaldson, William; Abraham, Alexander

    2009-01-01

    We report the anaesthetic management of a 48-year-old male patient with Deafness, Onycho-Osteodystrophy and mental Retardation syndrome, epilepsy and cerebral palsy who had two dental procedures under anaesthetic care. For the first short examination sedoanalgesia was employed and the second, longer, procedure was performed under general anaesthesia. His airway management was moderately difficult and the postoperative period was complicated by partial seizures involving the upper extremity an...

  9. Comparative efficacy of four anaesthetic agents in the yellow seahorse, Hippocampus kuda (Bleeker, 1852)

    Digital Repository Service at National Institute of Oceanography (India)

    Pawar, H.B.; Sanaye, S.V.; Sreepada, R.A.; Harish, V.; Suryavanshi, U.; Tanu; Ansari, Z.A.

    may entail lower water volumes splashed onto the gills (inadequate irrigation) and existence of slow rate of inhale and exhale water across the gills (Gert Roos, personal communication). It has been reported that entry and excretion of anaesthetics... could be related properties of each of the anaesthetic agent evaluated, more particularly to the mode of action and their pharmacokinetics. Further studies on different life stages, gender, reproductive state and sizes, followed by assessments...

  10. Anaesthetic management of a child with panthothenate kinase-associated neurodegeneration

    Directory of Open Access Journals (Sweden)

    Renu Sinha

    2015-01-01

    Full Text Available Panthothenate kinase-associated neurodegeneration (PKAN (Hallervorden-Spatz disease is a rare autosomal recessive chromosomal disorder characterised by progressive neuroaxonal dystrophy. The characteristic features include involuntary movements, rigidity, mental retardation, seizures, emaciation. The anaesthetic concerns include difficult airway, aspiration pneumonia, dehydration, and post-operative respiratory, and renal insufficiency. We report successful anaesthetic management of a 9-year-old intellectually disabled male child with PKAN, scheduled for ophthalmic surgery under general anaesthesia.

  11. Anaesthetics-Induced Neurotoxicity in Developing Brain: An Update on Preclinical Evidence

    Directory of Open Access Journals (Sweden)

    Zhaowei Zhou

    2014-03-01

    Full Text Available Every year millions of young people are treated with anaesthetic agents for surgery and sedation in a seemingly safe manner. However, growing and convincing preclinical evidence in rodents and nonhuman primates, together with recent epidemiological observations, suggest that exposure to anaesthetics in common clinical use can be neurotoxic to the developing brain and lead to long-term neurological sequelae. These findings have seriously questioned the safe use of general anaesthetics in obstetric and paediatric patients. The mechanisms and human applicability of anaesthetic neurotoxicity and neuroprotection have remained under intense investigation over the past decade. Ongoing pre-clinical investigation may have significant impact on clinical practice in the near future. This review represents recent developments in this rapidly emerging field. The aim is to summarise recently available laboratory data, especially those being published after 2010, in the field of anaesthetics-induced neurotoxicity and its impact on cognitive function. In addition, we will discuss recent findings in mechanisms of early-life anaesthetics-induced neurotoxicity, the role of human stem cell-derived models in detecting such toxicity, and new potential alleviating strategies.

  12. Lysosphingolipid receptor-mediated diuresis and natriuresis in anaesthetized rats.

    Science.gov (United States)

    Bischoff, A; Meyer Zu Heringdorf, D; Jakobs, K H; Michel, M C

    2001-04-01

    Lysosphingolipids such as sphingosine-1-phosphate (SPP) and sphingosylphosphorylcholine (SPPC) can act on specific G-protein-coupled receptors. Since SPP and SPPC cause renal vasoconstriction, we have investigated their effects on urine and electrolyte excretion in anaesthetized rats. Infusion of SPP (1 - 30 microg kg(-1) min(-1)) for up to 120 min dose-dependently but transiently (peak after 15 min, disappearance after 60 min) reduced renal blood flow without altering endogenous creatinine clearance. Nevertheless, infusion of SPP increased diuresis, natriuresis and calciuresis and, to a lesser extent, kaliuresis. These tubular lysosphingolipid effects developed more slowly (maximum after 60 - 90 min) and also abated more slowly upon lysosphingolipid washout than the renovascular effects. Infusion of SPPC, sphingosine and glucopsychosine (3 - 30 microg kg(-1) min(-1) each) caused little if any alterations in renal blood flow but also increased diuresis, natriuresis and calciuresis and, to a lesser extent, kaliuresis. Pretreatment with pertussis toxin (10 microg kg(-1) 3 days before the acute experiment) abolished the renovascular and tubular effects of 30 microg kg(-1) min(-1) SPP. These findings suggest that lysosphingolipids are a hitherto unrecognized class of endogenous modulators of renal function. SPP affects renovascular tone and tubular function via receptors coupled to G(i)-type G-proteins. SPPC, sphingosine and glucopsychosine mimic only the tubular effects of SPP, and hence may act on distinct sites.

  13. Anaesthetic Management for Laparoscopic Gastric Bypass Procedure in Morbid Obesity

    Directory of Open Access Journals (Sweden)

    P Mandal

    2008-01-01

    Full Text Available Gastric bypass procedure (GBP is one of the effective operative methods for weight loss in patients with morbid obesity. The anaesthesia team has a crucial role to play in managing these patients. Therefore it is important for anaesthesiologists to be familiar with the anatomical and physiological changes along with pharmacological alter-ations associated with obesity.So that they can offer optimal perioperative care to these patients. This study describes the anaesthetic management of a series of 100 consecutive patients with an average body mass index (BMI of 46.5 kg.m -2 who underwent laparoscopic GBP over a period of three years (September′04 to September′07 in the hands of nonbariatric surgeons.Patients were aged between 16 - 36 years with more female preponderance (73: 27 and had mean duration of the procedure of 2.82 ± 1.44 hours under standard endotracheal balanced anaesthesia tech-nique. The initial mortality is 1% along with 4% incidence of both difficult intubation and postoperative respiratory failure in this series which is quite comparable with world famous bariatric surgical centers.

  14. Local anaesthetics and additives for spinal anaesthesia--characteristics and factors influencing the spread and duration of the block.

    Science.gov (United States)

    Pitkänen, Mikko; Rosenberg, Per H

    2003-09-01

    Different characteristics of patients and local anaesthetic formulations will influence the spread of spinal anaesthesia. The predictability of the spread of spinal anaesthesia can be improved by altering both baricity of the solution, and the position of the patient during the intrathecal local anaesthetic injection. The role of adrenaline and clonidine in prolonging the block and associated side effects is discussed. The role of opioids added to local anaesthetic solutions is discussed from a cost/benefit point of view.

  15. Determination of contamination of a chemical warfare-proof operating theatre with volatile anaesthetic agents and assessment of anaesthetic gas scavenging systems.

    Science.gov (United States)

    Yoganathan, S; Johnston, I G; Parnell, C J; Houghton, I T; Restall, J

    1991-11-01

    Three types of anaesthetic waste scavenging systems (active antipollution system, Papworth Block passive system and activated charcoal absorber system) were compared with a non-scavenging control to assess their effectiveness in reducing waste halothane concentrations in a chemical warfare-proof operating theatre. All three systems were found to reduce the level of pollution significantly.

  16. Comparative efficacy and patient preference of topical anaesthetics in dermatological laser treatments and skin microneedling

    Directory of Open Access Journals (Sweden)

    Yi Zhen Chiang

    2015-01-01

    Full Text Available Background: Topical anaesthetics are effective for patients undergoing superficial dermatological and laser procedures. Our objective was to compare the efficacy and patient preference of three commonly used topical anaesthetics: (2.5% lidocaine/2.5% prilocaine cream (EMLA ® , 4% tetracaine gel (Ametop TM and 4% liposomal lidocaine gel (LMX4 ® in patients undergoing laser procedures and skin microneedling. Settings and Design: This was a prospective, double-blind study of patients undergoing laser and skin microneedling procedures at a laser unit in a tertiary referral dermatology centre. Materials and Methods: All 29 patients had three topical anaesthetics applied under occlusion for 1 hour prior to the procedure, at different treatment sites within the same anatomical zone. A self-assessment numerical pain rating scale was given to each patient to rate the pain during the procedure and each patient was asked to specify their preferred choice of topical anaesthetic at the end of the procedure. Statistical Analysis: Parametric data (mean pain scores and frequency of topical anaesthetic agent of choice were compared using the paired samples t-test. A P-value of ≤0.05 was considered as statistically significant. Results and Conclusions: Patients reported a mean (±SD; 95% confidence interval pain score of 5 (±2.58; 3.66-6.46 with Ametop TM , 4.38 (±2.53; 2.64-4.89 with EMLA ® and 3.91 (±1.95; 2.65-4.76 with LMX4 ® . There was no statistically significant difference in pain scores between the different topical anaesthetics. The majority of patients preferred LMX4 ® as their choice of topical anaesthetic for dermatological laser and skin microneedling procedures.

  17. Comparative Efficacy and Patient Preference of Topical Anaesthetics in Dermatological Laser Treatments and Skin Microneedling

    Science.gov (United States)

    Chiang, Yi Zhen; Al-Niaimi, Firas; Madan, Vishal

    2015-01-01

    Background: Topical anaesthetics are effective for patients undergoing superficial dermatological and laser procedures. Our objective was to compare the efficacy and patient preference of three commonly used topical anaesthetics: (2.5% lidocaine/2.5% prilocaine cream (EMLA®), 4% tetracaine gel (Ametop™) and 4% liposomal lidocaine gel (LMX4®)) in patients undergoing laser procedures and skin microneedling. Settings and Design: This was a prospective, double-blind study of patients undergoing laser and skin microneedling procedures at a laser unit in a tertiary referral dermatology centre. Materials and Methods: All 29 patients had three topical anaesthetics applied under occlusion for 1 hour prior to the procedure, at different treatment sites within the same anatomical zone. A self-assessment numerical pain rating scale was given to each patient to rate the pain during the procedure and each patient was asked to specify their preferred choice of topical anaesthetic at the end of the procedure. Statistical Analysis: Parametric data (mean pain scores and frequency of topical anaesthetic agent of choice) were compared using the paired samples t-test. A P-value of ≤0.05 was considered as statistically significant. Results and Conclusions: Patients reported a mean (±SD; 95% confidence interval) pain score of 5 (±2.58; 3.66-6.46) with Ametop™, 4.38 (±2.53; 2.64-4.89) with EMLA® and 3.91 (±1.95; 2.65-4.76) with LMX4®. There was no statistically significant difference in pain scores between the different topical anaesthetics. The majority of patients preferred LMX4® as their choice of topical anaesthetic for dermatological laser and skin microneedling procedures. PMID:26644737

  18. Interaction of local and general anaesthetics with liposomal membrane models: a QCM-D and DSC study.

    Science.gov (United States)

    Paiva, José Gabriel; Paradiso, Patrizia; Serro, Ana Paula; Fernandes, Anabela; Saramago, Benilde

    2012-06-15

    The behaviour of four local anaesthetics (lidocaine, levobupivacaine, ropivacaine and tetracaine) and one general anaesthetic (propofol) is compared when interacting with two types of model membranes: supported layers of liposomes and liposomes in solution. Several liposomal compositions were tested: dimyristoylphosphatidylcholine (DMPC), binary mixtures of DMPC with cholesterol (CHOL), and ternary mixtures of dipalmitoylphosphatidylcholine (DPPC), DMPC, and CHOL. A quartz crystal microbalance with dissipation, QCM-D, was used to assess changes in the properties of supported layers of liposomes. The effect of the anaesthetics on the phase behaviour of the liposomes in suspension was determined by differential scanning calorimetry. Both techniques show that all anaesthetics have a fluidizing effect on the model membranes but, apparently, the solid supported liposomes are less affected by the anaesthetics than the liposomes in solution. Although the different anaesthetics were compared at different concentrations, tetracaine and propofol seem to induce the strongest perturbation on the liposome membrane. The resistance of the liposomes to the anaesthetic action was found to increase with the presence of cholesterol, while adding DPPC to the binary mixture DMPC+CHOL does not change its behaviour. The novelty of the present work resides upon three points: (1) the use of supported layers of liposomes as model membranes to study interactions with anaesthetics; (2) application of QCM-D to assess changes of the adsorbed liposomes; (3) a comparison of the effect of local and general anaesthetics interacting with various model membranes in similar experimental conditions.

  19. Efficacy and safety of local anaesthetics for premature ejaculation: a systematic review and meta-analysis

    Institute of Scientific and Technical Information of China (English)

    Jia-Dong Xia; You-Feng Han; Liu-Hua Zhou; Yun Chen; Yu-Tian Dai

    2013-01-01

    To assess the efficacy and safety of local anaesthetics for premature ejaculation (PE),a systematic review of the literature was performed using the Cochrane Library,PUBMED and EMBASE.We screened and retrieved the randomized controlled trials on the treatment of PE with local anaesthetics.End points included intravaginal ejaculation latency time (IELT),patient-reported outcome assessments and adverse events.Meta-analyses were conducted with Stata 11.0.In total,seven publications involving 566 patients with local anaesthetics and 388 with placebos strictly met our eligibility criteria.Meta-analyses showed that after the patients were treated with the local anaesthetics,the value of the standardized mean difference of the changes in IELT was 5.02 (95% CI:3.03-7.00).A higher rate of adverse events occurred compared with placebos (odds ratio:3.30,95% CI:1.71-6.36),but these events were restricted to local side effects.In addition,significantly greater improvement was observed in patient-reported outcomes.In summary,local anaesthetics can prolong IELT and improve ejaculatory control and sexual satisfaction.

  20. Effect of Topically Applied Anaesthetic Formulation on the Sensitivity of Scoop Dehorning Wounds in Calves

    Science.gov (United States)

    McCarthy, Dominique; Windsor, Peter Andrew; Harris, Charissa; Lomax, Sabrina; White, Peter John

    2016-01-01

    The post-operative effects of three formulations of topical anaesthetic and a cornual nerve block on the sensitivity of scoop dehorning wounds in calves were compared in two trials. In Trial 1, 21 female Holstein dairy calves aged 8 to 24 weeks were randomly allocated to two groups: (1) scoop dehorning with a post-operative application of a novel topical anaesthetic powder (DTAP, n = 10); and (2) scoop dehorning with a post-operative application of a novel topical anaesthetic ethanol liquid (DTAE, n = 11). In Trial 2, 18 castrated male and 18 female Hereford beef calves aged 16 to 20 weeks were randomly allocated to four groups: (1) scoop dehorning with a pre-operative cornual nerve block of lignocaine (DCB, n = 9); (2) scoop dehorning with a post-operative application of the novel topical anaesthetic ethanol liquid from Trial 1 (DTAE, n = 9); (3) scoop dehorning with a post-operative application of a topical anaesthetic gel (DTAG, n = 9); and (4) sham dehorning (CON, n = 9). Sensitivity was assessed by scoring the behavioural response of calves to stimulation of the wound or skin at time points before and after treatment. In Trial 1, DTAP calves had a greater probability of displaying more severe responses than DTAE calves at 90 and 180 min (P wound following scoop dehorning in calves and may provide a practical option for pain relief on-farm. PMID:27648948

  1. Topical anaesthetics for premature ejaculation: a systematic review and meta-analysis.

    Science.gov (United States)

    Martyn-St James, Marrissa; Cooper, Katy; Ren, Kate; Kaltenthaler, Eva; Dickinson, Kath; Cantrell, Anna; Wylie, Kevan; Frodsham, Leila; Hood, Catherine

    2016-04-01

    Eutectic Mixture of Local Anaesthetics (EMLA) is recommended for use off-label as a treatment for premature ejaculation (PE). Other topical anaesthetics are available, some of which have been evaluated against oral treatments. The purpose of this systematic review was to evaluate the evidence from randomised controlled trials (RCTs) for topical anaesthetics in the management of PE. Bibliographic databases including MEDLINE were searched to August 2014. The primary outcome was intra-vaginal ejaculatory latency time (IELT). Methodological quality of RCTs was assessed. IELT and other outcomes were pooled across RCTs in a meta-analysis. Between-trial heterogeneity was assessed. Nine RCTs were included. Seven were of unclear methodological quality. Pooled evidence (two RCTs, 43 participants) suggests that EMLA is significantly more effective than placebo at increasing IELT (PPremature Ejaculation (TEMPE) spray and lidocaine gel are both significantly more effective than placebo (P=0.003; P<0.00001); and lidocaine gel is significantly more effective than sildenafil or paroxetine (P=0.01; P=0.0001). TEMPE spray is associated with significantly more adverse events than placebo (P=0.003). More systemic adverse events are reported with tramadol, sildenafil and paroxetine than with lidocaine gel. Diverse methods of assessing sexual satisfaction and ejaculatory control with topical anaesthetics are reported and evidence is conflicting. Topical anaesthetics appear more effective than placebo, paroxetine and sildenafil at increasing IELT in men with PE. However, the methodological quality of the existing RCT evidence base is uncertain.

  2. Evaluation of genotoxicity induced by repetitive administration of local anaesthetics: an experimental study in rats

    Directory of Open Access Journals (Sweden)

    Gisele Alborghetti Nai

    2015-02-01

    Full Text Available BACKGROUND AND OBJECTIVE: Previous studies regarding the effects of some local anaesthetics have suggested that these agents can cause genetic damage. However, they have not been tested for genotoxicity related to repetitive administration. The aim of this study was to evaluate the genotoxic potential of local anaesthetics upon repetitive administration. METHODS: 80 male Wistar rats were divided into: group A - 16 rats intraperitoneally injected with lidocaine hydrochloride 2%; group B - 16 rats IP injected with mepivacaine 2%; group C - 16 rats intraperitoneally injected with articaine 4%; group D - 16 rats IP injected with prilocaine 3% (6.0 mg/kg; group E - 8 rats subcutaneously injected with a single dose of cyclophosphamide; and group F - 8 rats intraperitoneally injected with saline. Eight rats from groups A to D received a single dose of anaesthetic on Day 1 of the experiment; the remaining rats were dosed once a day for 5 days. RESULTS: The median number of micronuclei in the local anaesthetics groups exposed for 1 or 5 days ranged from 0.00 to 1.00, in the cyclophosphamide-exposed group was 10.00, and the negative control group for 1 and 5 days was 1.00 and 0.00, respectively (p 0.05. CONCLUSION: No genotoxicity effect was observed upon repetitive exposure to any of the local anaesthetics evaluated.

  3. Does scorpion bite lead to development of resistance to the effect of local anaesthetics?

    Directory of Open Access Journals (Sweden)

    Minnu Mridul Panditrao

    2012-01-01

    Full Text Available A patient posted for vaginal hysterectomy was administered subarachnoid block, which failed, so was repeated in one space above. The block failed again, after waiting for 30 min. Patient gave a history of scorpion bite twice, once at the age of 17 years on her right foot and again about 8 months back. Thereafter, balanced general anaesthesia was given. On eighth post-operative day, after explaining about her possible special condition (?Resistance to local anaesthetic agents, the patient was given left median, ulnar and radial nerve blocks at the wrist and local infiltration near the anatomical snuff box. There was neither sensory nor motor block. The scorpion venom is known to affect the pumping mechanism of sodium channels in the nerve fibres, which are involved in the mechanism of action of local anaesthetic drugs, it may be responsible for the development of ′resistance′ to the action of local anaesthetic agents.

  4. Challenges in Anaesthetic management of a child for thoracoscopic assisted oesophageal replacement

    Directory of Open Access Journals (Sweden)

    K R Chandrakala

    2016-01-01

    Full Text Available The loss of oesophageal length or obliteration of oesophageal lumen due to stricture acquired by accidental caustic ingestion is more common in children that may require major operative reconstruction. A number of procedures have been developed for anatomic replacement of oesophagus of which thoracoscopic assisted gastric transposition has shown the best outcome in children. This demands an extensive pre-operative evaluation, preparation and anaesthetic management since this is challenging and prolonged procedure done under one lung ventilation (OLV. Though it is a minimally invasive procedure, providing OLV and management of complications associated with it are the anaesthetic challenges among these children. We report anaesthetic management of an 8-year-old boy with oesophageal stricture following corrosive injury posted for thoracoscopic assisted gastric transposition.

  5. Anaesthetic considerations in children with congenital heart disease undergoing non-cardiac surgery

    Directory of Open Access Journals (Sweden)

    Jagdish Menghraj Shahani

    2012-01-01

    Full Text Available The objective of this article is to provide an updated and comprehensive review on current perioperative anaesthetic management of paediatric patients with congenital heart disease (CHD coming for non-cardiac surgery. Search of terms such as "anaesthetic management," "congenital heart disease" and "non-cardiac surgery" was carried out in KKH eLibrary, PubMed, Medline and Google, focussing on significant current randomised control trials, case reports, review articles and editorials. Issues on how to tailor perioperative anaesthetic management on cases with left to right shunt, right to left shunt and complex heart disease are discussed in this article. Furthermore, the author also highlights special considerations such as pulmonary hypertension, neonates with CHD coming for extracardiac surgery and the role of regional anaesthesia in children with CHD undergoing non-cardiac operation.

  6. Anaesthetic Management of a Patient with Synchronous Kartagener Syndrome and Biliary Atresia.

    Science.gov (United States)

    Kendigelen, Pınar; Tütüncü, Ayşe Çiğdem; Erbabacan, Şafak Emre; Kaya, Güner; Altındaş, Fatiş

    2015-06-01

    Kartagener syndrome is an autosomal recessive disorder characterized by primary ciliary dyskinesia accompanied by sinusitis, bronchiectasis, and situs inversus. Synchronous extrahepatic biliary atresia and Kartagener syndrome are very rare. During the preoperative preparation of patients with Kartagener syndrome, special attention is required for the respiratory and cardiovascular system. It is important to provide suitable anaesthetic management to avoid problems because of ciliary dysfunction in the perioperative period. Further, maintaining an effective pain control with regional anaesthetic methods reduces the risk of pulmonary complications. Infants with biliary atresia operated earlier have a higher chance of survival. Hepatic dysfunction and decrease in plasma proteins are important for the kinetics of drugs. In this presentation, the anaesthetic management of patients with synchronous Kartagener syndrome and biliary atresia, both of which are rare diseases, is evaluated.

  7. The analgesic effect of wound infiltration with local anaesthetics after breast surgery

    DEFF Research Database (Denmark)

    Byager, N; Hansen, Mads; Mathiesen, Ole;

    2014-01-01

    BACKGROUND: Wound infiltration with local anaesthetics is commonly used during breast surgery in an attempt to reduce post-operative pain and opioid consumption. The aim of this review was to evaluate the effect of wound infiltration with local anaesthetics compared with a control group on post-operative...... pain after breast surgery. METHODS: A systematic review was performed by searching PubMed, Google Scholar, the Cochrane database and Embase for randomised, blinded, controlled trials of wound infiltration with local anaesthetics for post-operative pain relief in female adults undergoing breast surgery...... partial or segmental mastectomy, and three trials breast reduction, excision of benign lump and unspecified breast surgery, respectively. Six trials demonstrated a small and short-lasting, but statistically significant reduction of post-operative pain scores, and four trials observed a statistically...

  8. Preparation of the Drager Fabius CE and Drager Zeus anaesthetic machines for patients susceptible to malignant hyperthermia.

    LENUS (Irish Health Repository)

    Shanahan, Hiliary

    2012-05-01

    Malignant hyperthermia may follow exposure to trace quantities of inhalational anaesthetics. In susceptible patients, the complete avoidance of these triggers is advised when possible; however, failing this, it is essential to washout or purge the anaesthesia machine of residual inhalational anaesthetics.

  9. Anaesthetic management for caesarean section in a case of previously operated with residual pituitary tumour

    Directory of Open Access Journals (Sweden)

    Prerana N Shah

    2011-01-01

    Full Text Available Successful anaesthetic management for caesarean section in a case with previous pituitary tumour resection, with residual tumour, is reported. The pituitary gland undergoes global hyperplasia during pregnancy. Functional pituitary tumours may exhibit symptomatic enlargement during pregnancy. Growth hormone secreting tumour is associated with acromegaly which has associated anaesthetic implications of difficult airway, systemic hypertension, and diabetes and electrolyte imbalance. Intracranial space occupying lesions can increase intra cranial pressure and compromise cerebral perfusion or cause herniation. We report management of this case.

  10. Analgesic efficacy of local anaesthetic wound administration in knee arthroplasty: volume vs concentration

    DEFF Research Database (Denmark)

    Andersen, L Ø; Gaarn-Larsen, L; Kristensen, B B;

    2010-01-01

    Wound administration of local anaesthetic may be effective for postoperative pain management in knee arthroplasty, but the analgesic efficacy of local anaesthetic in relation to volume vs concentration has not been determined. In a double-blinded trial, 48 patients scheduled for total knee...... arthroplasty were randomly assigned to receive either a high volume/low concentration solution of ropivacaine (20 ml, 0.5%) or a low volume/high concentration solution of ropivacaine (10 ml, 1%), 6 and 24 h postoperatively through an intracapsular catheter. Pain was assessed for 2 h after administration. Pain...

  11. Anaesthetic management of total craniopagus twins for magnetic resonance imaging and cerebral angiography.

    Science.gov (United States)

    Parameswari, A; Vakamudi, M; Raghupathy, V; Siddhartha, R

    2010-09-01

    We describe the anaesthetic management of 4-yr-old total craniopagus twins for radiological investigations. There are some unique anaesthetic problems associated with this condition. These include cross-circulation between the twins that results in induction of both the twins after the administration of i.v. induction agent to one twin and difficulty in mask ventilating both the twins simultaneously due to the angle between the heads; different arterial pressures in the two children complicate pharmacological management and underline the importance of physiological measures to control arterial pressure. Adequate preparation and teamwork is the keystone to the management of these patients.

  12. Anaesthetic challenges in carotid body tumour resection: a case report and review of literature

    Directory of Open Access Journals (Sweden)

    Anuradha Malliwal

    2015-12-01

    Full Text Available Carotid body tumour (CBT is an extremely rare, non-chromaffin paraganglioma arising from chemoreceptor cells at the carotid bifurcation. Reported incidence is 1-2 per 100,000. Surgical excision of the tumour, the definitive treatment, poses several anaesthetic challenges and a high incidence of perioperative morbidity and mortality (20-40%. Very few cases have been reported so far. We report the anaesthetic management of a case of CBT excision with a review of recent literature on the same. [Int J Res Med Sci 2015; 3(12.000: 3897-3900

  13. Local anaesthetic toxicity in a pregnant patient undergoing lignocaine-induced intravenous regional anaesthesia.

    LENUS (Irish Health Repository)

    Coleman, M

    2012-02-03

    A pregnant patient at 38 weeks\\' gestation developed symptoms of local anaesthetic toxicity following intravenous regional anaesthesia (IVRA) for hand surgery, using a standard dose of lignocaine. Reports suggest that a number of factors, both physiological and pharmacological, combine to increase the likelihood of local anaesthetic (LA) toxicity in pregnancy despite employment of a conventional "safe" IVRA technique. It is suggested that for IVRA, pregnant patients are premedicated with a benzodiazepine, the tourniquet time is increased and the concentration of LA is decreased to reduce the risks of LA toxicity.

  14. Analgesic efficacy of local anaesthetic wound administration in knee arthroplasty: volume vs concentration

    DEFF Research Database (Denmark)

    Andersen, L Ø; Gaarn-Larsen, L; Kristensen, B B;

    2010-01-01

    Wound administration of local anaesthetic may be effective for postoperative pain management in knee arthroplasty, but the analgesic efficacy of local anaesthetic in relation to volume vs concentration has not been determined. In a double-blinded trial, 48 patients scheduled for total knee...... arthroplasty were randomly assigned to receive either a high volume/low concentration solution of ropivacaine (20 ml, 0.5%) or a low volume/high concentration solution of ropivacaine (10 ml, 1%), 6 and 24 h postoperatively through an intracapsular catheter. Pain was assessed for 2 h after administration. Pain...... was reduced in both groups with ropivacaine administration 24 h postoperatively (p

  15. The challenging aspects and successful anaesthetic management in a case of situs inversus totalis

    Directory of Open Access Journals (Sweden)

    Sukhminder Jit Singh Bajwa

    2012-01-01

    Full Text Available Situs inversus totalis is a rare condition with a predicted incidence of one in 10,000 among the general population, the aetiologic factors for which are still not completely understood. In a patient with situs inversus totalis, not just the diagnosis of any acute abdomen pathology is difficult due to distorted anatomy and transposition of thoraco abdominal viscera but equally challenging is the anaesthetic management during the respective surgical procedure. We are reporting a patient who had situs inversus totalis and was operated for open cholecystectomy. The present case report lays an emphasis on the potential difficulties during anaesthetic management and its various implications.

  16. [The profitability of various methods of desinfection for anaesthetic equipment (author's transl)].

    Science.gov (United States)

    Herbst, H

    1975-06-01

    This is a presentation of the three most utilized methods of desinfection - steam, acethylenoxide aldehyde solution - for anaesthetic equipment as to their costs. During series of tests the wear and tear has been checked. The desinfection by aldehyde solution is worth the price as to the investigation, the current costs and the wear and tear.

  17. Safety and efficacy of xenon in routine use as an inhalational anaesthetic

    NARCIS (Netherlands)

    B.F. Lachmann (Burkhard); S. Armbruster (S.); W. Schairer (W.); A.M. Landstra (A. M.); A. Trouwborst (Adrianus); G.J. van Daal; A. Kusuma (Ari); W. Erdmann (Wilhelm)

    1990-01-01

    markdownabstractAbstract 40 patients (24 male, 16 female, aged 21-59 years) of American Society of Anesthesiologists class I or II who were undergoing routine surgery took part in a randomised, double-blind comparison of the anaesthetic efficacy and potency of xenon and nitrous oxide and their eff

  18. Anaesthetic implications of laparoscopic splenectomy in patients with sickle cell anaemia.

    LENUS (Irish Health Repository)

    Doodnath, R.

    2010-04-01

    With the increasing immigrant population in the Republic of Ireland, the number of patients with sickle cell disease (SCD) seen in the paediatric hospitals is climbing. In this case report, we review the anaesthetic implications and outcome of the first two paediatric patients with SCD to have a laparoscopic splenectomy due to repeated splenic infarcts in the Republic of Ireland.

  19. Anaesthetic implications of laparoscopic splenectomy in patients with sickle cell anaemia.

    LENUS (Irish Health Repository)

    Doodnath, R

    2012-02-01

    With the increasing immigrant population in the Republic of Ireland, the number of patients with sickle cell disease (SCD) seen in the paediatric hospitals is climbing. In this case report, we review the anaesthetic implications and outcome of the first two paediatric patients with SCD to have a laparoscopic splenectomy due to repeated splenic infarcts in the Republic of Ireland.

  20. Effects of chronic occupational exposure to anaesthetic gases on the rate of neutrophil apoptosis among anaesthetists.

    LENUS (Irish Health Repository)

    Tyther, R

    2012-02-03

    BACKGROUND AND OBJECTIVE: Volatile anaesthetic agents are known to influence neutrophil function. The aim was to determine the effect of chronic occupational exposure to volatile anaesthetic agents on the rate of neutrophil apoptosis among anaesthetists. To test this hypothesis, we compared the rate of neutrophil apoptosis in anaesthetists who had been chronically exposed to volatile anaesthetic agents with that in unexposed volunteers. METHODS: Venous blood (20 mL) was withdrawn from 24 ASA I-II volunteers, from which neutrophils were isolated, and maintained in culture. At 1, 12 and 24 h in culture, the percentage of neutrophil apoptosis was assessed by dual staining with annexin V-FITC and propidium iodide. RESULTS: At 1 h (but not at 12 and 24 h) in culture, the rate of neutrophil apoptosis was significantly less in the anaesthetists--13.8 (12.9%) versus 34.4 (12.1%) (P = 0.001). CONCLUSIONS: Chronic occupational exposure to volatile anaesthetic agents may inhibit neutrophil apoptosis. This may have implications for anaesthetists and similarly exposed healthcare workers in terms of the adequacy of their inflammatory response.

  1. [Abnormal reaction for anaesthetics in a critically ill child with acute myeloid leukemia--case report].

    Science.gov (United States)

    Bujok, Grzegorz; Knapik, Piotr; Macioł, Zbigniew

    2004-01-01

    The authors present a case report of an abnormal reaction for anaesthetics correlated with cytostatic therapy in the course of preparation time for bone marrow transplantation due to acute myeloid leukemia. Problems of pharmacological interaction of ketamine and benzodiazepines are emphasized. Special attention was paid to the risk of abnormal drug reactions during general anaesthesia in children with leukemia.

  2. Analysis of the antimicrobial activity of local anaesthetics used for dental analgesia.

    Science.gov (United States)

    Pelz, Klaus; Wiedmann-Al-Ahmad, Margit; Bogdan, Christian; Otten, Jörg-Elard

    2008-01-01

    Seven local anaesthetics and their active anaesthetic components [Ultracaine D-S (articaine hydrochloride), Carbostesin (bupivacaine hydrochloride), Scandicaine (mepivacaine hydrochloride), Xylonest (prilocaine hydrochloride), Xylocaine (lidocaine hydrochloride), Hostacaine (butanilicaine phosphate) and Novocaine (procaine hydrochloride)] were tested for their antimicrobial activity against 311 bacterial strains from 52 different species and 14 Candida albicans strains. The tested pathogens were members of the oral flora, and partly members of the skin and intestinal flora. Additionally, the antimicrobial activity of methyl-4-hydroxybenzoate, sodium disulfite, adrenaline hydrogen tartrate and adrenaline (the preservative and vasoconstrictive components of the anaesthetics) was tested. For determination of MIC and minimal bactericidal concentration (MBC), the agar dilution method using Wilkins-Chalgren agar was applied. The trade preparation Ultracaine D-S showed the most prominent antimicrobial activity with regard to both MIC and MBC. Ultracaine D-S and its active substance, articaine hydrochloride, showed similar MIC values, suggesting that the antimicrobial activity is mainly caused by the anaesthetic component. Novocaine showed the lowest antimicrobial activity and did not inhibit 35 of the species tested. The MIC values of all local anaesthetics were between 0.25 and 16 mg ml(-1). The routinely applied concentration of Ultracaine D-S was roughly four times higher, and of Hostacaine was two times higher, than the MBC values for the tested bacteria, whereas for the other anaesthetics, the MBC values were not reached or exceeded with the concentrations used. The MIC range of the preservatives was 0.5-1.0 mg ml(-1) for methyl-4-hydroxybenzoate and 0.2-0.5 mg ml(-1) for sodium disulfite. The articaine MIC values were two to three serial dilution steps lower, and the butanilicaine MIC values one to two serial dilution steps lower, than the MIC of the preservatives

  3. Increasing membrane interactions of local anaesthetics as hypothetic mechanism for their cardiotoxicity enhanced by myocardial ischaemia.

    Science.gov (United States)

    Tsuchiya, Hironori; Mizogami, Maki; Shigemi, Kenji

    2012-11-01

    While myocardial ischaemia enhances the cardiotoxicity of local anaesthetics, the pharmacological background remains unclear. Cardiolipin (CL) localized in mitochondrial membranes is possibly the site of cardiotoxic action of local anaesthetics and peroxynitrite is produced by cardiac ischaemia and reperfusion. We verified the hypothetic mechanism that local anaesthetics may interact with CL-containing biomembranes to change the membrane biophysical property and their membrane interactions may be increased by peroxynitrite. Biomimetic membranes were prepared with different phospholipids and cholesterol of varying compositions. The membrane preparations were reacted with peroxynitrite of pathologically relevant concentrations and local anaesthetics (bupivacaine and lidocaine) of a cardiotoxic concentration separately or in combination. Changes in membrane fluidity were determined by measuring fluorescence polarization. Peroxynitrite decreased the fluidity of biomimetic membranes at 0.1-10 μM with the relative potency being CL>1-stearoyl-2-arachidonoylphosphatidylcholine>1,2-dipalmitoylphosphatidylcholine-constituting membranes, indicating the lipid peroxidation-induced membrane rigidification determined by the unsaturation degree of membrane lipids. When treated with 0.1-10 μM peroxynitrite, biomimetic membranes were more rigid with elevating the CL content from 0% to 30 mol%, suggesting that CL is a primary target of peroxynitrite. Bupivacaine and lidocaine fluidized at 200 μM biomimetic membranes containing 10 mol% CL and their effects were increased by pre-treating the membranes with 0.1 and 1 μM peroxynitrite. Cardiotoxic bupivacaine and lidocaine increasingly interact with CL-containing mitochondria model membranes which are relatively rigidified by peroxynitrite. Such an increasing membrane interaction may be, at least in part, responsible for the local anaesthetic cardiotoxicity enhanced by myocardial ischaemia.

  4. Topical anaesthetic effects on skin vasculature with potential implications for laser treatment.

    Science.gov (United States)

    Tollan, Clare Josephine; MacLaren, William; Mackay, Iain R

    2016-05-01

    Laser treatment of vascular lesions is affected by parameters including the diameter and depth of the vessels and flow within the vessels. Topical anaesthetics are in common use prior to laser treatment but may have effects on vessel parameters and, subsequently, the efficacy of laser treatment. Eleven patients with capillary vascular malformations were investigated for vessel diameter before and after elective application of a topical anaesthetic, Eutectic Mixture of Local Anaesthetics (EMLA) (AstraZeneca) or Ametop (S&N Health), prior to pulsed dye laser treatment. EMLA contains 2.5% lidocaine ad 2.5% prilocaine, and Ametop gel contains 4% tetracaine. Patients' capillary malformations were assessed using confocal laser scanning microscopy (CLSM) (Vivascope 1500 Mavig GmbH, Munich). Six of the 11 patients recruited had EMLA topical anaesthetic, and five had Ametop. Four hundred twenty-one diameters were measured. The mean vessel diameter was 50.87 μm. Previous laser treatments undergone by each patient were noted to exclude this as a confounding variable, and no significant difference was found between topical anaesthetic groups. Statistical calculations were made using GenStat and Minitab. There is no evidence that Ametop affects mean diameter (p value is 0.361). EMLA reduces the mean diameter of vessels (p = 0.002), with a 27% reduction in post-EMLA diameter. This study demonstrates that the use of EMLA cream has a statistically significant reduction vessel diameter. As it is known that vessel diameter is important for the response of laser treatment, the use of EMLA may affect outcome.

  5. Adjuncts to local anaesthetics in tonsillectomy: a systematic review and meta-analysis.

    Science.gov (United States)

    Vlok, R; Melhuish, T M; Chong, C; Ryan, T; White, Leigh D

    2017-01-24

    The infiltration of local anaesthetic agents has been shown to reduce post-tonsillectomy pain. A number of recent studies have shown that the addition of agents such as clonidine and dexamethasone improve the efficacy of nerve blocks and spinal anaesthesia. The aim of this review was to determine whether additives to local anaesthetic agents improve post-tonsillectomy outcomes. Four major databases were systematically searched for all relevant studies published up to August 2016. All study designs with a control group receiving local anaesthetic infiltration and an intervention receiving the same infiltration with an added agent were included in this review. These studies were then assessed for level of evidence and risk of bias. The data were then analysed both qualitatively and where appropriate by meta-analysis. We reviewed 11 randomised controlled trial (RCTs) that included 854 patients. Due to inconsistencies in the methods used to report outcomes, both quantitative and qualitative comparisons were required to analyse the extracted data. Overall, we found that dexamethasone, magnesium, pethidine and tramadol reduce post-operative pain and analgesia use, with dexamethasone in particular significantly reducing post-operative nausea and vomiting and magnesium infiltration significantly reducing the incidence of laryngospasm. This systematic review of RCTs provides strong evidence that the use of dexamethasone and magnesium as additives to local anaesthetics reduces post-tonsillectomy pain and analgesia requirement. There is limited evidence that pethidine and tramadol have a similar effect on pain and analgesia requirement. The studies in this pooled analysis are sufficiently strong to make a level one recommendation that the addition of magnesium to local anaesthetics reduces the incidence of laryngospasm, a potentially lethal post-operative complication. Review level of evidence: 1.

  6. TOPICAL APPLICATION OF LOCAL ANAESTHETIC GEL VS ICE IN PEDIATRIC PATIENTS FOR INFILTRATION ANAESTHESIA

    Directory of Open Access Journals (Sweden)

    Iqra

    2015-09-01

    Full Text Available BACKGROUND: Local anaesthetic injections are one of the most feared or anxiety - inducing stimuli in dental operatory. Due to the fear of pain attributed to injection of anaesthetic agents providing appropriate dental care in children is difficult. Various methods have been investigated to decrease pain perception during injection. Hence, the present study was directed towards reducing pain perception in pediatric patients by comparing the effect of cooling the injection site and use of local anaesthetic gel. AIMS AND OBJECTIVES: To comp are the effect of topical cooling and the use of local anesthetic gel before infiltration anesthesia in reducing pain in pediatric patients undergoing dental extractions in the maxillary anterior region. MATERIALS AND METHODS: A clinical trial was used to investigate pain perception in 100 healthy pediatric patients in the age group of 8 to 12 years who required infiltration anaesthesia for bilateral maxillary primary anterior teeth extraction. Before infiltration anaesthesia precooling was done on right si de, whereas on the left side local anaesthetic gel was applied. The patients were asked to individually rate their pain experience on each side using the visual analogue scale. Scores were tabulated and subjected to statistical analysis using Student’s t t est. Statistical significance was defined at P < 0.001. RESULTS: The results of the present study, showed a statistically significant differences between the two groups ( P < 0.001, with greater pain reduction in the ice group. CONCLUSION: Pre cooling injectio n site before infiltration anaesthesia significantly reduced the pain perception in pediatric patients when compared to local anaesthetic gel. Pre cooling of the injection site before infiltration anesthesia is an easy, reliable, and effective technique wi th no additional cost and can be beneficial to apply to all pediatric patients to reduce discomfort and facilitate clinical management.

  7. Clarifying the role of activated charcoal filters in preparing an anaesthetic workstation for malignant hyperthermia-susceptible patients.

    Science.gov (United States)

    Bilmen, J G; Gillies, R I

    2014-01-01

    Malignant hyperthermia (MH) is a life-threatening condition caused by exposure of susceptible individuals to volatile anaesthetics or suxamethonium. MH-susceptible individuals must avoid exposure to these drugs, so accurate and reproducible processes to remove residual anaesthetic agents from anaesthetic workstations are required. Activated charcoal filters (ACFs) have been used for this purpose. ACFs can reduce the time for preparing an anaesthetic workstation for MH patients. Currently, the only commercially available ACFs are the Vapor-Clean$trade; (Dynasthetics, Salt Lake City, UT, USA) filters which retail at approximately AUD$130 per set of two, both of which are to be used in a single anaesthetic. Anaesthetic workstations were saturated with anaesthetic vapours and connected to a Miran ambient air analyser (SapphRe XL, ThermoScientific, Waltham, MA, USA) to measure vapour concentration. Various scenarios were tested in order to determine the most economical configurations of machine flushing, component change and activated charcoal filter use. We found that placement of filters in an unprepared, saturated circuit was insufficient to safely prepare an anaesthetic workstation. Following flushing of the anaesthetic workstation with high-flow oxygen for 90 seconds, a circuit and soda lime canister change and the placement of an ACF on the inspiratory limb, we were able to safely prepare a workstation in less than three minutes. A single filter on the inspiratory limb was able to maintain a clean circuit for 12 hours, with gas flows dropped from 10 lpm to 3 lpm after 90 minutes or removal of the filter after 90 minutes if high gas flows were maintained.

  8. Control Strategy for Anaesthetic Drug Dosage with Interaction Among Human Physiological Organs Using Optimal Fractional Order PID Controller

    CERN Document Server

    Das, Saptarshi; Maharatna, Koushik

    2016-01-01

    In this paper, an efficient control strategy for physiological interaction based anaesthetic drug infusion model is explored using the fractional order (FO) proportional integral derivative (PID) controllers. The dynamic model is composed of several human organs by considering the brain response to the anaesthetic drug as output and the drug infusion rate as the control input. Particle Swarm Optimisation (PSO) is employed to obtain the optimal set of parameters for PID/FOPID controller structures. With the proposed FOPID control scheme much less amount of drug-infusion system can be designed to attain a specific anaesthetic target and also shows high robustness for +/-50% parametric uncertainty in the patient's brain model.

  9. Studies on the spread of local anaesthetic solution in transversus abdominis plane blocks.

    Science.gov (United States)

    Carney, J; Finnerty, O; Rauf, J; Bergin, D; Laffey, J G; Mc Donnell, J G

    2011-11-01

    The extent of analgesia provided by transversus abdominis plane blocks depends upon the site of injection and pattern of spread within the plane. There are currently a number of ultrasound-guided approaches in use, including an anterior oblique-subcostal approach, a mid-axillary approach and a more recently proposed posterior approach. We wished to determine whether the site of injection of local anaesthetic into the transversus abdominis plane affects the spread of the local anaesthetic within that plane, by studying the spread of a local anaesthetic and contrast solution in four groups of volunteers. The first group underwent the classical landmark-based transversus abdominis plane block whereby two different volumes of injectate were studied: 0.3 ml.kg(-1) vs 0.6 ml.kg(-1). The second group underwent transversus abdominis plane block using the anterior subcostal approach. The third group underwent transversus abdominis plane block using the mid-axillary approach. The fourth group underwent transversus abdominis plane block using the posterior approach, in which local anaesthetic was deposited close to the antero-lateral border of the quadratus lumborum. All volunteers subsequently underwent magnetic resonance imaging at 1, 2 and 4 h following each block to determine the spread of local anaesthetic over time. The studies demonstrated that the anterior subcostal and mid-axillary ultrasound approaches resulted in a predominantly anterior spread of the contrast solution within the transversus abdominis plane and relatively little posterior spread. There was no spread to the paravertebral space with the anterior subcostal approach. The mid-axillary transversus abdominis plane block gave faint contrast enhancement in the paravertebral space at T12-L2. In contrast, the posterior approaches, using both landmark and ultrasound identifications, resulted in predominantly posterior spread of contrast around the quadratus lumborum to the paravertebral space from T5 to L1

  10. Co-administration of hyaluronic acid with local anaesthetics shows lower cytotoxicity than local anaesthetic treatment alone in bovine articular chondrocytes

    OpenAIRE

    Onur, T. S.; Sitron, C. S.; Dang, A

    2013-01-01

    Objective To study the effect of hyaluronic acid (HA) on local anaesthetic chondrotoxicity in vitro. Methods Chondrocytes were harvested from bovine femoral condyle cartilage and isolated using collagenase-containing media. At 24 hours after seeding 15 000 cells per well onto a 96-well plate, chondrocytes were treated with media (DMEM/F12 + ITS), PBS, 1:1 lidocaine (2%):PBS, 1:1 bupivacaine (0.5%):PBS, 1:1 lidocaine (2%):HA, 1:1 bupivacaine (0. 5%):HA, or 1:1 HA:PBS for one hour. Following tr...

  11. Anaesthetic contribution to deaths in the operating theatre at the University Hospital Kuala Lumpur--a retrospective survey.

    Science.gov (United States)

    Tan, I; Delilkan, A E

    1993-12-01

    From January 1980 to August 1992, there were 125 deaths occurring in the operating theatre at the University Hospital Kuala Lumpur. Out of these 125, six were judged to have been mainly 'due to anaesthesia.' In the same time period, there were a total of 155,000 anaesthetics given in the hospital. This gives an anaesthetic death rate (in the operating theatre) of six out of 155,000 or 0.39:10,000.

  12. EVALUATION OF THE EFFECTIVENESS OF TOPICAL EMLA CREAM AS LOCAL ANAESTHETIC IN VENEPUNCTURE

    Directory of Open Access Journals (Sweden)

    Bodicherla Siva

    2016-05-01

    Full Text Available BACKGROUND AND OBJECTIVES The efficacy of a topical anaesthetic formulation, EMLA 5% cream (Eutectic Mixture of Local Anaesthetics in obtunding the pain produced by intravenous cannulation was determined in our study. This study aims at evaluating the eff icacy of EMLA cream in producing dermal analgesia for venous cannulation and the effect of timing of application of EMLA cream prior to cannulation. MATERIALS AND METHODS Amongst 60 patients, EMLA cream was applied for 60 minutes in 20 patients, 30 minutes in another 20 and in the remaining 20 no cream or placebo was applied. RESULTS Pain was assessed in all the groups by a 4-point rank score. It was found that patients with EMLA cream had lower pain scores and decreased haemodynamic stress response to venous cannulation when compared to the control group. INTERPRETATION AND CONCLUSION Maximum analgesia was observed in patients who had EMLA cream applied for 60 minutes. No significant side effects were seen with this formulation

  13. Anaesthetic management of a patient with dilated cardiomyopathy posted for non-cardiac surgery

    Directory of Open Access Journals (Sweden)

    Madhusudan M

    2016-07-01

    Full Text Available Dilated cardiomyopathy (DCM is characterized by impaired ventricular contractility and causes concern in anaesthetic management as it may sometimes predispose to malignant arrhythmias. A 77-year-old woman diagnosed to have irreducible umbilical hernia, was posted for emergency laparotomy and hernia repair. On examination, she belonged to American Society of Anesthesiologists (ASA physical status grade III with a functional status of 4 metabolic equivalents (METs. She was also suffering from DCM with severe left ventricular (LV dysfunction (LV ejection fraction 25%. This patient was successfully managed by administering general anaesthesia with ProSeal laryngeal mask airway. We report the detailed anaesthetic management of this patient who underwent emergency laparotomy and hernia repair.

  14. Evaluation of three topical anaesthetic agents against pain : A clinical study

    Directory of Open Access Journals (Sweden)

    Nayak R

    2006-01-01

    Full Text Available AIM : To compare pain responses of children during local anaesthetic infiltration at bilateral buccal sites prepared with topical application of EMLA 5% cream, benzocaine 18% gel or lignocaine 5% ointment and also to find out the rapidity of onset of action of these agents. METHODS : 60 healthy children aged 6 to 12 years old, received bilateral buccal infiltration following application of topical anaesthetic agents applied in a double blind design. Pain responses were compared based on subject self report using visual analogue scale (VAS and operator assessment using Sound -Eye -Motor (SEM scale. RESULTS : Benzocaine gel had the rapidest onset of action. EMLA 5% cream proved to be superior in pain reduction compared to benzocaine and lignocaine. Taste acceptance was better with benzocaine gel. Further studies are required for EMLA cream with an improved formulation more suitable for mucosal application before its routine use in dentistry.

  15. Anaesthetic Management of A Child with Multiple Congenital Anomalies Scheduled for Cataract Extraction

    Directory of Open Access Journals (Sweden)

    Kalpana Kulkarni

    2009-01-01

    Full Text Available In infants& children variety of conditions and syndromes are associated with difficult Airway. Anaesthetic management becomes a challenge if it remains unrecognized until induction and sometimes results in disaster, leading to oropharyngeal trauma, laryngeal oedema, cardiovascular& neurological complications. A 4-month-old child with multiple congenital anomalies was posted for cataract extraction for early and better development of vision. He had history of post birth respiratory distress, difficulty in feeding, breath holding with delayed mile stones. He was treated as for Juvenile asthma. This child was induced with inhalation anaesthesia. There was difficulty in laryngoscopic intubation and could pass much smaller size of the tube than predicted. He developed post operative stridor and desaturation. The problems which we faced during the anaesthetic management and during postoperative period are discussed with this case.

  16. Robot Assisted Renal Auto Transplantation: A Case Based Discussion of Unique Anaesthetic Considerations

    Directory of Open Access Journals (Sweden)

    Praveen Gupta

    2015-02-01

    Full Text Available Laparoscopic renal autotransplantation has serious perturbations on the body's homeostasis due to its non physiological positioning, use of pneumoperitoneum, changing fluid strategy at different points of time and on-going steps to maintain optimal environment for the transplanted kidney. Generally speaking, the anaesthetic management of renal auto-transplantation by open technique is not very complex and the perioperative management can be categorized in the intermediate level of clinical skill requirement. Adding to the comfort of the anaesthesiologist is the fact that these patients are not in end stage renal disease state and does not manifest the comorbidities, multisystem involvement and technical complexities of long term renal dysfunction and renal replacement therapy. In our case report surgeons used the da Vinci surgical robotic system for laparoscopic transplantation of the kidney at a new site. In this article we discuss the anaesthetic challenges of robot assisted laparoscopic renal auto-transplantation along with a description of our index case.

  17. Ear acupuncture or local anaesthetics as pain relief during postpartum surgical repair: a randomised controlled trial

    DEFF Research Database (Denmark)

    Kindberg, S; Klünder, L; Strøm, J

    2009-01-01

    -hour hands-on training in the use of ear acupuncture. All midwives (n= 36) in the department had previous experience in using acupuncture for obstetric pain relief. Pain and wound healing were evaluated using validated scores. Data collection was performed by research assistants blinded towards...... treatment allocation. Randomisation was computer assisted. A total of 207 women were randomised to receive ear acupuncture (105) and local anaesthetics (102), respectively. Main outcome measures The primary outcome was pain during surgical repair. Secondary outcomes were wound healing at 24-48 hours and 14...... days postpartum, participant satisfaction, revision of wound or dyspareunia reported 6 months postpartum. Results Pain during surgical repair was more frequently reported by participants allocated to ear acupuncture compared with participants receiving local anaesthetics (89 versus 54%, P

  18. Formation of granulocytes and macrophages in mouse bone marrow cultures exposed to various anaesthetics.

    Science.gov (United States)

    Benestad, H B; Bjertnaes, L J; Hersleth, I B

    1982-08-01

    The effects of anaesthetics on mouse bone marrow colony growth in vitro were examined. The culture dishes were kept in boxes of stainless steel, so that the composition of the gas phase could easily be controlled. After 1 week of culturing, cell colonies were counted. The cells (macrophages and in one type of culture also granulocytes) were then washed out of the dishes and counted. Enflurane, as well as halothane, present in the gas phase at concentrations used clinically, decreased the number of colonies and cells in a dose-dependent fashion. However, intravenously administered drugs such as diazepam, fentanyl, alfentanyl, sufentanyl, thiopental and pentobarbital were not inhibitory at concentrations used in anaesthetic practice, but at least some of them depressed cell formation when high concentrations were used.

  19. Impact of anaesthetic technique on survival in colon cancer: a review of the literature.

    Science.gov (United States)

    Vogelaar, F Jeroen; Lips, Daan J; van Dorsten, Frank R C; Lemmens, Valery E; Bosscha, Koop

    2016-02-01

    An oncological surgical resection is the mainstay of treatment for potentially curable colon cancer. At the time of surgery, a large fraction of patients do harbour-although not visibly-minimal residual disease at the time of surgery. The immunosuppression that accompanies surgery may have an effect on disease recurrence and survival. Regional or neuraxial anaesthetic techniques like epidural anaesthesia may suppress immune function less than opioid analgesia, by reducing stress response and significantly reducing exposure to opioids. Consistent with this hypothesis, regional anaesthetic techniques have been associated with lower recurrence rates in breast cancer and prostate cancer. Results for colon cancer, however, are contradictory. In this review of the literature we describe all studies addressing the association of the use of epidural anaesthesia and survival in colon cancer surgery.

  20. Anaesthetic management of patients with congenital heart disease presenting for non-cardiac surgery.

    Directory of Open Access Journals (Sweden)

    Mohindra R

    2002-01-01

    Full Text Available The incidence of congenital heart disease is about one percent of all live births in the United States. Treatment is being performed at a younger age and these children are showing improved survival. It is not unusual for children with congenital heart disease to present for non-cardiac surgery. Their management depends on their age, type of lesion, extent of corrective procedure, the presence of complications and other congenital anomalies. Each patient needs a detailed pre-operative evaluation to understand the abnormal anatomy and physiology, and related anaesthetic implications. No anaesthetic agent is an absolute contraindication, although drugs beneficial for one lesion may be detrimental for another. Regional anaesthesia has also been safely used in children with congenital heart disease. However the anaesthesiologist must have a detailed understanding of the pathophysiology of the lesion and the pharmacology of drugs being used to be able to provide safe anaesthesia for children with congenital heart disease.

  1. Emergency anaesthetic management of a severely anaemic, chronic schizophrenic patient with history of neuroleptic malignant syndrome

    Directory of Open Access Journals (Sweden)

    Shrividya Chellam

    2011-01-01

    Full Text Available Administering anaesthesia to a patient with chronic schizophrenia is a challenge due to the increased risk of various perioperative complications. Neuroleptic agents are highly effective drugs used for the treatment of psychiatric disorders, but are rarely associated with neuroleptic malignant syndrome (NMS. Here, we describe the successful anaesthetic management of a patient of chronic schizophrenia with past history of NMS who presented in emergency with active bleeding per rectum and haemoglobin of 3 gm%.

  2. Anaesthetics may change the shape of isolated type I hair cells.

    Science.gov (United States)

    Scarfone, E; Ulfendahl, M; Figueroa, L; Flock, A

    1991-08-01

    Type I hair cells isolated from animals anaesthetised with barbiturates or ether were found to be shorter and to lack a prominent 'neck' region when compared to cells isolated from non-anaesthetised animals. Ketamine did not have this effect. The changes observed could have important implications for the physiology of inner ear receptors. These findings infer that care should be taken in the choice of anaesthetics used in studies on cells from the inner ear.

  3. Perivascular action of the local anaesthetic, lidocaine, on pial terminal arterioles: direct observations on the microcirculation.

    OpenAIRE

    Altura, B. M.; Lassoff, S.

    1981-01-01

    Considerable controversy currently exists with respect to whether or not local anaesthetics exert direct action on cerebral arteriolar tone. In situ experiments were therefore undertaken on pial terminal arterioles of rats to determine whether or not perivascular application of lidocaine exerts any action on such cerebral vessels. Vessel size was assessed with an image-splitting television microscope recording system. The vessels studied ranged in size from 25 to 30 micron. Lidocaine was appl...

  4. Anaesthetic Management of A Patient with Hypokalemic Periodic Paralysis- A Case Report

    Directory of Open Access Journals (Sweden)

    S Chitra

    2009-01-01

    Full Text Available We report the anaesthetic management of a patient with hypokalemic periodic paralysis who underwent hepaticojejunostomy for stricture of the common bile duct. Patients with this disorder, who are apparently normal, can develop sudden paralysis as they are exposed to many of the predisposing factors, perioperatively. The complications due to this rare genetic disorder, the factors that can precipitate these problems and preventive measures are dis-cussed.

  5. Perioperative Anaesthetic Management of Caesarean Delivery in a Parturient with Portal Gastropathy

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    Ashwini H Ramaswamy

    2014-12-01

    Full Text Available Portal hypertensive gastropathy occurs both in cirrhotic and non cirrhotic patients leading to haemetemesis secondary to oesophageal varices. The hyper dynamic circulatory state of pregnancy in these patients poses special problems necessitating specialized care preferably in a tertiary care centre. We report the perioperative anaesthetic management for elective caesarean section in a 32-year-old pregnant lady at 39 weeks gestation with portal gastropathy secondary to periportal fibrosis of the liver.

  6. Anaesthetic Management of Cataract Surgery in a Patient with Sturge-Weber Syndrome

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    Vasantha Kumar

    2015-05-01

    Full Text Available Sturge-Weber Syndrome (SWS, also called as encephalo trigeminal angiomatosis, is a rare congenital syndrome, characterized by lepto meningeal haemangioma, a facial port-wine stains distributed over the trigeminal nerve area, (usually involving one side and glaucoma. During cataract surgery, there may be rupture of choroid haemangioma, leading to excessive bleeding, or of haemangioma involving the airway, leading to difficult mask ventilation, laryngoscopy and intubation. We discuss the anaesthetic management of the patient with SWS for cataract surgery.

  7. Theory versus Practice in the Twentieth-Century Search for the Ideal Anaesthetic Gas.

    Science.gov (United States)

    Rae, Ian D

    2016-02-01

    At the beginning of the twentieth century, an anaesthetist could choose between nitrous oxide, chloroform, and ether (diethyl ether) for the induction of painrelieving unconsciousness. By the end of century, the choice was between a small number of fluorinated aliphatic ethers such as Enflurane, Desflurane, and Sevoflurane, and (in some jurisdictions) the rare gas, xenon. Between these endpoints researchers had identified a surprisingly broad range of hydrocarbons, noble gases, organohalogens, and aliphatic ethers that possessed anaesthetic properties. None was entirely satisfactory, but clinicians at various times and in various places employed substances in each of these categories. Behind the search for new anaesthetic gases was a theory of action (Meyer- Overton theory) that was known to be inadequate, but as no alternative was strong enough to displace it the search continued on purely empirical grounds, while lip-service was paid to the theory. By the time a theory couched in more modern terms was proposed, a suite of modern anaesthetic gases was in place, and there have been no attempts to use that theory to drive a new search.

  8. THE USE OF SELECTED ANAESTHETIC DRUGS IN SEARCH OF A METHOD FOR IMPROVING EARTHWORMS’ WELFARE

    Directory of Open Access Journals (Sweden)

    Agnieszka Podolak-Machowska

    2013-07-01

    Full Text Available This paper describes selected effects of body contact of earthworms Dendrobaena veneta Rosa with local anaesthetic (LA drugs used for human anesthesia (lidocaine and prilocaine and anaesthetics for aquatic animals (MS-222. The findings showed safe and effective immobilization of earthworms with prilocaine at a concentration of 0.25-1%. At the applied concentrations lidocaine was safe, but less effective. On the other hand, MS-222, at the applied concentrations had a strongly irritating effect for earthworms and induced convulsive body movements connected with a discharge of coelomic fluid. The results may be relevant both for improving the welfare of earthworms during experiments and for the organization of research involving testing drugs on invertebrates. In this case, by using earthworms as an experimental model and by applying the method for measuring their mobility after contact with anaesthetics, which has been described in this article, it might be possible to replace experiments on guinea pigs, rabbits, rats and mice, which are expensive and require an approval of an ethics committee, with laboratory tests on earthworms.

  9. Clinical assessment of a new anaesthetic drug administration system: a prospective, controlled, longitudinal incident monitoring study.

    Science.gov (United States)

    Webster, C S; Larsson, L; Frampton, C M; Weller, J; McKenzie, A; Cumin, D; Merry, Alan F

    2010-05-01

    A safety-orientated system of delivering parenteral anaesthetic drugs was assessed in a prospective incident monitoring study at two hospitals. Anaesthetists completed an incident form for every anaesthetic, indicating if an incident occurred. Case mix data were collected and the number of drug administrations made during procedures estimated. From February 1998 at Hospital A and from June 1999 at Hospital B, until November 2003, 74,478 anaesthetics were included, for which 59,273 incident forms were returned (a 79.6% response rate). Fewer parenteral drug errors occurred with the new system than with conventional methods (58 errors in an estimated 183,852 drug administrations (0.032%, 95% CI 0.024-0.041%) vs 268 in 550,105 (0.049%, 95% CI 0.043-0.055%) respectively, p = 0.002), a relative reduction of 35% (difference 0.017%, 95% CI 0.006-0.028%). No major adverse outcomes from these errors were reported with the new system while 11 (0.002%) were reported with conventional methods (p = 0.055). We conclude that targeted system re-design can reduce medical error.

  10. Continuous wound infusion of local anaesthetic agents following colorectal surgery: Systematic review and meta-analysis

    Institute of Scientific and Technical Information of China (English)

    Alan Karthikesalingam; Stewart R Walsh; Sheraz R Markar; Umar Sadat; Tjun Y Tang; Charles M Malata

    2008-01-01

    AIM:To provide a specific review and meta-analysis of the available evidence for continuous wound infusion of local anaesthetic agents following midline laparotomy for major colorectal surgery.METHODS:Medline,Embase,trial registries,conference proceedings and article reference lists were searched to identify randomised,controlled trials of continuous wound infusion of local anaesthetic agents following colorectal surgery.The primary outcomes were opioid consumption,pain visual analogue scores(VASs),return to bowel function and length of hospital stay.Weighted mean difference were calculated for continuous outcomes.RESULTS:Five trials containing 542 laparotomy wounds were eligible for inclusion.There was a significant decrease in post-operative pain VAS at rest on day 3 (weighted mean difference:-0.43;95% CI:-0.81 to-0.04;P=0.03) but not on post-operative day 1 and 2.Local anaesthetic infusion was associated with a significant reduction in pain VAS on movement on all three post-operative days (day 1 weighted meandifference:-1.14;95% CI:-2.24 to-0.041;P=0.04,day 2 weighted mean difference:-0.97,95% CI:-1.91to-0.029;P=0.04,day 3 weighted mean difference:-0.61;95% CI:1.01 to-0.20;P=0.0038).Local anaesthetic wound infusion was associated with a significant decrease in total opioid consumption (weighted mean difference:-40.13;95% CI:-76.74 to-3.53;P=0.03).There was no significant decrease in length of stay (weighted mean difference:-20.87;95% CI:-46.96 to 5.21,P=0.12) or return of bowel function(weighted mean difference:-9.40;95% CI:-33.98 to15.17;P=0.45).CONCLUSION:The results of this systematic review and recta-analysis suggest that local anaesthetic wound infusion following laparotomy for major colorectal surgery is a promising technique but do not provide conclusive evidence of benefit.Further research is required including cost-effectiveness analysis.

  11. Continuous wound infusion of local anaesthetic agents following colorectal surgery: Systematic review and meta-analysis

    Science.gov (United States)

    Karthikesalingam, Alan; Walsh, Stewart R; Markar, Sheraz R; Sadat, Umar; Tang, Tjun Y; Malata, Charles M

    2008-01-01

    AIM: To provide a specific review and meta-analysis of the available evidence for continuous wound infusion of local anaesthetic agents following midline laparotomy for major colorectal surgery. METHODS: Medline, Embase, trial registries, conference proceedings and article reference lists were searched to identify randomised, controlled trials of continuous wound infusion of local anaesthetic agents following colorectal surgery. The primary outcomes were opioid consumption, pain visual analogue scores (VASs), return to bowel function and length of hospital stay. Weighted mean difference were calculated for continuous outcomes. RESULTS: Five trials containing 542 laparotomy wounds were eligible for inclusion. There was a significant decrease in post-operative pain VAS at rest on day 3 (weighted mean difference: -0.43; 95% CI: -0.81 to -0.04; P = 0.03) but not on post-operative day 1 and 2. Local anaesthetic infusion was associated with a significant reduction in pain VAS on movement on all three post-operative days (day 1 weighted mean difference: -1.14; 95% CI: -2.24 to -0.041; P = 0.04, day 2 weighted mean difference: -0.97, 95% CI: -1.91 to -0.029; P = 0.04, day 3 weighted mean difference: -0.61; 95% CI: 1.01 to -0.20; P = 0.0038). Local anaesthetic wound infusion was associated with a significant decrease in total opioid consumption (weighted mean difference: -40.13; 95% CI: -76.74 to -3.53; P = 0.03). There was no significant decrease in length of stay (weighted mean difference: -20.87; 95% CI: -46.96 to 5.21; P = 0.12) or return of bowel function (weighted mean difference: -9.40; 95% CI: -33.98 to 15.17; P = 0.45). CONCLUSION: The results of this systematic review and meta-analysis suggest that local anaesthetic wound infusion following laparotomy for major colorectal surgery is a promising technique but do not provide conclusive evidence of benefit. Further research is required including cost-effectiveness analysis. PMID:18785282

  12. Local anaesthetic wound infiltration used for caesarean section pain relief: a meta-analysis

    Science.gov (United States)

    Li, Xiangnan; Zhou, Miao; Shi, Xuan; Yang, Haiqin; Li, Yonghua; Li, Jian; Yang, Mei; Yuan, Hongbin

    2015-01-01

    Purpose: Local anaesthetic wound infiltration techniques were reported to reduce opiate requirements and pain scores in women undergoing caesarean section (CS). However, the results were conflicting. The primary aim of this meta-analysis was to assess whether local analgesia could reduce pain intensity when injected via wound catheters. Methods: A search of randomized clinical trials (RCTs) evaluating local analgesia in caesarean surgery in PubMed, EMBASE and the Cochrane database was performed. Cumulative morphine consumption and pain scores at rest at different time point after surgery were extracted and synthesized using random or fixed model for meta-analysis. Subgroup analysis was performed according to incision type and administration regimen. Results: Nine RCTs with a total of 512 patients were included. Cumulative morphine consumption was lower in LA group compared with placebo group in the first 12 h (SMD = -0.736, 95% CI (-1.105, -0.368)), 24 h (SMD = -0.378, 95% CI (-0.624, -0.132)) and 48 h after surgery (SMD = -0.913, 95% CI (-1.683 to -0.143)). Lower morphine consumption was observed in the first 6 h after surgery but the reduction failed to meet the common level of significance. Pain scores was significantly reducedat 12 h but not 6 h after surgery in the LA group compared with placebo group. At 24 h and 48 h after surgery, the pain sore was lower but the difference did not meet the common level of significance. Lower rate of post-operative nausea was observed in the LA group. Conclusions: Local anaesthetic wound infiltration can reduce morphine requirements and the rate of patients suffer nausea but not pain scores after caesarean section. Further procedure-specific RCTs were encouraged to confirm the efficacy of local anaesthetic wound infiltration techniques. PMID:26309720

  13. Possible mechanisms of hypotension produced 70% alcoholic extract of Terminalia arjuna (L. in anaesthetized dogs

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    Lodagala Durga S

    2003-10-01

    Full Text Available Abstract Background The bark of Terminalia arjuna L. (Combretaceae is used in Ayurveda since ancient times for the treatment of cardiac disorders. Previous laboratory investigations have demonstrated the use of the bark in cardiovascular complications. The present study was aimed to find the effect of 70% alcoholic extract of Terminalia arjuna on anaesthetized dog blood pressure and probable site of action. Methods Six dogs were anaesthetized with intraperitoneal injection of thiopental sodium and the blood pressure of each dog (n = 6 was measured from the left common carotid artery connected to a mercury manometer on kymograph. The femoral vein was cannulated for administration of drug solutions. The extract of T. arjuna (dissolved in propylene glycol in the dose range of 5 to 15 mg/kg were administered intravenously in a pilot study and the dose (6 mg/kg which produced appreciable hypotension was selected for further studies. Results Intravenous administration of T. arjuna produced dose-dependent hypotension in anaesthetized dogs. The hypotension produced by 6 mg/kg dose of the extract was blocked by propranolol but not by atropine or mepyramine maleate. This indicates that muscarinic or histaminergic mechanisms are not likely to be involved in the hypotension produced by the extract. The blockade by propranolol of the hypotension produced by T. arjuna indicates that the extract might contain active compound(s possessing adrenergic ß2-receptor agonist action and/or that act directly on the heart muscle. Conclusion The results indicated the likely involvement of peripheral mechanism for hypotension produced by the 70% alcoholic extract of Terminalia arjuna and lends support for the claims of its traditional usage in cardiovascular disorders.

  14. Anaesthetic impairment of immune function is mediated via GABA(A receptors.

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    Daniel W Wheeler

    Full Text Available GABA(A receptors are members of the Cys-loop family of neurotransmitter receptors, proteins which are responsible for fast synaptic transmission, and are the site of action of wide range of drugs. Recent work has shown that Cys-loop receptors are present on immune cells, but their physiological roles and the effects of drugs that modify their function in the innate immune system are currently unclear. We are interested in how and why anaesthetics increase infections in intensive care patients; a serious problem as more than 50% of patients with severe sepsis will die. As many anaesthetics act via GABA(A receptors, the aim of this study was to determine if these receptors are present on immune cells, and could play a role in immunocompromising patients.We demonstrate, using RT-PCR, that monocytes express GABA(A receptors constructed of α1, α4, β2, γ1 and/or δ subunits. Whole cell patch clamp electrophysiological studies show that GABA can activate these receptors, resulting in the opening of a chloride-selective channel; activation is inhibited by the GABA(A receptor antagonists bicuculline and picrotoxin, but not enhanced by the positive modulator diazepam. The anaesthetic drugs propofol and thiopental, which can act via GABA(A receptors, impaired monocyte function in classic immunological chemotaxis and phagocytosis assays, an effect reversed by bicuculline and picrotoxin.Our results show that functional GABA(A receptors are present on monocytes with properties similar to CNS GABA(A receptors. The functional data provide a possible explanation as to why chronic propofol and thiopental administration can increase the risk of infection in critically ill patients: their action on GABA(A receptors inhibits normal monocyte behaviour. The data also suggest a potential solution: monocyte GABA(A receptors are insensitive to diazepam, thus the use of benzodiazepines as an alternative anesthetising agent may be advantageous where infection is a life

  15. Anaesthetic management of patients undergoing surgery for Moyamoya disease - our institutional experience

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    Vivek B Sharma

    2014-01-01

    Full Text Available Background: Moyamoya disease (MMD is a chronic cerebrovascular disorder, defined as the progressive stenosis or occlusion of the intracranial vessels. Because of the insecure cerebral circulation, these patients represent an anaesthetic challenge. Literature is scarce on the anaesthetic management of MMD, especially from the Indian subcontinent. The main objective of our study was to evaluate the peri-operative course and outcome of patients undergoing surgery for MMD. Materials and Methods: We analysed available medical records of all patients who underwent revascularisation surgeries for MMD over a period of 10 years (January 2002 to June 2012. Various intra- and post-operative data related to anaesthesia were recorded. The patients for the analysis were divided into two groups: Group 1, paediatrics (<18 years and group 2, adults (≥18 years. Data are presented as number (% or mean ± SD or median (range. Results: There were 36 patients (12 adults and 24 children. Normotension, normovolaemia, normo- or mild-hypercapnia and normothermia were maintained in all patients. No patient developed complications or new neurological deficit in the post-operative period. All patients were discharged with a full Glasgow coma scale (GCS and no new neurologic deficit. Conclusion: Although the incidence of MMD is not high in India, it is an important cause of cerebral stroke in children and adults. Proper pre-operative evaluation is the most effective method to achieve good results. Anaesthetic management of MMD should focus on the maintenance of adequate cerebral blood flow and cerebral perfusion pressure ensuring adequate cerebral oxygenation to avoid ischaemic complications.

  16. Anaesthetic management of a patient with Liddle's syndrome for emergency caesarean hysterectomy.

    LENUS (Irish Health Repository)

    Hayes, N E

    2011-04-01

    We describe the anaesthetic management of a patient with Liddle\\'s syndrome during caesarean section and emergency hysterectomy for placenta accreta associated with significant intrapartum haemorrhage. Liddle\\'s syndrome is a rare autosomal dominant disorder characterised by early onset arterial hypertension and hypokalaemic metabolic alkalosis. Additional issues were the presence of short stature, limb hypertonicity and preeclampsia. Initial management with a low-dose combined spinal-epidural technique was subsequently converted to general anaesthesia due to patient discomfort. The management of Liddle\\'s syndrome in the setting of neuraxial and general anaesthesia in a patient undergoing caesarean section is discussed.

  17. Anaesthetic management of a patient with Liddle's syndrome for emergency caesarean hysterectomy.

    LENUS (Irish Health Repository)

    Hayes, N E

    2012-02-01

    We describe the anaesthetic management of a patient with Liddle\\'s syndrome during caesarean section and emergency hysterectomy for placenta accreta associated with significant intrapartum haemorrhage. Liddle\\'s syndrome is a rare autosomal dominant disorder characterised by early onset arterial hypertension and hypokalaemic metabolic alkalosis. Additional issues were the presence of short stature, limb hypertonicity and preeclampsia. Initial management with a low-dose combined spinal-epidural technique was subsequently converted to general anaesthesia due to patient discomfort. The management of Liddle\\'s syndrome in the setting of neuraxial and general anaesthesia in a patient undergoing caesarean section is discussed.

  18. Effectiveness of Two Topical Anaesthetic Agents used along with Audio Visual Aids in Paediatric Dental Patients

    Science.gov (United States)

    Dhawan, Jayata; Kumar, Dipanshu; Anand, Ashish; Tangri, Karan

    2017-01-01

    Abstract Introduction Topical anaesthetic agents enable pain free intraoral procedures, symptomatic pain relief for toothache, superficial mucosal lesions and pain related to post extraction time. Most common anxiety provoking and fearful experience for children in dental operatory is administration of local anaesthesia because on seeing the needle, children usually become uncooperative. One of recent trend of behaviour management technique is using non-aversive techniques out of which audiovisual distraction has emerged as a very successful technique for managing children in dental settings. Audio visual distraction could decrease the procedure related anxiety of patients undergoing dental treatment and can be very relaxing for highly anxious patients. Aim The aim of the present study was to compare the efficacy of topical anaesthetics EMLA (Eutectic Mixture of Local Anaesthetics) cream and benzocaine (20%) gel in reducing the pain during the needle insertion with and without the use of Audio Visual (AV) aids. Materials and Methods The study was conducted on 120 children, the age range of 3-14 years attending the outpatient department for their treatment. EMLA and benzocaine gel (20%) were assessed for their effectiveness in reducing the pain on needle insertion during local anaesthesia administration. Based on the inclusion and the exclusion criteria, children requiring local anaesthesia for the dental treatment were randomly divided into four equal groups of 30 children based upon whether AV aids were used or not. AV aids were given using Sony Vaio laptop with earphones with nursery rhymes and cartoon movies DVD. The pain assessment was done by using the Visual Analogue Scale (VAS) scale and measurement of the physiological responses of pulse rate and oxygen saturation were done by pulse oximeter. Results There was a statistically significant difference in the mean pain score, pulse rate and mean oxygen saturation rate when it was compared between the four

  19. Morbidly obese patient with obstructive sleep apnoea for major spine surgery: An anaesthetic challenge

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    Shruti Redhu

    2016-01-01

    Full Text Available Morbidly obese patients with clinical features of obstructive sleep apnoea can present a myriad of challenges to the anaesthesiologists which must be addressed to minimise the perioperative risks. Initiation of continuous positive airway pressure (CPAP therapy early in the pre- and post-operative period along with appropriate anaesthetic planning is of paramount importance in such patients. This case report emphasises the usefulness of CPAP therapy, even for a short duration, to minimise morbidity, improve recovery and hasten early discharge from the hospital after major surgery.

  20. Calculation of the fresh gas flow requirements of the Hafnia A and D anaesthetic circuits.

    Science.gov (United States)

    Thomsen, A

    1980-01-01

    Semi-closed anaesthetic circuits are converted into the corresponding Hafnia circuits by replacing the expiratory valve by a side tube connected to an ejector flowmeter. Theoretical analysis of the Hafnia A and D circuits revealed by the fresh gas flow requirements are dependent on the inspiration/expiration time ratio. Using a ratio of 1/1.2 and a sine-wave respiratory waveform, the minimal fresh gas requirements were calculated as 2.1 (Hafnia A) and 2.5 (Hafnia D) times the respiratory minute volume. The fresh gas requirements are identical with spontaneous or controlled ventilation.

  1. Assessment of anaesthetic depth by clustering analysis and autoregressive modelling of electroencephalograms

    DEFF Research Database (Denmark)

    Thomsen, C E; Rosenfalck, A; Nørregaard Christensen, K

    1991-01-01

    The brain activity electroencephalogram (EEG) was recorded from 30 healthy women scheduled for hysterectomy. The patients were anaesthetized with isoflurane, halothane or etomidate/fentanyl. A multiparametric method was used for extraction of amplitude and frequency information from the EEG....... The method applied autoregressive modelling of the signal, segmented in 2 s fixed intervals. The features from the EEG segments were used for learning and for classification. The learning process was unsupervised and hierarchical clustering analysis was used to construct a learning set of EEG amplitude...

  2. Microdialysis as a tool for drug quantification in the bronchioles of anaesthetized pigs

    DEFF Research Database (Denmark)

    Rottbøll, Lisa Amanda Holm; Friis, Christian

    2014-01-01

    was to develop a readily accessible microdialysis (MD) method for antibiotic drug quantification in PELF of pigs. The fluoroquinolone danofloxacin was administered to anaesthetized pigs allocated to three groups: intravenous injection, intravenous infusion and intramuscular injection. MD probes were guided......Target site drug determinations are crucial for optimizing treatment of infectious diseases. There is limited knowledge of antibiotic drug penetration into the pulmonary epithelial lining fluid (PELF) and a lack of easily performed methods for continuous drug sampling hereof. The aim of this study...

  3. Anaesthetic management of a patient with deep brain stimulation implant for radical nephrectomy

    Directory of Open Access Journals (Sweden)

    Monica Khetarpal

    2014-01-01

    Full Text Available A 63-year-old man with severe Parkinson′s disease (PD who had been implanted with deep brain stimulators into both sides underwent radical nephrectomy under general anaesthesia with standard monitoring. Deep brain stimulation (DBS is an alternative and effective treatment option for severe and refractory PD and other illnesses such as essential tremor and intractable epilepsy. Anaesthesia in the patients with implanted neurostimulator requires special consideration because of the interaction between neurostimulator and the diathermy. The diathermy can damage the brain tissue at the site of electrode. There are no standard guidelines for the anaesthetic management of a patient with DBS electrode in situ posted for surgery.

  4. Anaesthetic Management for Appendectomy in a Patient with Situs Inversus Totalis

    Science.gov (United States)

    Koç, Alparslan; Sönmez, Yalçın; Balaban, Onur

    2016-01-01

    Situs inversus totalis is a congenital syndrome, in which all the internal organs are in the opposite position, including dextrokardia. Most patients are asymptomatic and maintain their normal life. Kartagener syndrome may accompany situs inversus totalis. Diagnosis may be overlooked in patients with situs inversus totalis in emergency situations. Patients with this syndrome should inform the clinician as this will facilitate the diagnosis. Acute appendicitis is an emergency situation that would require urgent intervention. Appendicitis symptoms can be observed in the left lower quadrant of patients. We present a case concerning the anaesthetic management of a patient with situs inversus undergoing an emergency appendectomy. PMID:27366569

  5. The analysis of variance in anaesthetic research: statistics, biography and history.

    Science.gov (United States)

    Pandit, J J

    2010-12-01

    Multiple t-tests (or their non-parametric equivalents) are often used erroneously to compare the means of three or more groups in anaesthetic research. Methods for correcting the p value regarded as significant can be applied to take account of multiple testing, but these are somewhat arbitrary and do not avoid several unwieldy calculations. The appropriate method for most such comparisons is the 'analysis of variance' that not only economises on the number of statistical procedures, but also indicates if underlying factors or sub-groups have contributed to any significant results. This article outlines the history, rationale and method of this analysis.

  6. Simultaneous pancreas–kidney transplant for type I diabetes with renal failure: Anaesthetic considerations

    Directory of Open Access Journals (Sweden)

    Lakshmi Kumar

    2016-01-01

    Full Text Available Pancreatic grafts have been successfully used in patients with diabetes and are combined with kidney transplantation in patients with renal failure. The propagation of awareness in organ donation in India has increased the donor pool of transplantable organs in the last few years making multi visceral transplants feasible in our country. We present the anaesthetic management of a 32-year-old male with diabetes mellitus and end-stage renal failure who was successfully managed with a combined pancreas and kidney transplantation.

  7. Anaesthetic Implications in Primary Hyperparathyroidism with Severe Hypercalcaemia; a Case Report

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    Pranav Bansal

    2013-07-01

    Full Text Available Primary hyperparathyroidism is a rare endocrinal disorder of excess production of parathormone. A wide array of presenting symptoms may occur from parathormone induced hypercalcaemia leading to nephrolithiasis, osteoporosis, muscle weakness and cardiac arrhythmias. We present a case of young female who presented with non union of an operated fracture femur and generalized bony pains and frequent complaints of vomiting, polyuria and polydipsia. She was diagnosed to have primary hyperparathyroidism with hypercalcaemia and underwent parathyroidectomy. The potential perioperative problems and anaesthetic concerns require a focused management and are discussed.

  8. Anaesthetic Management of a patient with Myasthenia Gravis and Small Bowel Intussusception for Jejuno-Ileal Anastomoses

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    Pawan Kumar Jain

    2016-01-01

    Full Text Available Myasthenia gravis is a chronic autoimmune disease affecting voluntary skeletal muscles. The altered sensitivity of acetylcholine receptors to muscle relaxants and concomitant treatment with anticholinesterase in these patients affect their anaesthetic management. Patients who have undergone bowel anastomosis and are on regular anticholinesterase treatment are susceptible to anastomotic leaks. We report successful anaesthetic management of class I myasthenic patient with coexisting small bowel intussusception operated for jejuno-ileal anastomoses using regional, inhalational and intravenous (i.v anaesthesia based on train of four responses, and avoiding the use of reversal (anticholinesterase.

  9. Robotic invasion of operation theatre and associated anaesthetic issues: A review.

    Science.gov (United States)

    Kakar, Prem N; Das, Jyotirmoy; Roy, Preeti Mittal; Pant, Vijaya

    2011-01-01

    A Robotic device is a powered, computer controlled manipulator with artificial sensing that can be reprogrammed to move and position tools to carry out a wide range of tasks. Robots and Telemanipulators were first developed by the National Aeronautics and Space Administration (NASA) for use in space exploration. Today's medical robotic systems were the brainchild of the United States Department of Defence's desire to decrease war casualties with the development of 'telerobotic surgery'. The 'master-slave' telemanipulator concept was developed for medical use in the early 1990s where the surgeon's (master) manual movements were transmitted to end-effector (slave) instruments at a remote site. Since then, the field of surgical robotics has undergone massive transformation and the future is even brighter. As expected, any new technique brings with it risks and the possibility of technical difficulties. The person who bears the brunt of complications or benefit from a new invention is the 'Patient'. Anaesthesiologists as always must do their part to be the patient's 'best man' in the perioperative period. We should be prepared for screening and selection of patients in a different perspective keeping in mind the steep learning curves of surgeons, long surgical hours, extreme patient positioning and other previously unknown anaesthetic challenges brought about by the surgical robot. In this article we have tried to track the development of surgical robots and consider the unique anaesthetic issues related to robot assisted surgeries.

  10. Robotic invasion of operation theatre and associated anaesthetic issues: A review

    Directory of Open Access Journals (Sweden)

    Prem N Kakar

    2011-01-01

    Full Text Available A Robotic device is a powered, computer controlled manipulator with artificial sensing that can be reprogrammed to move and position tools to carry out a wide range of tasks. Robots and Telemanipulators were first developed by the National Aeronautics and Space Administration (NASA for use in space exploration. Today′s medical robotic systems were the brainchild of the United States Department of Defence′s desire to decrease war casualties with the development of ′telerobotic surgery′. The ′master-slave′ telemanipulator concept was developed for medical use in the early 1990s where the surgeon′s (master manual movements were transmitted to end-effector (slave instruments at a remote site. Since then, the field of surgical robotics has undergone massive transformation and the future is even brighter. As expected, any new technique brings with it risks and the possibility of technical difficulties. The person who bears the brunt of complications or benefit from a new invention is the ′Patient′. Anaesthesiologists as always must do their part to be the patient′s ′best man′ in the perioperative period. We should be prepared for screening and selection of patients in a different perspective keeping in mind the steep learning curves of surgeons, long surgical hours, extreme patient positioning and other previously unknown anaesthetic challenges brought about by the surgical robot. In this article we have tried to track the development of surgical robots and consider the unique anaesthetic issues related to robot assisted surgeries.

  11. Comparison of three different formulations of local anaesthetics for cervical epidural anaesthesia during thyroid surgery

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    Gaurav Jain

    2012-01-01

    Full Text Available Background: To compare the efficacy and safety of local anaesthetics under cervical epidural anaesthesia (CEA using lignocaine (1%, bupivacaine (0.25% and ropivacaine (0.5% for thyroid surgery. Methods: In a prospective, randomized fashion, 81 patients were selected for thyroid surgery under CEA. They were assigned to one of three groups: Group L, B and R to receive 10 mL of 1% lignocaine, 0.25% bupivacaine and 0.5% ropivacaine, respectively. We compared their efficacy in terms of pulmonary and haemodynamic parameters, blockade quality and complications. Results: Of the total, 74 patients completed the study successfully. Sensory block attained the median dermatomal range of C2-T4/T5 in all the groups. Motor block was more pronounced in the ropivacaine group. Cardiorespiratory parameters decreased significantly in all the groups; however, none of the patients had any major complications except for bradycardia in two patients. Among the measured variables, the decrease in heart rate and peak expiratory force was more in the lignocaine group while forced vital capacity and forced expiratory volume at 1 sec declined to a greater extent in the ropivacaine group. The lignocaine group required significantly more epidural top-ups compared with the other two groups. Conclusion: We conclude that cervical epidural route can be safely used for surgery on thyroid gland in patients with normal cardiorespiratory reserve, using either of local anaesthetics chosen for our study. Under the selected dose and concentrations, the decrease in cardiorespiratory parameters was lesser with bupivacaine.

  12. Airway management using a supraglottic airway device without endotracheal intubation for positive ventilation of anaesthetized rats.

    Science.gov (United States)

    Cheong, S H; Lee, J H; Kim, M H; Cho, K R; Lim, S H; Lee, K M; Park, M Y; Yang, Y I; Kim, D K; Choi, C S

    2013-04-01

    Endotracheal intubation is often necessary for positive pressure ventilation of rats during open thoracic surgery. Since endotracheal intubation in rats is technically difficult and is associated with numerous complications, many techniques using various devices have been described in the scientific literature. In this study, we compared the effectiveness of airway management of a home-made supraglottic airway device (SAD), which is cheap to fabricate and easy to place with that of an endotracheal intubation tube in enflurane-anaesthetized rats. Twenty male Sprague-Dawley rats (200-300 g) were randomly assigned to two equal groups for positive pressure mechanical ventilation using either the SAD or an endotracheal intubation tube. The carotid artery of each rat was cannulated for continuous blood pressure measurements and obtaining blood samples for determination of oxygen tension, carbon dioxide tension, and blood acidity before, during and after SAD placement or endotracheal intubation. Proper placement of the SAD was confirmed by observing chest wall movements that coincided with the operation of the mechanical ventilator. No complications and adverse events were encountered in the rats in which the SAD was placed, during SAD placement and immediate removal, during their mechanical ventilation through the SAD, and one week after SAD removal. From the results of blood gas analyses, we conclude that anaesthetized rats can be successfully ventilated using an SAD for open thoracic surgery.

  13. Surgical interventions in patients undergoing percutaneous balloon mitral valvotomy : a retrospective analysis of anaesthetic considerations.

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    Tempe Deepak

    2004-01-01

    Full Text Available Between 1990 and 2000, 5499 balloon mitral valvotomies were performed at GB Pant Hospital. Amongst these, 45 patients required surgical intervention, which form the basis of this report. There were 18 males and 27 females with the mean age of 26.5+/-8.3 years and weight of 42.9+/-7.39 kg. Thirty-five patients underwent open-heart surgery and 10 closed-heart surgery. Twenty-five patients developed acute severe mitral regurgitation during balloon mitral valvotomy and required emergency open-heart surgery. Morphine based anaesthetic technique with careful attention to haemodynamic monitoring was used in these patients. All patients required a high inotropic support to terminate the cardiopulmonary bypass. The closed-heart surgical procedures included emergency exploration for cardiac tamponade (4, exploration + closed mitral valvotomy (4, and elective closed mitral valvotomy (2. The overall mortality was 9%, which is much higher than the reported mortality for elective mitral valve replacement. Morphine based anaesthetic technique is useful in these patients. Adequate oxygenation, vasodilators, inotropes and diuretics are required for preoperative stabilisation of patients who develop acute mitral regurgitation, while those who develop cardiac tamponade need volume replacement along with inotropes and immediate surgical decompression of the tamponade.

  14. Pharmacology and structures of the free base of the anaesthetic kazcaine and its complex with beta-cyclodextrin

    NARCIS (Netherlands)

    Kemelbekov, U. S.; Hagenbach, A.; Lentz, D.; Imachova, Sh. O.; Pichkhadze, G. M.; Rustembekov, Zh. I.; Beketov, K. M.; Praliev, K. D.; Gabdulkhakov, A.; Guskov, A.; Saenger, W.

    2010-01-01

    The base form of the local anaesthetic kazcaine (BFK, [1-(2-ethoxyethyl)-4-ethynyl-4-benzoyloxypiperidine, C(18)H(23)NO(3)]) and beta-cyclodextrin (beta-CD) co-crystallized as BFK:beta-CD inclusion complex in 1:2 M ratio from a mixture of water and ethanol while the filtered mother liquor yielded cr

  15. Volatile Anaesthetic Depression of the Carotid Body Chemoreflex-Mediated Ventilatory Response to Hypoxia: Directions for Future Research

    Directory of Open Access Journals (Sweden)

    J. J. Pandit

    2014-01-01

    Full Text Available In assessing whether volatile anaesthetics directly depress the carotid body response to hypoxia it is necessary to combine in meta-analysis studies of when it is “functionally isolated” (e.g., recordings are made from its afferent nerve. Key articles were retrieved (full papers in English and subjected to quantitative analysis to yield an aggregate estimate of effect. Results from articles that did not use such methodology were assessed separately from this quantitative approach, to see what could be learned also from a nonquantitative overview. Just 7 articles met the inclusion criteria for hypoxia and just 6 articles for hypercapnia. Within these articles, the anaesthetic (mean dose 0.75, standard deviation (SD 0.40 minimum alveolar concentration, MAC statistically significantly depressed carotid body hypoxic response by 24% (P=0.041, but a similar dose (mean 0.81 (0.42 MAC did not affect the hypercapnic response. The articles not included in the quantitative analysis (31 articles, assessed qualitatively, also indicated that anaesthetics depress carotid body function. This conclusion helps direct future research on the anaesthetic effects on putative cellular/molecular processes that underlie the transduction of hypoxia in the carotid body.

  16. Anaesthetic management of a case of Wolff-Parkinson-White syndrome

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    Savitri D Kabade

    2011-01-01

    Full Text Available We report a case of fibroid uterus with Wolff-Parkinson-White (WPW syndrome in a 48-year-old female, posted for elective hysterectomy. Patient gave history of short recurrent episodes of palpitation and electrocardiograph confirmed the diagnosis of WPW syndrome. The anaesthetic management of these patients is challenging as they are known to develop life threatening tachyarrhythmia like paroxysmal supra-ventricular tachycardia (PSVT and atrial fibrillation (AF. Epidural anaesthesia is preferred compared to general anaesthesia to avoid polypharmacy, noxious stimuli of laryngoscopy and intubation. To deal with perioperative complications like PSVT and AF, anti-arrhythmic drugs like adenosine, beta blockers and defibrillator should be kept ready. Perioperative monitoring is essential as patients can develop complications.

  17. ANAESTHETIC MANAGEMENT OF PREGNANT PATIENT WITH UNCONTROLLED HYPERTHYROIDISM FOR EMERGENCY CAESARIAN SECTION

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    Bala Subramanya

    2014-09-01

    Full Text Available The anaesthetic management of patient with uncontrolled hyperthyroidism requiring emergency cesarean section is presented here. Elevated free T3 and T4 and severely suppressed TSH levels confirmed the diagnosis. Propyl thio uracil was started preoperatively. IV Metoprolol was used to control the pre-operative heart rate. After adequate preloading with crystalloids, spinal anaesthesia was administered. There were three episodes of hypotension and tachycardia which were successfully managed with small dose of IV Phenylephrine. Post-operative anaelgesia was administered through epidural catheter. Patient was observed in intensive care unit for congestive cardiac failure and thyroid storm. Anti-thyroid drugs, Propranolol and Dexamethasone were given in the post-operative period.

  18. Conjugates of methylated cyclodextrin derivatives and hydroxyethyl starch (HES: Synthesis, cytotoxicity and inclusion of anaesthetic actives

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    Lisa Markenstein

    2014-12-01

    Full Text Available The mono-6-deoxy-6-azides of 2,6-di-O-methyl-β-cyclodextrin (DIMEB and randomly methylated-β-cyclodextrin (RAMEB were conjugated to propargylated hydroxyethyl starch (HES by Cu+-catalysed [2 + 3] cycloaddition. The resulting water soluble polymers showed lower critical solution temperatures (LCST at 52.5 °C (DIMEB-HES and 84.5 °C (RAMEB-HES, respectively. LCST phase separations could be completely avoided by the introduction of a small amount of carboxylate groups at the HES backbone. The methylated CDs conjugated to the HES backbone exhibited significantly lower cytotoxicities than the corresponding monomeric CD derivatives. Since the binding potentials of these CD conjugates were very high, they are promising candidates for new oral dosage forms of anaesthetic actives.

  19. Quantitative EEG in assessment of anaesthetic depth: comparative study of methodology

    DEFF Research Database (Denmark)

    Thomsen, C. E.; Prior, P. F.

    1996-01-01

    Methodology for assessment of depth of anaesthesia based on analysis of the electroencephalogram (EEG) is controversial. Techniques range from display of single measures, for example median value of the frequency spectrum, to dedicated pattern recognition systems based on measures of several EEG......) and (4) a depth of anaesthesia monitor based on EEG pattern recognition (ADAM). Dose-response curves are presented for stepwise increases in stable end-tidal concentrations of each agent. Results indicated considerable inter-patient variability and the limitations of single EEG measures, particularly...... with deeper anaesthesia producing a burst suppression pattern in the EEG. Pattern recognition techniques reduced these difficulties and appeared to be promising over a wide range of anaesthetic levels....

  20. ANAESTHETIC MANAGEMENT OF A 5 MONTH OLD PREMATURE INFANT WITH RESPIRATORY STRIDOR FOR PDA CLOSURE

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    Sushanta Kumar

    2015-08-01

    Full Text Available Management of a premature infant with PDA poses a significant challenge in the perioperative period for the anaesthesiologist. The risk is multiplied when it is associated with other congenital respiratory anomalies. In our case a premature child at 5 month of age presented with PDA and tracheomalacia. There was a risk of airway collapse during sedation or induction of anaesthesia along with a n anticipated difficu lt intubation. We have managed the case by inducing and intubating the patient in the lateral position without using muscle relaxants. We have used Sevoflurane as the sole anaesthetic agent for inducing and intubating the patient. Postoperatively patient w as extubated in lateral position and succesfully discharged from ICU.

  1. A case of chronic neuropathic pain treated with auricula injection of local anaesthetic

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    Paolo Barbagli

    2006-09-01

    Full Text Available The case under discussion is that of a 69 years old woman, who has suffered from saphenus nerve neuralgia for about one and a half years. This illness has proved resistant to all the therapeutic treatments she has undergone. The case has been solved in just one session of a rarely used technique, not even well-documented in literature: the injection of local anaesthetic into some auricular points. After about one month of significant aggravation, the pain has disappeared and it has never reappeared throughout the 1-year follow up. The new denomination suggested for this technique is neural-auriculotherapy, which well summarizes the therapeutic branches from which it stems.

  2. Transient neurologic symptoms (TNS) following spinal anaesthesia with lidocaine versus other local anaesthetics

    DEFF Research Database (Denmark)

    Zaric, Dusanka; Pace, Nathan Leon

    2009-01-01

    uncomplicated spinal anaesthesia revealed that some of them developed pain in the lower extremities after an initial full recovery. This painful condition that occurs in the immediate postoperative period was named 'transient neurologic symptoms' (TNS). OBJECTIVES: To study the frequency of TNS and neurologic......); and handsearched the reference lists of trials and review articles. SELECTION CRITERIA: We included all randomized and quasi-randomized studies comparing the frequency of TNS and neurologic complications after spinal anaesthesia with lidocaine as compared to other local anaesthetics. DATA COLLECTION AND ANALYSIS......: Two authors independently evaluated the quality of the relevant studies and extracted the data from the included studies. MAIN RESULTS: Sixteen trials reporting on 1467 patients, 125 of whom developed TNS, were included in the analysis. The use of lidocaine for spinal anaesthesia increased the risk...

  3. Postoperative recovery profile after elective abdominal hysterectomy: a prospective, observational study of a multimodal anaesthetic regime

    DEFF Research Database (Denmark)

    Jensen, Kenneth; Kehlet, Henrik; Lund, Claus M

    2009-01-01

    BACKGROUND AND OBJECTIVE: To evaluate the applicability, effectiveness, immediate postoperative complaints and requirements for a postanaesthesia care unit stay after elective abdominal hysterectomy under a well defined, multimodal anaesthetic regime. METHODS: Observational study of 145 consecutive...... patients scheduled for the procedure at a major university hospital in Denmark. Perioperative treatments and postoperative complaints were recorded continuously until discharge from the postanaesthesia care unit. Main outcome measures were treatment regimen adherence, pain, nausea and vomiting, respiratory...... epidural analgesia (bupivacaine, morphine) was feasible in more than 90% of all patients. In the postanaesthesia care unit, 64% did not require opioids, but 25% experienced severe pain. Mean length of stay was 2 h with a mean discharge readiness of 80 min. Half the patients required supplemental oxygen...

  4. Anaesthetic management of splenectomy in Evan′s syndrome during pregnancy with pregnancy induced hypertension.

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    Sherke R

    2001-07-01

    Full Text Available The management of idiopathic thrombocytopenic purpura (ITP during pregnancy, especially with ongoing bleeding diathesis, has not been highlighted sufficiently in the literature. Aortocaval compression and reduction in uteroplacental circulation resulting in foetal hypoxia and acidosis, Mendelson′s syndrome due to gravid uterus, trauma to airway with resultant haemorrhage and aspiration into lungs, compromised airway due to short neck, anasarca and heavy breast, limitation in using invasive monitoring and regional anaesthesia and uncontrolled bleeding leading to placental hypoperfusion and foetal hypoxia are some of the important risks. In the present case report, anaesthetic management for splenectomy during pregnancy complicated with pregnancy induced hypertension and bleeding diathesis secondary to ITP is described with reference to above risks.

  5. [Questions on the first operation with ethyl ether as anaesthetic by Dr. Peter Parker].

    Science.gov (United States)

    Chen, Q

    2017-01-28

    Ethyl ether was the first accepted effective general anaesthetic. It was introduced into China by an America missionary, Dr. Peter Parker. This was one of the historical events of medical communication between China and the West. In the records of the first operation with ether, however, Dr. Parker unusually omitted the patient's medical record number and the date of the operation, while those of other operations with ether anesthetics were all available. This was very unusual for a doctor like Peter Parker who always recorded every important case in detail in the hospital reports. It seems that he deliberately rather than carelessly omitted the information for some reasons. Based on the analysis of Parker's reports, a conclusion is made that the anesthetic effect of the case was actually ineffective. Furthermore, possible answers to this are outlined and question by discussion based on the situation that Parker faced in the late Qing era.

  6. GOAL ORIENTED ANAESTHETIC MANAGEMENT FOR CAESAREAN SECTION IN A PARTURIENT WITH PITUITARY TUMOUR

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    Sushma

    2015-03-01

    Full Text Available BACKGROUND AND OBJECTIVE: Anesthesia for Pregnancy with pituitary tumours is a challenge to an Anesthesiologist , requires careful preoperative assessment and meticulous perioperative management to achieve optimal safety of mother and fetus. There are very limited studies in literature to guide the anaesthetic management of such patients. Here we report the successful Anaesthetic management of a parturient with pituitary tumour with epilepsy posted for emergency caesarean section. PRESENTATION, DIAGNOSIS, MANAGEMENT: A 25 year young woman, G2P1L1, a known epileptic, diagnosed with pituitary macroadenoma presented at 40 weeks of gestation with severe Oligohydramnios (AFI - 4cm was posted for an emergency caesarean section. Following consultation with the obstetrician, neonato logist and the neurosurgeon the decision was made to proceed with caesarean section under general anesthesia. Rapid sequence induction and intubation was performed with inj Thiopentone sodium and inj Rocuronium and was maintained with Isoflurane, titrated to maintain the stability of mean arterial pressure until extraction. A live 4. 25kgs male child was born with Apgar scores of 8 and 9 at 1 and 5 mins respectively. Following extraction 10U run as infusion in Ringers lactate. Intraoperative analgesia was a dministered after extraction. Dexmedetomedine infusion was used. Postoperative period was uneventful. DISCUSSION & CONCLUSION: Management of obstetric patients with pituitary tumour is complex, requiring knowledge of the physiological effects of pregnancy on tumour size and labour on intracranial pressure. General anesthesia combined with multimodal balanced analgesia is associated with a favorable outcome. General anaesthesia using Thiopentone, Fentanyl, Dexmedetomedine and titrated dose of Isoflurane was used in our case were found to be safe with adequate hemodynamic stability and postoperative pain control. A team approach involving the Anaesthethesiologist

  7. Anaesthetic specialist registrars in Ireland: current teaching practices and perceptions of their role as undergraduate teachers.

    LENUS (Irish Health Repository)

    Walsh, K

    2012-02-03

    BACKGROUND AND OBJECTIVES: Teaching is an important responsibility of non-consultant hospital doctors. In Ireland, specialist registrars (SpRs) in anaesthesia are contractually obliged to teach medical students, other doctors and nurses. Both medical students and fellow non-consultant hospital doctors attribute between 30 and 40% of their knowledge gain to non-consultant hospital doctors. METHODS: We carried out a confidential telephone survey of anaesthetic SpRs in Ireland regarding their current teaching practices and the perceptions of their role as undergraduate teachers. All the SpRs currently working in clinical practice in Ireland were eligible. RESULTS: Fifty-five of the 79 (70%) SpRs responded to the questionnaire. Only 7 (12.7%) of the respondents said they had been well trained as a teacher. The majority of the respondents stated that they would attend a learning-to-teach course\\/workshop if one was available, and felt that such a course would improve their ability as a teacher. Only 8 (14.5%) agreed that adequate emphasis is placed on commitment to teaching in the assessment of SpRs, both by individual departments and by the College of Anaesthetists. Anaesthetic SpRs in Ireland spend a considerable amount of time each day teaching undergraduate medical students, the majority (68.9%) stated that they had inadequate time to prepare for teaching. CONCLUSION: The majority of the respondents stated that they enjoy teaching, feel that they play an important role in undergraduate teaching but have inadequate time to prepare for teaching. An adequate emphasis is not placed on their commitment to teaching.

  8. Cardiovascular effects of selective agonists and antagonists of histamine H3 receptors in the anaesthetized rat.

    Science.gov (United States)

    Coruzzi, G; Gambarelli, E; Bertaccini, G; Timmerman, H

    1995-06-01

    The cardiovascular responses to a series of selective histamine H3 receptor agonists, (R) alpha-methylhistamine, imetit and immepip and selective antagonists, thioperamide, clobenpropit and clophenpropit, were studied in anaesthetized rats. At 0.003-1 mumol/kg i.v. doses, H3 agonists failed to produce any significant change in the basal blood pressure and heart rate. Larger doses of (R) alpha-methylhistamine increased the blood pressure and heart rate and higher doses of imetit caused vasodepressor responses and reduced heart rate, whereas immepip proved virtually inactive. While (R) alpha-methylhistamine-induced effects were not blocked by histamine H1-, H2- and H3-receptor antagonists, they were however reduced by idazoxan and propranolol, which indicates that the mechanisms involved are adrenergic. The effects induced by imetit are not related to histamine H3 receptors but are mediated by indirect (via 5HT3 receptors) cholinergic mechanisms, since these effects were prevented by 1 mg/kg i.v. atropine and by 0.1 mg/kg i.v. ondansetron. Similarly, the H3 antagonists per se failed to change basal cardiovascular function up to 10 mumol/kg i.v. and only at 30 mumol/kg i.v. were marked decreases observed in the blood pressure and heart rate with a significant reduction in the effects of noradrenaline. These data indicate that in anaesthetized rats, histamine H3 receptor activation or blockade has no effect on basal cardiovascular function. The effects recorded after the administration of large doses of (R) alpha-methylhistamine and imetit are clearly unrelated to histamine H3 receptors and should be taken into account when using these compounds as H3 ligands for "in vivo" experiments.

  9. Anaesthetic and other treatments of shell shock: World War I and beyond.

    Science.gov (United States)

    McKenzie, A G

    2012-03-01

    Post-traumatic stress disorder (PTSD) is an important health risk factor for military personnel deployed in modern warfare. In World War I this condition (then known as shell shock or 'neurasthenia') was such a problem that 'forward psychiatry' was begun by French doctors in 1915. Some British doctors tried general anaesthesia as a treatment (ether and chloroform), while others preferred application of electricity. Four British 'forward psychiatric units' were set up in 1917. Hospitals for shell shocked soldiers were also established in Britain, including (for officers) Craiglockhart War Hospital in Edinburgh; patients diagnosed to have more serious psychiatric conditions were transferred to the Royal Edinburgh Asylum. Towards the end of 1918 anaesthetic and electrical treatments of shell shock were gradually displaced by modified Freudian methods psychodynamic intervention. The efficacy of 'forward psychiatry' was controversial. In 1922 the War Office produced a report on shell shock with recommendations for prevention of war neurosis. However, when World War II broke out in 1939, this seemed to have been ignored. The term 'combat fatigue' was introduced as breakdown rates became alarming, and then the value of pre-selection was recognised. At the Maudsley Hospital in London in 1940 barbiturate abreaction was advocated for quick relief from severe anxiety and hysteria, using i.v. anaesthetics: Somnifaine, paraldehyde, Sodium Amytal. 'Pentothal narcosis' and 'narco-analysis' were adopted by British and American military psychiatrists. However, by 1945 medical thinking gradually settled on the same approaches that had seemed to be effective in 1918. The term PTSD was introduced in 1980. In the UK the National Institute for Health and Clinical Excellence (NICE) guidelines for management (2005) recommend trauma-focussed Cognitive Behavioural Therapy and consideration of antidepressants.

  10. Intraoperative esmolol infusion reduces postoperative analgesic consumption and anaesthetic use during septorhinoplasty: a randomized trial

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    Nalan Celebi

    2014-09-01

    Full Text Available Background and objectives: Esmolol is known to have no analgesic activity and no anaesthetic properties; however, it could potentiate the reduction in anaesthetic requirements and reduce postoperative analgesic use. The objective of this study is to evaluate the effect of intravenous esmolol infusion on intraoperative and postoperative analgesic consumptions as well as its effect on depth of anaesthesia. Methods: This randomized-controlled double blind study was conducted in a tertiary care hospital between March and June 2010. Sixty patients undergoing septorhinoplasty were randomized into two groups. History of allergy to drugs used in the study, ischaemic heart disease, heart block, bronchial asthma, hepatic or renal dysfunction, obesity and a history of chronic use of analgesic or β-blockers were considered cause for exclusion from the study. Thirty patients received esmolol and remifentanil (esmolol group and 30 patients received normal saline and remifentanil (control group as an intravenous infusion during the procedure. Mean arterial pressure, heart rate, and bispectral index values were recorded every 10min. Total remifentanil consumption, visual analogue scale scores, time to first analgesia and total postoperative morphine consumption were recorded. Results: The total remifentanil consumption, visual analogue scale scores at 0, 20 and 60 min, total morphine consumption, time to first analgesia and the number of patients who needed an intravenous morphine were lower in the esmolol group. Conclusions: Intravenous infusion of esmolol reduced the intraoperative and postoperative analgesic consumption, reduced visual analogue scale scores in the early postoperative period and prolonged the time to first analgesia; however it did not influence the depth of anaesthesia.

  11. Evidence for safety margins of lignocaine local anaesthetics for peri-oral use.

    Science.gov (United States)

    Cannell, H

    1996-10-05

    The evidence for the safety margins of doses of lignocaine local anaesthetics for standard injections for oral and dental purposes has been reviewed. Trials of peri-oral dosages leading to toxicity in humans have not been reported. The overwhelming evidence from trials of the normal dose range used clinically points to a restriction of total doses much lower than the 25 ml (500 mg) as published for 2% lignocaine with 1:80,000 adrenaline for a healthy adult. The recommendations are: 1. In mixtures of two pharmacologically active drugs (dual formulations) for peri-oral injections, to base the safety limit of local anaesthetic on the circulating level of lignocaine, rather than the amount of adrenaline contained in the injected volume. 2. Thus the suggested usual upper limit for dosage for a healthy adult patient is four and a half 2 ml (or 2.2-ml) cartridges of lignocaine with adrenaline (180-198 mg lignocaine or 2.57-2.82 mg/kg) body weight, if carefully given. 3. For some medically compromised patients, minimal doses only of lignocaine and adrenaline (about one cartridge) should be used and especial caution is necessary in patients likely to react adversely to the exogenous adrenaline of the dual formulation. 4. For both children and adults, the dosages should broadly be related to body size and note taken of the total dose which accrues from topical use of other formulations of lignocaine, such as pastes or creams or sprays. The doses injected should be the minimum that allow the treatment to proceed. If necessary the doses are better given at a series of appointments rather than as a large volume on one single occasion.

  12. Anaesthetic induction and recovery characteristics of a diazepam-ketamine combination compared with propofol in dogs

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    Jacques P. Ferreira

    2015-03-01

    Full Text Available Induction of anaesthesia occasionally has been associated with undesirable behaviour in dogs. High quality of induction of anaesthesia with propofol has been well described while in contrast variable induction and recovery quality has been associated with diazepam-ketamine. In this study, anaesthetic induction and recovery characteristics of diazepam-ketamine combination with propofol alone were compared in dogs undergoing elective orchidectomy. Thirty-six healthy adult male dogs were used. After habitus scoring (simple descriptive scale [SDS], the dogs were sedated with morphine and acepromazine. Forty minutes later a premedication score (SDS was allocated and general anaesthesia was induced using a combination of diazepam-ketamine (Group D/K or propofol (Group P and maintained with isoflurane. Scores for the quality of induction, intubation and degree of myoclonus were allocated (SDS. Orchidectomy was performed after which recovery from anaesthesia was scored (SDS and times to extubation and standing were recorded. Data were analysed using descriptive statistics and Kappa Reliability and Kendall Tau B tests. Both groups were associated with acceptable quality of induction and recovery from anaesthesia. Group P, however, was associated with a poorer quality of induction (p = 0.014, prolonged induction period (p = 0.0018 and more pronounced myoclonus (p = 0.003, but had better quality of recovery (p = 0.000002 and shorter recovery times (p = 0.035 compared with Group D/K. Diazepam-ketamine and propofol are associated with acceptable induction and recovery from anaesthesia. Propofol had inferior anaesthetic induction characteristics, but superior and quicker recovery from anaesthesia compared with diazepam-ketamine.

  13. Towards evidence-based emergency medicine: best BETs from the Manchester Royal Infirmary. BET 2: the use of local anaesthetic lubrication for the catheterisation of males.

    Science.gov (United States)

    Roberts, Gareth; Law, Amelia

    2014-09-01

    A short cut review was carried out to establish whether local anaesthetic lubrication is necessary for urethral catheterisation in men. Two studies were directly relevant to the question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. The clinical bottom line is that the use of local anaesthetic is effective in this population and should form part of the procedure.

  14. Efficacy of sub-Tenon's block using an equal volume of local anaesthetic administered either as a single or as divided doses. A randomised clinical trial.

    LENUS (Irish Health Repository)

    Khan, Ehtesham I

    2009-01-01

    Sub-Tenon\\'s anaesthetic is effective and reliable in producing both akinesia and anaesthesia for cataract surgery. Our clinical experience indicates that it is sometimes necessary when absolute akinesia is required during surgery to augment the block with 1-2 ml of local anaesthetic. Hypothesis was that after first injection some of the volume injected may spill out and before second injection the effect of hyaluronidase has taken place and second volume injectate will have desired effect.

  15. Anaesthetics modulate tumour necrosis factor α: effects of L-carnitine supplementation in surgical patients. Preliminary results.

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    Giovanna Delogu

    1993-01-01

    Full Text Available Both anaesthetics and surgical trauma could strongly affect the production of tumour necrosis factor α (TNFα. During in vitro experiments the authors found that anaesthetics modulate the production of TNFα by peripheral blood mononuclear cells. Notably, Pentothal strongly increased the production of the cytokine as compared to both lipopolysacchride treated and control mononuclear cells, whereas in supernatants from Leptofen driven mononuclear cells TNFα was strongly reduced. On the other hand, Pavulon did not significantly affect the cytokine production. In the in vivo study, in an attempt to ameliorate the metabolic response to surgical trauma, L-carnitine was administered to 20 surgical patients, then the circulating TNFα was measured. The results indicate that the levels of circulating TNFα were strongly increased following surgery and that L-carnitine administration resulted in a strong reduction of TNFα. Thus, the data suggest that L-carnitine could be helpful in protecting surgical patients against dysmetabolism dependent on dysregulated production of TNFα.

  16. An investigation into how the European Working Time Directive has affected anaesthetic training

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    Bowhay Andrew R

    2008-08-01

    Full Text Available Abstract Background The European Working Time Directive (EWTD became law in 1993 but only applied to doctors in training in the United Kingdom in 2004. The trainees have in consequence had a reduction in their working hours but also a change to a shift pattern of working. For craft specialities, such as anaesthesia, there are concerns that a reduction in working hours has also led to a reduction in the time available for learning and that ultimately this may affect patient care. However, there is scant research on the perceptions of trainees concerning the impact of the EWTD on their training and working lives. This study investigated what the anaesthetic Specialist Registrars (SpRs on the Mersey Deanery SpR rotation perceived to be training and also what effect the EWTD has had on that training and their quality of life, both within and outside work. Methods The project was a cross sectional survey, using a quantitative questionnaire with qualitative free text comments which were aggregated into overarching themes and sub themes. Results 117 SpRs were sent questionnaires in April 2005; 73 completed questionnaires were returned (response rate 62.4%. Hierarchies of training opportunities emerged with training by consultants being most valued. 71.8% (95% CI 60.7 – 81.3 of trainees believed the EWTD has had a deleterious effect on their training and experience and 74.3% (95% CI 63.2 – 83.4 thought that they will be less prepared for a consultant post. 69.9% (95% CI 58.7 – 79.5 considered that their quality of life outside work had deteriorated, with only 15% (95% CI 8.3 – 24.6 finding improvement. 38.6% (95% CI 27.8 – 50.3 felt that they were not functioning as well as doctors, only 14.3% (95% CI 7.6 – 23.9 noting improvement. The trainees were still positive about anaesthesia and 73.2% (95% CI 62.2 – 82.5 would recommend this specialty to a student. Conclusion The majority of anaesthetic SpRs in the Mersey Deanery have not welcomed

  17. Anaesthetic effects in the ferret of alfaxalone alone and in combination with medetomidine or tramadol: a pilot study.

    Science.gov (United States)

    Giral, M; García-Olmo, D C; Gómez-Juárez, M; Gómez de Segura, I A

    2014-10-01

    Alfaxalone is a neurosteroid with anaesthetic effects and it has been used successfully in several animal species. However, there are no data, to our knowledge, about its efficacy and safety in ferrets (Mustela putorius furo). We evaluated a variety of anaesthetic regimens in ferrets, namely, alfaxalone at 20, 10 and 5 mg/kg (n = 1, 10 and 9, respectively; intravenously); medetomidine at 20 µg/kg (n = 3; intramuscularly); medetomidine (20 µg/kg, intramuscularly) plus alfaxalone (2.5 mg/kg, intravenously; n = 7); and tramadol (5 mg/kg, intramuscularly) plus alfaxalone (5 mg/kg, intravenously; n = 2). Two animals treated with alfaxalone at 10 mg/kg and 20 mg/kg, respectively, died. At 5 mg/kg alfaxalone produced anaesthesia with a similar onset but a shorter duration of anaesthesia and analgesia than alfaxalone at 10 mg/kg. The medetomidine-alfaxalone combination produced anaesthesia and analgesia of a longer duration than alfaxalone administered alone at 5 mg/kg (P tramadol was administered, all the animals exhibited a strong excitation reaction and in no case was the toe-pinch reflex clearly abolished. Thus, alfaxalone plus medetomidine provided safe and effective anaesthesia in ferrets. Alfaxalone, alone or in combination with tramadol, did not produce satisfactory results for use as an anaesthetic for this species.

  18. An anaesthetic pre-operative assessment clinic reduces pre-operative inpatient stay in patients requiring major vascular surgery.

    LENUS (Irish Health Repository)

    O'Connor, D B

    2012-02-01

    BACKGROUND: Patients undergoing major vascular surgery (MVS) require extensive anaesthetic assessment. This can require extended pre-operative stays. AIMS: We investigated whether a newly established anaesthetic pre-operative assessment clinic (PAC) would reduce the pre-operative inpatient stay, avoid unnecessary investigations and facilitate day before surgery (DBS) admissions for patients undergoing MVS. PATIENT AND METHODS: One year following and preceding the establishment of the PAC the records of patients undergoing open or endovascular aortic aneurysm repair, carotid endarterectomy and infra-inguinal bypass were reviewed to measure pre-operative length of stay (LoS). RESULTS: Pre-operative LoS was significantly reduced in the study period (1.85 vs. 4.2 days, respectively, P < 0.0001). Only 12 out of 61 patients in 2007 were admitted on the DBS and this increased to 33 out of 63 patients (P = 0.0002). No procedure was cancelled for medical reasons. CONCLUSION: The PAC has facilitated accurate outpatient anaesthetic assessment for patients requiring MVS. The pre-operative in-patient stay has been significantly reduced.

  19. Local anaesthetic toxicity after bilateral thoracic paravertebral block in patients undergoing coronary artery bypass surgery.

    Science.gov (United States)

    Ho, A M-H; Karmakar, M K; Ng, S K; Wan, S; Ng, C S H; Wong, R H L; Chan, S K C; Joynt, G M

    2016-09-01

    We conducted a small pilot observational study of the effects of bilateral thoracic paravertebral block (BTPB) as an adjunct to perioperative analgesia in coronary artery bypass surgery patients. The initial ropivacaine dose prior to induction of general anaesthesia was 3 mg/kg, which was followed at the end of the surgery by infusion of ropivacaine 0.25% 0.1 ml/kg/hour on each side (e.g. total 35 mg/hour for a 70 kg person). The BTPB did not eliminate the need for supplemental opioids after CABG in the eight patients studied. Moreover, in spite of boluses that were within the manufacturer's recommendation for epidural and major nerve blocks, and an infusion rate that was only slightly higher than what appeared to be safe for epidural infusion, potentially toxic total plasma ropivacaine concentrations were common. We also could not exclude the possibility that the high ropivacaine concentrations were contributing to postoperative mental state changes in the postoperative period. Also, one patient developed local anaesthetic toxicity after the bilateral paravertebral dose. As a result, the study was terminated early after four days. The question of whether paravertebral block confers benefits in cardiac surgery remains unanswered. However, we believe that the bolus dosage and the injection rate we used for BTPB were both too high, and caution other clinicians against the use of these doses. Future studies on the use of BTPB in cardiac surgery patients should include reduced ropivacaine doses injected over longer periods.

  20. Anaesthetic management for balloon dilation of cor triatriatum dexter in a dog.

    Science.gov (United States)

    De Monte, Valentina; Staffieri, Francesco; Caivano, Domenico; Bufalari, Antonello

    2015-06-10

    A three-month-old female Rottweiler puppy was referred for intravascular correction of a previously identified cor triatriatum dexter. Echocardiography confirmed the presence of a hyperechoic membrane that divided the right atrium into a cranial and caudal chamber. A foramen in this membrane allowed the blood to flow from the caudal to the cranial chamber. Balloon dilation of the defect under transthoracic echocardiographic guidance was scheduled for the following day. The dog was premedicated with 0.5 μg/kg sufentanil and 0.2 mg/kg midazolam administered intravenously. General anaesthesia was induced with 2 mg/kg propofol and maintained with inhaled isoflurane in oxygen; at the same time, a constant rate infusion of 0.5 μg/kg/h sufentanil was administered by means of an infusion pump. Uneventful ventricular and supraventricular tachyarrhythmias developed during the placement of catheters and balloon dilation. At the end of procedure, when the guide wire and balloon catheter were removed, normal sinus rhythm was observed. To the authors' knowledge, no previous reports have described the anaesthetic management of a balloon dilation procedure for cor triatriatum dexter in dogs.

  1. Modified PADSS (Post Anaesthetic Discharge Scoring System) for monitoring outpatients discharge.

    Science.gov (United States)

    Palumbo, Piergaspare; Tellan, Guglielmo; Perotti, Bruno; Pacilè, Maria Antonietta; Vietri, Francesco; Illuminati, Giulio

    2013-01-01

    The decision to discharge a patient undergoing day surgery is a major step in the hospitalization pathway, because it must be achieved without compromising the quality of care, thus ensuring the same assistance and wellbeing as for a long-term stay. Therefore, the use of an objective assessment for the management of a fair and safe discharge is essential. The authors propose the Post Anaesthetic Discharge Scoring System (PADSS), which considers six criteria: vital signs, ambulation, nausea/vomiting, pain, bleeding and voiding. Each criterion is given a score ranging from 0 to 2. Only patients who achieve a score of 9 or more are considered ready for discharge. Furthermore, PADSS has been modified to ensure a higher level of safety, thus the "vital signs" criteria must never score lower than 2, and none of the other five criteria must ever be equal to 0, even if the total score reaches 9. The effectiveness of PADSS was analyzed on 2432 patients, by recording the incidence of postoperative complications and the readmission to hospital. So far PADDS has proved to be an efficient system that guarantees safe discharge.

  2. Microdialysis as a tool for drug quantification in the bronchioles of anaesthetized pigs.

    Science.gov (United States)

    Rottbøll, Lisa A H; Friis, Christian

    2014-03-01

    Target site drug determinations are crucial for optimizing treatment of infectious diseases. There is limited knowledge of antibiotic drug penetration into the pulmonary epithelial lining fluid (PELF) and a lack of easily performed methods for continuous drug sampling hereof. The aim of this study was to develop a readily accessible microdialysis (MD) method for antibiotic drug quantification in PELF of pigs. The fluoroquinolone danofloxacin was administered to anaesthetized pigs allocated to three groups: intravenous injection, intravenous infusion and intramuscular injection. MD probes were guided through a tracheostomy into the distal bronchioles using an insertion tube. Intravenously administered inulin served as a marker of extracellular fluid contamination of PELF. Concentrations of free drug in MD fractions were compared to total and non-protein-bound drug concentrations in plasma. Rising and declining danofloxacin plasma concentrations were rapidly reflected in PELF, suggesting an efficient drug transport across the blood bronchial barrier. The AUC FREE DRUG PELF /AUC FREE DRUG PLASMA ratio was 1.8 (S.D. 0.4, 95% CL 1.4-2.3). Although the probes were placed without fiberscopic or other special equipment, the danofloxacin concentrations in PELF were consistent within the different administration groups. The described MD method for drug quantification in PELF is easily accessible and provides repeatable results. However, trace amount of inulin was detected in the MD fractions, suggesting a local tissue reaction induced by the MD membrane. The significance of this finding needs to be clarified in future studies.

  3. Design and validation of an oral health questionnaire for preoperative anaesthetic evaluation

    Directory of Open Access Journals (Sweden)

    Gema Ruíz-López del Prado

    Full Text Available Abstract Background and objectives: Dental injuries incurred during endotracheal intubation are more frequent in patients with previous oral pathology. The study objectives were to develop an oral health questionnaire for preanaesthesia evaluation, easy to apply for personnel without special dental training; and establish a cut-off value for detecting persons with poor oral health. Methods: Validation study of a self-administered questionnaire, designed according to a literature review and an expert group's recommendations. The questionnaire was applied to a sample of patients evaluated in a preanaesthesia consultation. Rasch analysis of the questionnaire psychometric properties included viability, acceptability, content validity and reliability of the scale. Results: The sample included 115 individuals, 50.4% of men, with a median age of 58 years (range: 38-71. The final analysis of 11 items presented a Person Separation Index of 0.861 and good adjustment of data to the Rasch model. The scale was unidimensional and its items were not biased by sex, age or nationality. The oral health linear measure presented good construct validity. The cut-off value was set at 52 points. Conclusions: The questionnaire showed sufficient psychometric properties to be considered a reliable tool, valid for measuring the state of oral health in preoperative anaesthetic evaluations.

  4. Anaesthetic management for combined emergency caesarean section and craniotomy tumour removal

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    Dewi Y Bisri

    2017-01-01

    Full Text Available Presentation of primary intracranial tumour during pregnancy is extremely rare. Symptoms of brain tumour include nausea, vomiting, headache and seizures which mimic symptoms of pregnancy-related hyperemesis or eclampsia. In very few cases, craniotomy tumour removal is performed earlier or even simultaneously with foetal delivery. A 40-year-old woman at 32 weeks of gestation in foetal distress presented to the emergency room with decreased level of consciousness Glasgow Coma Scale 6 (E2M2V2. Computed tomographic scan revealed a mass lesion over the left temporoparietal region with midline shift and intratumoural bleeding. In view of high risk of herniation and foetal distress, she underwent emergency caesarean section followed by craniotomy tumour removal. In parturient with brain tumour, combined surgery of tumour removal and caesarean section is decided based on clinical symptoms, type of tumour and foetal viability. Successful anaesthetic management requires a comprehensive knowledge of physiology and pharmacology, individually tailored to control intracranial pressure while ensuring the safety of mother and foetus.

  5. The effect of the anaesthetic agent isoflurane on the rate of neutrophil apoptosis in vitro.

    LENUS (Irish Health Repository)

    Tyther, R

    2012-02-03

    BACKGROUND: Volatile anaesthetic agents influence neutrophil function, and potentially, the inflammatory response to surgery. AIM: The objective of this study was to determine the effect of isoflurane (1-4%) on human polymorphonuclear neutrophil apoptosis in vitro. METHODS: Venous blood from 12 healthy volunteers was exposed to 0, 1, and 4% isoflurane delivered via a 14G Wallace flexihub internal jugular cannula, at a fresh gas flow of 0.51\\/min for 5 minutes. Isolated neutrophils were assessed for apoptosis at 1, 12, and 24 hours in culture using dual staining with annexin V-FITC and propidium iodide (Annexin-V FITC assay). Data were analysed using paired, one-tailed Student\\'s t-tests. p<0.05 was considered significant. RESULTS: At 1 hour apoptosis was inhibited in the 1% (5.1 [6.8]%; p=0.017) and 4% (4.8 [4.5]%; p=0.008) isoflurane groups compared to control (11.3 [6.9]%). At 12 and 24 hours, a dose-dependent inhibition of apoptosis was demonstrated, i.e. 4% > 1% > 0%. CONCLUSION: Human neutrophil apoptosis is inhibited in a concentration-dependent manner in vitro by isoflurane in clinical concentrations.

  6. Attenuation of pressor response and dose sparing of opioids and anaesthetics with pre-operative dexmedetomidine

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    Sukhminder Jit Singh Bajwa

    2012-01-01

    Full Text Available Background and Aims: Alpha-2 agonists are being increasingly used as adjuncts in general anaesthesia, and the present study was carried out to investigate the ability of intravenous dexmedetomidine in decreasing the dose of opioids and anaesthetics for attenuation of haemodynamic responses during laryngoscopy and tracheal intubation. Methods: One hundred patients scheduled for elective general surgery were randomized into two groups: D and F (n=50 in each group. Group D were administered 1 μg/kg each of dexmedetomidine and fentanyl while group F received 2 μg/kg of fentanyl pre-operatively. Thiopental was given until eyelash reflex disappeared. Anaesthesia was maintained with 33:66 oxygen: nitrous oxide. Isoflurane concentration was adjusted to maintain systolic blood pressure within 20% of the pre-operative values. Haemodynamic parameters were recorded at regular intervals during induction, intubation, surgery and extubation. Statistical analysis was carried out using analysis of variance, chi-square test, Student′s t test and Mann-Whitney U test. Results: The demographic profile was comparable. The pressor response to laryngoscopy, intubation, surgery and extubation were effectively decreased by dexmedetomidine, and were highly significant on comparison (P50% by the administration of dexmedetomidine. The mean recovery time was also shorter in group D as compared with group F (P=0.014. Conclusions: Dexmedetomidine is an excellent drug as it not only decreased the magnitude of haemodynamic response to intubation, surgery and extubation but also decreased the dose of opioids and isoflurane in achieving adequate analgesia and anaesthesia, respectively.

  7. In vitro exposure of human fibroblasts to local anaesthetics impairs cell growth

    Science.gov (United States)

    Fedder, C; Beck-Schimmer, B; Aguirre, J; Hasler, M; Roth-Z'graggen, B; Urner, M; Kalberer, S; Schlicker, A; Votta-Velis, G; Bonvini, J M; Graetz, K; Borgeat, A

    2010-01-01

    Lidocaine, bupivacaine or ropivacaine are used routinely to manage perioperative pain. Sparse data exist evaluating the effects of local anaesthetics (LA) on fibroblasts, which are involved actively in wound healing. Therefore, we investigated the effects of the three LA to assess the survival, viability and proliferation rate of fibroblasts. Human fibroblasts were exposed to 0·3 mg/ml and 0·6 mg/ml of each LA for 2 days, followed by incubation with normal medium for another 1, 4 or 7 days (group 1). Alternatively, cells were incubated permanently with LA for 3, 6 or 9 days (group 2). Live cell count was assessed using trypan blue staining. Viability was measured by the tetrazolium bromide assay. Proliferation tests were performed with the help of the colorimetric bromodeoxyuridine assay. Production of reactive oxygen species (ROS) was determined, measuring the oxidation of non-fluorescent-2,7′-dichlorofluorescin. Treatment of cells with the three LA showed a concentration-dependent decrease of live cells, mitochondrial activity and proliferation rate. Group arrangement played a significant role for cell count and proliferation, while exposure time influenced viability. Among the analysed LA, bupivacaine showed the most severe cytotoxic effects. Increased production of ROS correlated with decreased viability of fibroblasts in lidocaine- and bupivacaine-exposed cells, but not upon stimulation with ropivacaine. This study shows a concentration-dependent cytotoxic effect of lidocaine, bupivacaine and ropivacaine on fibroblasts in vitro, with more pronounced effects after continuous incubation. A possible mechanism of cell impairment could be triggered by production of ROS upon stimulation with lidocaine and bupivacaine. PMID:20819090

  8. Interactions between platelet activating factor and eicosanoids during endotoxic shock in anaesthetized pigs

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    T. Mózes

    1992-01-01

    Full Text Available The effects of platelet activating factor (PAF on eicosanoid release during endotoxic shock was investigated in anaesthetized pigs receiving 5 μg kg−1 Escherichia coli endotoxin (LPS into the superior mesenteric artery over a 60 min period, by measuring plasma levels of a variety of mediators. Fifteen of the 31 animals infused with LPS and not treated with BN 52021, a PAF receptor antagonist, died within 30 min after the commencement of LPS infusion (non-survivors, while the other 16 survived the experimental period of 3 h, though in a state of shock (survivors. No alterations were observed in plasma concentrations of eicosanoids in the non-survivors. A significant, though transient, increase in eicosanoid concentrations occurred only in the survivors. Treatment with BN 52021 (4 mg kg-1, i.v. injected 5 min prior to LPS infusion, failed to exert any effect on the survival rate. However, pretreatment with BN 52021 prevented circulatory collapse in the survivors and reduced the concentration of cyclooxygenase enzyme products, without affecting LTB4 release. Exogenous administration of PAF (0.01 μg kg−1 caused hypotension and increased TXB2 levels although 6-keto PGF1α and LTB4 concentrations were unchanged. The data suggest that prostanoid formation may be secondary to PAF release in circulatory collapse evoked by LPS infusion in survivors, and give further support to the suggestion that PAF prostanoid interaction is important during endotoxic shock. However, their role in early death seems to be negligible, indicating the importance of other mediators.

  9. Species of Compassion: Aesthetics, Anaesthetics, and Pain in the Physiological Laboratory

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    Rob Boddice

    2012-12-01

    Full Text Available This essay explores the interplay of different species of compassion with regard to physiological practices in the final decades of the nineteenth century. Drawing on the lexicon from which ideals of late-Victorian compassion were formed, it illustrates their contested nature, demonstrating how physiologists developed their own concepts of compassion based on the theories of Darwin and Spencer. Within this purview, the essay examines the historical specificity of antivivisectionist compassion as well as ways in which pain in the laboratory was conceptualized, experienced, and managed ethically. This article explores the interplay of different species of compassion with regard to physiological practices in the last quarter of the nineteenth century in Britain. The lexicographical web of late-Victorian compassion included ‘humanity’, ‘pity’, ‘commiseration’, ‘tenderness’ (or ‘tender sympathy’, and ‘sympathetic pain’, all of which projected contested ideals of both individual character and moral conduct. As well as showing the historical specificity of antivivisectionist compassion – a complex aesthetic of pain closely linked to disgust – the article will principally demonstrate that physiologists (and the community of evolutionary scientists in general were applying their own newly, but no less highly, developed form of compassion that emerged straight from the pages of Darwin and Spencer. There is a story here of pain awareness and pain imagination within physiology, specifically connected to feelings of ‘humanity’. In practice, this story centres on anaesthesia and its role in allowing physiologists to live up to an ideal of ‘imperturbability’. It includes an investigation into what physiologists thought about causing pain in animals, as well as analysis of what changed after the use of anaesthetics became widespread. The article inquires anew about the ways in which pain in the laboratory was conceptualized

  10. Feed forward and feedback control for over-ground locomotion in anaesthetized cats

    Science.gov (United States)

    Mazurek, K. A.; Holinski, B. J.; Everaert, D. G.; Stein, R. B.; Etienne-Cummings, R.; Mushahwar, V. K.

    2012-04-01

    The biological central pattern generator (CPG) integrates open and closed loop control to produce over-ground walking. The goal of this study was to develop a physiologically based algorithm capable of mimicking the biological system to control multiple joints in the lower extremities for producing over-ground walking. The algorithm used state-based models of the step cycle each of which produced different stimulation patterns. Two configurations were implemented to restore over-ground walking in five adult anaesthetized cats using intramuscular stimulation (IMS) of the main hip, knee and ankle flexor and extensor muscles in the hind limbs. An open loop controller relied only on intrinsic timing while a hybrid-CPG controller added sensory feedback from force plates (representing limb loading), and accelerometers and gyroscopes (representing limb position). Stimulation applied to hind limb muscles caused extension or flexion in the hips, knees and ankles. A total of 113 walking trials were obtained across all experiments. Of these, 74 were successful in which the cats traversed 75% of the 3.5 m over-ground walkway. In these trials, the average peak step length decreased from 24.9 ± 8.4 to 21.8 ± 7.5 (normalized units) and the median number of steps per trial increased from 7 (Q1 = 6, Q3 = 9) to 9 (8, 11) with the hybrid-CPG controller. Moreover, within these trials, the hybrid-CPG controller produced more successful steps (step length ≤ 20 cm ground reaction force ≥ 12.5% body weight) than the open loop controller: 372 of 544 steps (68%) versus 65 of 134 steps (49%), respectively. This supports our previous preliminary findings, and affirms that physiologically based hybrid-CPG approaches produce more successful stepping than open loop controllers. The algorithm provides the foundation for a neural prosthetic controller and a framework to implement more detailed control of locomotion in the future.

  11. Target-controlled infusion (Propofol versus inhaled anaesthetic (Sevoflurane in patients undergoing shoulder arthroscopic surgery

    Directory of Open Access Journals (Sweden)

    Thrivikrama Padur Tantry

    2013-01-01

    Full Text Available Background: One of the challenges of anaesthesia for shoulder arthroscopic procedures is the need for controlled hypotension to lessen intra-articular haemorrhage and thereby provide adequate visualisation to the surgeon. Achievement of optimal conditions necessitates several interventions and manipulations by the anaesthesiologist and the surgeon, most of which directly or indirectly involve maintaining intra-operative blood pressure (BP control. Aim: This study aimed to compare the efficacy and convenience of target controlled infusion (TCI of propofol and inhalational agent sevoflurane in patients undergoing shoulder arthroscopic surgery after preliminary inter-scalene blockade. Methods: Of thirty four patients studied, seventeen received TCI propofol (target plasma concentration of 3 μg/ml and an equal number, sevoflurane (1.2-1.5 Minimum Alveolar Concentration. N 2 O was used in both groups. Systolic, diastolic, mean blood pressures and heart rate were recorded regularly throughout the procedure. All interventions to control BP by the anaesthesiologist and pump manipulation requested by the surgeon were recorded. The volume of saline irrigant used and the haemoglobin (Hb content of the return fluid were measured. Results: TCI propofol could achieve lower systolic, mean BP levels and the number of interventions required was also lower as compared to the sevoflurane group. The number of patients with measurable Hb was lower in the TCI propofol group and this translated into better visualisation of the joint space. A higher volume of saline irrigant was required in the sevoflurane group. No immediate peri-operative anaesthetic complications were noted in either category. Conclusion: TCI propofol appears to be superior to and more convenient than sevoflurane anaesthesia in inter-scalene blocked patients undergoing shoulder arthroscopy.

  12. Bi-directional CB1 receptor-mediated cardiovascular effects of cannabinoids in anaesthetized rats: role of the paraventricular nucleus.

    Science.gov (United States)

    Grzeda, E; Schlicker, E; Luczaj, W; Harasim, E; Baranowska-Kuczko, M; Malinowska, B

    2015-06-01

    The activation of cannabinoid CB1 receptors decreases and increases blood pressure (BP) in anaesthetized and conscious rats, respectively. The aim of our study was to check the possible involvement of CB1 receptors in the paraventricular nucleus of the hypothalamus (PVN) in the cardiovascular effects of cannabinoids in rats. Methanandamide (metabolically stable analogue of the endocannabinoid anandamide) and the synthetic cannabinoid receptor agonist CP55940 were microinjected into the PVN of urethane-anaesthetized rats twice (S1 and S2, 20 min apart). Receptor antagonists were administered intravenously (i.v.) 5 min before S1. Methanandamide and CP55940 decreased blood pressure by 15 - 20%. The CB1 receptor antagonist AM251 reversed the depressor effect into a pressor response of 20 - 30%. The pressor effect of CP55940 observed in the presence of AM251 i.v. was reduced by AM251 given additionally into the PVN but not by the i.v. injection of the CB2 antagonist SR144528 or the vanilloid TRPV1 antagonist ruthenium red. In the presence of the peripherally restricted CB1 receptor antagonist AM6545, CP55940 given into the PVN increased BP by 40%. AM6545 reversed the decrease in BP induced by CP55940 i.v. into a marked increase. Bilateral chemical lesion of the PVN by kainic acid abolished all cardiovascular effects of CP55940 i.v. In conclusion, the cannabinoid CP55940 administered to the PVN of urethane-anaesthetized rats can induce depressor and pressor effects. The direction of the response probably depends on the sympathetic tone. The centrally induced hypertensive response of CP55940 can, in addition, be masked by peripheral CB1 receptors.

  13. The effect of four anaesthetic protocols for maintenance of anaesthesia on trans-diaphragmatic pressure in dogs.

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    Kiriaki Pavlidou

    Full Text Available The diaphragm is the main inspiratory muscle and the main indicator of diaphragmatic contractility is the trans-diaphragmatic pressure (Pdi. The aim of this clinical study was to determine the effect of four different anaesthetic protocols on Pdi in anaesthetized healthy dogs. Eighty client-owned dogs were recruited in this clinical study. All the animals received dexmedetomidine and morphine as premedication and propofol for induction. Anaesthesia was maintained with one of four protocols: isoflurane (I, isoflurane with CRI of propofol (IP, isoflurane with CRI of fentanyl (IF, and isoflurane with CRI of ketamine (IK. When the surgical plane of anaesthesia was achieved, two balloon catheters were inserted, one into the stomach and one into the mid-third of the oesophagus for Pdi measurement. Pdi value was the highest in groups I (14.9±4.7 mmHg and IK (15.2±3.5 mmHg and the lowest in groups IP (12.2±3.2 mmHg and IF (12.0±5.9 mmHg. There was a statistically significant difference (p = 0.029 between groups IK and IF. PE'CO2 was statistically significantly higher (p<0.0005 in group IF (7.7±0.8 kPa than in group IK (6.5±0.7 kPa. Isoflurane alone or isoflurane with ketamine for the maintenance of anaesthesia seem to better preserve the respiratory function and the diaphragmatic contractility than isoflurane with either propofol or fentanyl in dogs. Therefore, the use of isoflurane or isoflurane with ketamine may be of benefit when animals with respiratory problems have to be anaesthetized.

  14. Effect of a topical anaesthetic formulation on the cortisol response to surgical castration of unweaned beef calves.

    Science.gov (United States)

    McCarthy, D; Lomax, S; Windsor, P A; White, P J

    2016-01-01

    Impracticality and cost of existing pain management strategies during surgical castration of beef cattle have limited their widespread implementation on-farm. A farmer-applied topical anaesthetic formulation, originally developed and used commercially to mitigate the pain of mulesing in lambs, was investigated for its potential use for managing pain in surgically castrated calves. This formulation contained lidocaine, bupivacaine, adrenalin and cetrimide. In this study, 24 Angus bull calves were randomly allocated to (1) surgical castration (C, n=8), (2) surgical castration with the post-operative application of topical anaesthetic (CTA, n=8) and (3) sham castration/control (CON, n=8). The experiment was conducted over 2 days, with treatment groups evenly represented across each day. Calves were habituated to handling before the experiment and blood samples were collected for plasma cortisol measurement at defined time periods before, at and post treatment, (at -0.5, 0 h, then +0.5, 1, 1.5, 2, 4 and 6 h). There was a significant effect of time on cortisol concentrations across all treatment groups (Pcortisol response at 0 h. The effect of treatment was not significant (P=0.077), however, there was a trend for CON calves to display lower cortisol concentrations than C and CTA calves and CTA calves to display lower cortisol concentrations than C calves. The mean area under the curve (AUC) of CON calves was significantly lower than those of C and CTA calves (P=0.04), however, there was no significant difference between the AUCs of CTA and C calves. Immediate application of topical anaesthetic after surgical castration did not significantly reduce plasma cortisol concentrations. However, the trend for CTA calves to display lower cortisol concentrations than C calves warrants further investigation into the use of TA for pain relief of surgically castrated beef calves.

  15. Only a whisper away. A philosophical view of the awake patient's situation during regional anaesthetics and surgery.

    Science.gov (United States)

    Karlsson, Ann-Christin; Ekebergh, Margaretha; Larsson Mauléon, Annika; Almerud Österberg, Sofia

    2012-10-01

    In this study the awake patient's intraoperative situation and experiences during regional anaesthetics and surgery are reflected upon by using the work of the French philosopher Maurice Merleau-Ponty. Merleau-Ponty's phenomenological idea of the body as being at the centre of the world highlights the patient's embodied position and bestows significance onto the body as a whole, as a lived body. A case, based on the findings from a previous interview study, is presented as a contextual starting point where a patient goes from having a familiar body recognized as her own to having a partially anaesthetized body experienced as an unknown object. The intraoperative caring space is described in this context as the mutual ground where the awake patient and the nurse anaesthetist (NA) can interact to create meaning. The NA can act as the patient's bodily extension to bridge the gap between the patient's experiences and the situation. This calls for the NA's proximity and genuine presence in order to meet and understand the patient's awake experiences. Learning from the patient's situatedness gives information that is valuable for NAs to share with patients who are less experienced with this contextual situation. The challenge for the NA is not to perform routine-based care, but to acknowledge every patient's lifeworld and uniqueness thus enabling the patient to move easily along the mind-body-world continuum. The core of intraoperative care is to provide support and promote well-being of awake patients in the intraoperative environment. The use of a philosophical perspective is relevant for nurses who work in an intraoperative setting where patients undergo regional anaesthetics. This study shows how nursing research using phenomenological philosophy can help uncover new meanings known only to the patients living the experience.

  16. Enhancement of delayed-rectifier potassium conductance by low concentrations of local anaesthetics in spinal sensory neurones

    OpenAIRE

    Olschewski, Andrea; Wolff, Matthias; Bräu, Michael E; Hempelmann, Gunter; Vogel, Werner; Safronov, Boris V.

    2002-01-01

    Combining the patch-clamp recordings in slice preparation with the ‘entire soma isolation' method we studied action of several local anaesthetics on delayed-rectifier K+ currents in spinal dorsal horn neurones.Bupivacaine, lidocaine and mepivacaine at low concentrations (1–100 μM) enhanced delayed-rectifier K+ current in intact neurones within the spinal cord slice, while exhibiting a partial blocking effect at higher concentrations (>100 μM). In isolated somata 0.1–10 μM bupivacaine enhanced...

  17. An investigation into the hepatic cytochrome P-450 catalysed metabolism of the anaesthetic fluroxene (2,2,2-trifluoroethyl vinyl ether).

    Science.gov (United States)

    Marsh, J A; Ivanetich, K M; Bradshaw, J J; Harrison, G G; Webber, B L; Kaminsky, L S

    1975-01-01

    The role of the different cytochromes P-450 in the metabolism of the anaesthetic agent fluroxene, and the mechanism of production of toxic effects seen after pre-treatment of the animals with pehnobarbital prior to anaesthesia, have been investigated. Male rats were anaesthetized with fluroxene, or with 2,2,2-trifluroethyl ethyl ether, or with ethyl vinyl ether in an attempt to ascertain the in vivo toxic effects of the three anaesthetic agents. The resultant hepatic histology is reported. A study of the binding and metabolism of fluroxene by isolated rat hepatic microsomes was also made. We conclude that it is elevated levels of cytochrome P-450 which potentiate the toxicity of fluroxene anaesthesia in phenobarbital treated animals and that cytochrome P-448 does not bind or metabolize fluroxene. The potential toxicity of the fluroxene molecule is considered to reside in the trifluoroethyl moiety, while the vinyl group of fluroxene appears to play a role in the observed liver damage.

  18. Addition of clonidine or fentanyl to local anaesthetics prolongs the duration of surgical analgesia after single shot caudal block in children.

    Science.gov (United States)

    Constant, I; Gall, O; Gouyet, L; Chauvin, M; Murat, I

    1998-03-01

    Caudal anaesthesia is indicated for surgical procedures lasting less than 90 min. Fentanyl and clonidine are known to prolong postoperative caudal analgesia, but there are no data on their effect on duration of surgical analgesia. We evaluated if the addition of clonidine or fentanyl to local anaesthetics prolonged the duration of surgical analgesia after single shot caudal block in children in a randomized, double-blind study. We studied 64 children, aged 6-108 months, undergoing bilateral correction of vesicoureteral reflux which was expected to last more than 90 min. Patients were allocated to one of four groups: group O received 1 ml kg-1 of a mixture of 0.25% bupivacaine with epinephrine and 1% lidocaine in equal parts; group F received the same mixture of local anaesthetics in addition to fentanyl 1 microgram kg-1; group C received the same mixture of local anaesthetics in addition to clonidine 1.5 micrograms kg-1; and group C + F received the same mixture of local anaesthetics in addition to fentanyl 0.5 microgram kg-1 and clonidine 0.75 microgram kg-1. Single shot caudal block was sufficient in only 57% of children in group O compared with 93% in groups C and F and 86% in group C + F (P = 0.035). Global assessment of anaesthesia, defined as the time from caudal injection to the first administration of analgesic (either during or after surgery), was significantly longer in the three groups of children who received additives compared with local anaesthetics alone (P = 0.035), but there were no differences between the three additive groups. Vomiting was observed only in children who received fentanyl. Addition of clonidine or fentanyl to local anaesthetics prolonged the duration of surgical analgesia of caudal block, allowing single shot caudal anaesthesia to be recommended for surgery lasting 90-150 minutes. Clonidine had some advantages over fentanyl as it did not produce clinically significant side effects.

  19. The role of adenosine in exercise hyperaemia of the gracilis muscle in anaesthetized cats.

    Science.gov (United States)

    Poucher, S M; Nowell, C G; Collis, M G

    1990-01-01

    1. A number of metabolites have been proposed to control the vascular tone of skeletal muscle during exercise. The present study was designed to investigate the role of adenosine in this response by determining the effect of the adenosine receptor antagonist 8-phenyltheophylline. 2. The gracilis muscle of anaesthetized cats was exposed and made to contract by stimulating the obturator nerve (at 1 Hz, 5 V, 0.1 ms) for 20 min. Gracilis muscle blood flow and tension were measured during exercise and for 20 min following exercise. Initially this was performed in each animal during the infusion of a vehicle solution (50% polyethylene glycol 400, 50% 0.1 M-NaOH, 0.1 ml min-1 I.V.). Exercise was then repeated during infusion of either further vehicle (group I), 8-phenyltheophylline (group II) or 3-propylxanthine (group III), both at 2.7 x 10(7) mol min-1 kg-1. 3. In group 1 (n = 4) gracilis muscle blood flow during the first exercise period increased by 47.5 +/- 11.3 ml min-1 (110 g)-1 and gracilis muscle tension by 8.6 +/- 1.3 kg (100 g muscle mass)-1 at 20 min of exercise. These responses were not significantly different when repeated. 4. In group II (n = 5), blood flow increased by 46.9 +/- 9.9 ml min-1 (100 g)-1 and tension by 6.5 +/- 0.7 kg (100 g muscle mass)-1 during vehicle infusion. Infusion of 8-phenyltheophylline at a rate which abolished the vasodilatation response to 2-chloroadenosine, significantly reduced the muscle blood flow increase to 19.8 +/- 2.7 ml min-1 (100 g muscle mass)-1 (P less than 0.05) but the tension response was unaffected (increased by 7.0 +/- 0.8 kg (100 g muscle mass)-1). 8-Phenyltheophylline did not affect gracilis muscle blood flow or tension at rest. 5. Administration of 3-propylxanthine, which did not modify the vasodilatation response to 2-chloroadenosine, failed to alter the vascular responses to muscle contraction. 6. These results suggest that activation of adenosine receptors can contribute to up to 40% of the vasodilatation

  20. Serotonin in the solitary tract nucleus shortens the laryngeal chemoreflex in anaesthetized neonatal rats.

    Science.gov (United States)

    Donnelly, William T; Bartlett, Donald; Leiter, J C

    2016-07-01

    What is the central question of this study? Failure to terminate apnoea and arouse is likely to contribute to sudden infant death syndrome (SIDS). Serotonin is deficient in the brainstems of babies who died of SIDS. Therefore, we tested the hypothesis that serotonin in the nucleus of the solitary tract (NTS) would shorten reflex apnoea. What is the main finding and its importance? Serotonin microinjected into the NTS shortened the apnoea and respiratory inhibition associated with the laryngeal chemoreflex. Moreover, this effect was achieved through a 5-HT3 receptor. This is a new insight that is likely to be relevant to the pathogenesis of SIDS. The laryngeal chemoreflex (LCR), an airway-protective reflex that causes apnoea and bradycardia, has long been suspected as an initiating event in the sudden infant death syndrome. Serotonin (5-HT) and 5-HT receptors may be deficient in the brainstems of babies who die of sudden infant death syndrome, and 5-HT seems to be important in terminating apnoeas directly or in causing arousals or as part of the process of autoresuscitation. We hypothesized that 5-HT in the brainstem would limit the duration of the LCR. We studied anaesthetized rat pups between 7 and 21 days of age and made microinjections into the cisterna magna or into the nucleus of the solitary tract (NTS). Focal, bilateral microinjections of 5-HT into the caudal NTS significantly shortened the LCR. The 5-HT1a receptor antagonist, WAY 100635, did not affect the LCR consistently, nor did a 5-HT2 receptor antagonist, ketanserin, alter the duration of the LCR. The 5-HT3 specific agonist, 1-(3-chlorophenyl)-biguanide, microinjected bilaterally into the caudal NTS significantly shortened the LCR. Thus, endogenous 5-HT released within the NTS may curtail the respiratory depression that is part of the LCR, and serotonergic shortening of the LCR may be attributed to activation of 5-HT3 receptors within the NTS. 5-HT3 receptors are expressed presynaptically on C

  1. Validation of an EIA kit for determination of total thyroid hormones in rat serum. Effects of different anaesthetics.

    Science.gov (United States)

    Alfonso, M; Arufe, M C; Durán, R

    1998-03-01

    Two enzyme immunoassays for the quantitative determination of total thyroxine (T4) and total triiodothyronine (T3) in human serum were validated to measure total T4 and T3 in rat serum. The specificity, sensitivity, detectability and reproducibility have been tested as well as the effects of different anaesthetics (pentobarbital and a mixture of ketamine and xylacine) on serum thyroid hormone levels. Hormones were quantified, by means of a previously validated technique, 18 hours after surgery for the placement of a stem for blood extraction in conscious and freely moving animals. Thyroid serum levels, especially T3, were slightly lower in xylacine plus ketamine treated animals than in those treated with pentobarbital. The administration of glutamic acid, stimulated the secretion of thyroid hormones, this effect appearing 30 minutes after its administration and it was independent of the anaesthetic used during the surgery for the cannula placement, although in pentobarbital treated rats, the serum T3 level increase induced by glutamate appears 60 minutes after the treatment.

  2. Effect of barnidipine on blood flow to major organs and renal function in anaesthetized dogs and spontaneously hypertensive rats.

    Science.gov (United States)

    Saitoh, M; Kasai, C; Ishikawa, J; Masaki, K; Asano, M

    1995-12-01

    1. The effects of barnidipine on blood flow to major organs and on renal function were investigated in anaesthetized dogs and conscious spontaneously hypertensive rats (SHR), and the results were compared with those for nicardipine, nitrendipine, nisoldipine, manidipine and amlodipine. 2. In anaesthetized dogs, barnidipine (0.3-3 mu g/kg i.v.) dose-dependently decreased blood pressure and increased or preserved blood flow in the vertebral, coronary, femoral and renal arteries. The effect of barnidipine on blood flow was the most potent of the compounds tested. In conscious SHR, barnidipine (0.3-3 mg/kg p.o.) produced a dose-dependent antihypertensive effect and decreased renal vascular resistance. Barnidipine also dose-dependently increased urinary volume. The antihypertensive and diuretic effects of barnidipine were the most potent of the drugs tested. 3. In summary, barnidipine was shown to preserve or increase blood flow to major organs and to produce diuretic activity with a decrease in blood pressure. These findings suggest that barnidipine maintains or promotes renal function at antihypertensive doses.

  3. Maternal and Foetal Cardiovascular Effects of the Anaesthetic Alfaxalone in 2-Hydroxypropyl-β-cyclodextrin in the Pregnant Ewe

    Directory of Open Access Journals (Sweden)

    Anna Andaluz

    2013-01-01

    Full Text Available The objective of this study was to determine the pharmacodynamics effects of the anaesthetic alfaxalone in 2-hydroxypropyl-β-cyclodextrin in pregnant sheep after the intravenous injection of a 2 mg/kg weight dose. Six pregnant Ripollesa sheep, weighing 47.1 ± 4.4 kg, were used. Twenty-four hours after instrumentation, sheep were anaesthetized with intravenous alfaxalone in cyclodextrin. Time to standing from anaesthesia was 30.0 ± 10.81 min. Foetal heart rate increased significantly during the first 5 min after alfaxalone administration. Significant differences were observed in maternal diastolic arterial blood pressure between minute 10 and minutes 90, 120, 150, 180, 210, and 240. Significant differences were observed for foetal systolic arterial blood pressure between 5 and 30 min after alfaxalone administration. Significant differences in foetal pH were detected during the entire study period, whereas maternal pH returned to baseline values by 60 min after alfaxalone administration. The present study indicated that alfaxalone in 2-hydroxypropyl-β-cyclodextrin administered as an intravenous bolus at 2 mg/kg body weight produced minimal adverse effects and an uneventful recovery from anaesthesia in pregnant sheep and their foetus.

  4. Effect of topical anaesthetics on interstitial colloid osmotic pressure in human subcutaneous tissue sampled by wick technique.

    Directory of Open Access Journals (Sweden)

    Hans Jørgen Timm Guthe

    Full Text Available OBJECTIVES: To measure colloid osmotic pressure in interstitial fluid (COP(i from human subcutaneous tissue with the modified wick technique in order to determine influence of topical application of anaesthetics, dry vs. wet wick and implantation time on COP(i. MATERIAL AND METHODS: In 50 healthy volunteers interstitial fluid (IF was collected by subcutaneous implantation of multi-filamentous nylon wicks. Study subjects were allocated to two groups; one for comparing COP(i obtained from dry and saline soaked wicks, and one for comparing COP(i from unanaesthetized skin, and skin after application of a eutectic mixture of local anaesthetic (EMLA®, Astra Zeneca cream. IF was sampled from the skin of the shoulders, and implantation time was 30, 60, 75, 90 and 120 min. Colloid osmotic pressure was measured with a colloid osmometer. Pain assessment during the procedure was compared for EMLA cream and no topical anaesthesia using a visual analogue scale (VAS in a subgroup of 10 subjects. RESULTS: There were no significant differences between COP(i obtained from dry compared to wet wicks, except that the values after 75 and 90 min. were somewhat higher for the dry wicks. Topical anaesthesia with EMLA cream did not affect COP(i values. COP(i decreased from 30 to 75 min. of implantation (23.2 ± 4.4 mmHg to 19.6 ± 2.9 mmHg, p = 0.008 and subsequently tended to increase until 120 min. EMLA cream resulted in significant lower VAS score for the procedure. CONCLUSION: COP(i from subcutaneous tissue was easily obtained and fluid harvesting was well tolerated when topical anaesthetic was used. The difference in COP(i assessed by dry and wet wicks between 75 min. and 90 min. of implantation was in accordance with previous reports. The use of topical analgesia did not influence COP(i and topical analgesia may make the wick technique more acceptable for subjects who dislike technical procedures, including children. TRIAL REGISTRATION: ClinicalTrials.gov NCT

  5. Efficacy of sub-Tenon's block using an equal volume of local anaesthetic administered either as a single or as divided doses. A randomised clinical trial

    Directory of Open Access Journals (Sweden)

    McAdoo John

    2009-03-01

    Full Text Available Abstract Background Sub-Tenon's anaesthetic is effective and reliable in producing both akinesia and anaesthesia for cataract surgery. Our clinical experience indicates that it is sometimes necessary when absolute akinesia is required during surgery to augment the block with 1–2 ml of local anaesthetic. Hypothesis was that after first injection some of the volume injected may spill out and before second injection the effect of hyaluronidase has taken place and second volume injectate will have desired effect. Methods A prospective, randomised, control trial in which patients were randomly allocated to one of two groups. In group 1, single injection of 5 ml of local anaesthetic was injected. In group 2, 3 ml of the same anaesthetic solution was injected followed by application of gentle orbital pressure for 2 minutes. A further 2 ml of the same anaesthetic solution was injected through the same conjunctival incision. Measurement of movement in four quadrants of eye was done by the surgeon at 3 and 6 minutes. Intraocular pressure, chemosis, and subconjuctival haemorrhage were also measured. Results Significant differences at 3 minutes between groups for overall movement, medial, superior, and lateral quadrants occurred. At 6 minutes no significant group differences emerged for the overall movement or for any of four quadrants. Conclusion Single injection of local anaesthesia for sub-Tenon's block with mixture of lignocaine with adrenaline, bupivacaine and hyaluronidase was found to be superior to provide akinesia of ocular muscles compared to divided dose given by two injections. No difference in groups in terms of haemorrhage, chemosis, patient's satisfaction and intraocular pressure was found. Trial registration Trial registration no-ISRCTN73431052

  6. Anaesthetic Management of Laparoscopic Morgagni Hernia Repair in a Patient with Coexisting Down Syndrome, Patent Foramen Ovale and Pectus Carinatum.

    Science.gov (United States)

    Kozanhan, Betül; Başaran, Betül; Aygın, Feride; Akkoyun, İbrahim; Özmen, Sadık

    2016-02-01

    Laparoscopic repair has several advantages with a minimally invasive surgical option for children with Morgagni hernias; however, a number of physiological sequelae results from pneumoperitoneum and insufflation. These physiological changes may be more significant in patients with a congenital heart disease. Perioperative detailed evaluation, meticulous monitorization and cooperation with a surgical team are important in cases with patent foramen ovale for the possible risk of the paradoxical gas embolism. We present the anaesthetic management of a patient with patent foramen ovale, Down syndrome and pectus carinatus who successfully underwent laparoscopic Morgagni hernia repair. Under a well-managed anaesthesia that prevented complications because of pneumoperitoneum, laparoscopic surgery would be safe enough for patients with Morgagni hernia having an associated congenital heart disease.

  7. Increase in volume of lignocaine/adrenaline-containing local anaesthetic solution causes increase in acute postoperative pain after gingivectomy.

    Science.gov (United States)

    Jorkjend, L; Skoglund, L A

    2000-06-01

    A randomized, single-blind, within-patient, crossover study was done in 44 patients (27 women and 17 men mean age 47 years, range 29-63) who had bilateral 'identical' gingivectomies. On one occasion a standard volume of local anaesthetic containing lignocaine 2% and adrenaline (1/80 000) was infiltrated into the mucosal tissue before operation. On the other occasion double the standard volume was infiltrated. The intensity of pain postoperatively was recorded by the patients on 100 mm visual analogue scale every hour for an 11-hour observation period. The intensity of pain when double volume had been given was significantly higher than that after the standard volume from 2 to 8 hours postoperatively (P gingivectomy.

  8. Post-operative recovery profile after laparoscopic cholecystectomy: a prospective, observational study of a multimodal anaesthetic regime

    DEFF Research Database (Denmark)

    Jensen, K; Kehlet, H; Lund, Claus

    2007-01-01

    BACKGROUND: Laparoscopic cholecystectomy is now often an ambulatory procedure, but dependent on short-term post-operative complaints of pain and post-operative nausea and vomiting (PONV). The efficacy of post-anaesthesia care units (PACUs) is therefore important to facilitate return to normal...... functions. We investigated the feasibility and efficacy of a standardized, evidence-based anaesthesia/analgesic regime to identify residual problems in the early post-operative phase. METHODS: One hundred and thirty-four consecutive patients admitted for elective laparoscopic cholecystectomy at Hvidovre...... to discharge (mean, 88 min). There were on average 2.7 treatment interventions (range, 0-11) before discharge. CONCLUSION: An evidence-based, multimodal approach to the anaesthetic/analgesic management in laparoscopic cholecystectomy is feasible and advantageous in the early post-operative phase. Pain and PONV...

  9. Evaluation of the anaesthetic depth during piglet castration under an automated isoflurane-anaesthesia at farm level.

    Science.gov (United States)

    Schwennen, Cornelia; Kolbaum, Nina; Waldmann, Karl-Heinz; Höltig, Doris

    2016-01-01

    Piglet castration under isoflurane-anaesthesia could represent an alternative to the practice of castration without anaesthesia. The objective of this study was to evaluate practicality and effectiveness of an automated isoflurane-anaesthesia for castration. A field study on three different farms in Germany (farm A, B: 200 sows; C: 540 sows) was performed. In total, 1429 (1166 anaesthetised and 263 conventionally castrated) male piglets (age: 1-8 days; bodyweight: 0.7-3.7 kg) were monitored. All piglets were treated with nonsteroidal anti-inflammatory drugs directly before castration. Castration and anaesthesia were performed by the farm-manager in presence of a veterinarian. All farmers used the PIGNAP Pro® (Agrosystems GmbH, CH) anaesthetic device (5 vol.% isoflurane, 30% oxygen; flow rate: 2 l/min). Vocalisation and defensive movements of 1166 anaesthetised piglets was rated using a scoring system. Presence or absence of the palpebral- and flexor-reflex was noted. Approximately every second piglet was weighed and oxygen-saturation and pulse- frequency of 231 animals were measured during treatment. Rectal temperatures before and after castration of 264 anaesthetised and 263 conventionally castrated piglets were compared. Only 77% of the anaesthetised piglets showed a sufficient anaesthetic depth based on the assessment of reflexes as well as vocalisations and defensive movements. It was found that the probability for a sufficient depth of anaesthesia decreases with increasing age and weight. The measurements of the pulse-frequency and oxygen-saturation showed an average oxygen-saturation of 98% and an average heart rate of 270/min during anaesthesia. The conventionally castrated piglets had significantly higher rectal temperatures in comparison to the anaesthetised (p piglets is not adequate for commercial application of this technology.

  10. COMPARATIVE EFFICACY (SEDATIVE AND ANAESTHETIC OF DETOMIDINE, KETAMINE AND DETOMIDINE-KETAMINE COCKTAIL IN PIGEONS (COLUMBA LIVIA

    Directory of Open Access Journals (Sweden)

    UZMA F. DURRANI, M. ARIF KHAN1 AND S. SALEEM AHMAD

    2008-07-01

    Full Text Available A study was conducted to compare the synergistic efficacy of detomidine, ketamine and their cocktail in pigeons (Columba livia. For this study, 15 adult and healthy pigeons were divided into three equal groups A, B and C. Birds of groups A and B were intramuscularly administered detomidine and ketamine @ 1.4 and 60 mg/kg b. wt., respectively. Pigeons of group C received detomidine + Ketamine cocktail @ 0.7 and 30 mg/kg b. wt. Induction of sedation and anaesthesia was smooth in all groups. Mean duration of induction was 11.1 + 2.03, 11.0 + 1.49 and 1.6 + 0.48 minutes in groups A, B, C, respectively. In groups A and B, smooth but light sedation and anaesthesia were observed accompanied by superficial analgesia, while in group C, birds showed deep anaesthesia alongwith deep analgesia. Birds in groups A and C elicited hypothermia, respiratory depression and bradycardia till complete recovery, while group B showed hyperthermia and tachycardia with rapid respiration. In group A, sedation persisted for 54.2 + 21.82 minutes and mean recovery period was 49.9 + 5.91 minutes, while groups B and C had anaesthesia for 47.7 + 8.06 and 103.5 + 27.52 minutes, and recovery periods were 52.6 + 9.64 and 61.3 + 17.26 minutes, respectively. Recovery was rough in group B and smooth in groups A and C. It was concluded that in pigeons, detomidine (alone is safe for handling and for least painful procedures, while detomidine-ketamine cocktail is safe as intramuscular anaesthetic for major surgical procedures. However, ketamine is not a good anaesthetic to be used alone in pigeons.

  11. Effect of sodium nitrite on ischaemia and reperfusion-induced arrhythmias in anaesthetized dogs: is protein S-nitrosylation involved?

    Directory of Open Access Journals (Sweden)

    Mária Kovács

    Full Text Available To provide evidence for the protective role of inorganic nitrite against acute ischaemia and reperfusion-induced ventricular arrhythmias in a large animal model.Dogs, anaesthetized with chloralose and urethane, were administered intravenously with sodium nitrite (0.2 µmol kg(-1 min(-1 in two protocols. In protocol 1 nitrite was infused 10 min prior to and during a 25 min occlusion of the left anterior descending (LAD coronary artery (NaNO2-PO; n = 14, whereas in protocol 2 the infusion was started 10 min prior to reperfusion of the occluded vessel (NaNO2-PR; n = 12. Control dogs (n = 15 were infused with saline and subjected to the same period of ischaemia and reperfusion. Severities of ischaemia and ventricular arrhythmias, as well as changes in plasma nitrate/nitrite (NOx levels in the coronary sinus blood, were assessed throughout the experiment. Myocardial superoxide and nitrotyrosine (NT levels were determined during reperfusion. Changes in protein S-nitrosylation (SNO and S-glutathionylation were also examined.Compared with controls, sodium nitrite administered either pre-occlusion or pre-reperfusion markedly suppressed the number and severity of ventricular arrhythmias during occlusion and increased survival (0% vs. 50 and 92% upon reperfusion. There were also significant decreases in superoxide and NT levels in the nitrite treated dogs. Compared with controls, increased SNO was found only in NaNO2-PR dogs, whereas S-glutathionylation occurred primarily in NaNO2-PO dogs.Intravenous infusion of nitrite profoundly reduced the severity of ventricular arrhythmias resulting from acute ischaemia and reperfusion in anaesthetized dogs. This effect, among several others, may result from an NO-mediated reduction in oxidative stress, perhaps through protein SNO and/or S-glutathionylation.

  12. Increase in volume of dental local anaesthetic solution while maintaining the tissue lidocaine and adrenaline concentration does not increase acute postoperative pain after gingivectomy.

    Science.gov (United States)

    Hanvold, K I; Vigen, E C; Jorkjend, L; Aass, A M; Skoglund, L A

    2008-04-01

    A randomised, single-blind, within-patient, crossover study was done in 45 patients (29 women and 16 men, mean age 49 years, range 37-71) who had bilateral "identical" gingivectomies. On one occasion a standard volume of local anaesthetic containing 2% lidocaine and 1/80,000 adrenaline was infiltrated into the mucosal tissue before operation. On the other, double the standard volume with 1% lidocaine and 1/160,000 adrenaline was infiltrated. The intensity of postoperative pain was recorded by the patients on a 100 mm visual analogue scale every hour for an 11-hour observation period. The time courses and the sum of pain intensity after injection of the double and standard volumes did not differ significantly. Doubling the volume of local anaesthetic while maintaining the total lidocaine and adrenaline concentration that was infiltrated does not influence the intensity of acute pain after gingivectomy.

  13. Determination of the exposure parameters that maximise the concentrations of the anaesthetic/sedative eugenol in rainbow trout (Oncorhynchus mykiss) skin-on fillet tissue.

    Science.gov (United States)

    Meinertz, J R; Porcher, S T; Smerud, J R; Gaikowski, M P

    2014-01-01

    Studies were conducted to determine the anaesthetic/sedative concentrations and durations that would maximise anaesthetic/sedative residue concentrations in rainbow trout (Oncorhynchus mykiss) skin-on fillet tissue. Rainbow trout (167-404 g) were exposed to 50 mg l(-1) AQUI-S(®) 20E (10% active ingredient, eugenol) in 17°C freshwater for durations up to 1440 min, 100 and 250 mg l(-1) AQUI-S(®) 20E for durations up to 240 min, and 500 and 1000 mg l(-1) AQUI-S(®) 20E for durations up to 90 min. Fish exposed to 100 mg l(-1) AQUI-S(®) 20E for durations of 30, 60, 120 and 240 min had the greatest eugenol concentrations in the fillet tissue, 50, 58, 54 and 62 µg g(-1), respectively. All other exposure concentrations and durations resulted in significantly lower eugenol concentrations, i.e. all < 39 µg g(-1).

  14. A synopsis on different homologous series of fomocaine derivatives. In vitro interactions with the cytochrome P450 system, toxicity, and local anaesthetic effects in rats--Part 1.

    Science.gov (United States)

    Lupp, Amelie; Karge, Elke; Dahse, Thomas; Glassl, Peter; Jung, Beate; Listing, Monika; Seeling, Andreas; Wange, Johannes; Wennek-Klose, Janett; Oelschläger, Herbert; Fleck, Christian

    2007-01-01

    Fomocaine (CAS 56583-43-6) is a basic ether-type local anaesthetic used in dermatological practice for surface anaesthesia. For many years, modifications of the fomocaine molecule have been pursued, e.g. to improve its physicochemical properties and also in view of possible new (systemic) applications, e.g. in the treatment of migraine or as antiarrhythmic. The present paper provides a survey of the investigations undertaken with all the different series of fomocaine derivatives synthesized so far with respect to their in vitro interaction capacity at the cytochrome P450 system, in vivo toxicity (LD50; paresis of the N. ischiadicus) and local anaesthetic effects (conduction anaesthesia at the N. ischiadicus; surface anaesthesia of the cornea) in rats. The main objective of this systematic comparison of the effects of all these substances was to assess possible basic structure-activity relationships.

  15. SUCCESSFUL ANAESTHETIC MANAGEMENT OF A PATIENT WITH PARADOXICAL VENTRICULAR SEPTAL MOTION (PVSM POSTED FOR MODIFIED RADICAL NECK DISSECTION WITH RADIAL FREE FLAP

    Directory of Open Access Journals (Sweden)

    Amruta

    2015-04-01

    Full Text Available BACKGROUND : Patients with paradoxical ventricular septal motion are a challenge to anaesthesiologist due to risk of perioperative myocardial ischaemia and sudden cardiac arrest. CASE DESCRIPTION : We present anaesthetic management of a 45year old lady with a diagnosed case of carcinoma left buccal mucosa with paradoxical ventricular septal motion posted for modified radical neck disse ction with radial free flap. CONCLUSION : Although clinical manifestations of this cardiac condition may be mild, there is certainly associated pathology of direct relevance, which carries importance in the anaesthetic management in the peri - operative perio d. Patients with paradoxical ventricular septal motion of any etiology are more prone for perioperative myocardial ischaemia and sudden cardiac arrest, because if cardiac conduction is not maintained properly then it may result in further increase in the p aradoxical ventricular septal motion

  16. Effects of administration of a local anaesthetic and/or an NSAID and of docking length on the behaviour of piglets during 5 h after tail docking

    DEFF Research Database (Denmark)

    Herskin, Mette S.; Di Giminiani, Pierpaolo; Thodberg, Karen

    2016-01-01

    In many countries, piglets are tail docked to prevent tail biting. The aim of this study was 1) to evaluate the efficacy of a local anaesthetic and/or NSAID to reduce pain caused by tail docking; and 2) to examine interactions with docking length. This was examined in 295 piglets docked by hot iron...... cautery 2–4 days after birth and based on behaviour during docking as well as the following 5 h. The study involved three main factors: local anaesthetic (Lidocain), NSAID (Meloxicam) and docking length. Either 100%, 75%, 50% or 25% of the tails were left on the body of the piglets. Irrespective...... of the tail length, tail docking led to signs of procedural pain, which could be reduced by administration of Lidocain. Preemptive use of Meloxicam did not affect the signs of procedural pain. The results show that tail docking led to behavioural changes throughout the 5 h observation period indicating...

  17. Autonomic Nervous System Mediates the Hypotensive Effects of Aqueous and Residual Methanolic Extracts of Syzygium polyanthum (Wight) Walp. var. polyanthum Leaves in Anaesthetized Rats

    OpenAIRE

    A.Ismail; Mohamed, M.; Sulaiman, S. A.; Wan Ahmad, W. A. N.

    2013-01-01

    Syzygium polyanthum (Wight) Walp. var. polyanthum leaves are consumed as a traditional Malay treatment of hypertension. This study investigates hypotensive potential of aqueous (AESP) and residual methanolic (met-AESP) extracts of S. polyanthum leaves and possible involvement of autonomic receptors. AESP and met-AESP (20 to 100 mg/kg) were intravenously administered into anaesthetized Wistar-Kyoto (WKY) and spontaneously hypertensive (SHR) rats. Blood pressure and heart were monitored for 20 ...

  18. Local anaesthetic eye drops for prevention of pain in preterm infants undergoing screening for retinopathy of prematurity.

    LENUS (Irish Health Repository)

    Dempsey, Eugene

    2012-01-31

    BACKGROUND: Screening examinations for retinopathy of prematurity (ROP) are performed routinely in the neonatal intensive care unit and are a recognised cause of pain in the newborn. OBJECTIVES: To determine the effect of instillation of topical anaesthetic eye drops compared with placebo or no treatment on pain in infants undergoing ROP screening. SEARCH STRATEGY: We used the standard search strategy of the Cochrane Neonatal Review Group. This included a search of the Cochrane Neonatal Group register and the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 10, 2010). We identified relevant studies by searching the following: (1) computerised bibliographic databases: MEDLINE (1966 to October 2010), EMBASE (1988 to October 2010) and Web of Science (1975 to March 2010; (2) the Oxford Database of Perinatal Trials. We searched electronically abstracts from PAS from 2000 to 2010 and handsearched abstracts from ESPR from 2000 to 2009. SELECTION CRITERIA: All randomised, or quasi-randomised controlled trials, or randomised cross-over trials. DATA COLLECTION AND ANALYSIS: We used the standard methods of the Cochrane Neonatal Review Group. MAIN RESULTS: We identified two studies for inclusion. Both studies were randomised cross-over trials performed in single centres. Both studies used the Premature Infant Pain Profile (PIPP) score as a measure of pain response. Different methods of evaluating PIPP scores are presented including the absolute PIPP score, a PIPP score > 10 or > 12 and an increase in PIPP >\\/= 4 from the baseline value. There is a nonsignificant reduction in pain scores at one minute and a nonsignificant increase at five minutes post insertion of the speculum. PIPP score > 12 at one minute resulted in a statistically significant reduction in the number of patients who experienced pain (typical risk ratio (RR) 0.56, 95% CI 0.36 to 0.89; typical risk difference (RD) -0.23, 95% CI -0.39 to -0.86; number needed to treat to

  19. Anaesthesia with sevoflurane in pigeons: minimal anaesthetic concentration (MAC) determination and investigation of cardiorespiratory variables at 1 MAC.

    Science.gov (United States)

    Botman, J; Gabriel, F; Dugdale, A H A; Vandeweerd, J-M

    2016-05-28

    The objective of the study was to determine the minimal anaesthetic concentration (MAC) of sevoflurane (SEVO) in pigeons and investigate the effects of 1 MAC SEVO anaesthesia on cardiovascular and respiratory variables compared with the awake state. This is a prospective, experimental study. Animals were seven healthy adult pigeons. After acclimatisation to handling, heart rate (HR), heart rhythm, respiratory rate (fR), end-expired carbon dioxide tension (PE'CO2), inspired CO2 tension, indirect systolic arterial blood pressure (SAP) and cloacal temperature were measured to determine baseline, 'awake' values. Pigeons were then anaesthetised with SEVO and MAC was determined by the 'bracketing' method. The same variables were monitored during a 40 minute period at 1.0 MAC SEVO for each bird. Mean MAC was 3.0±0.6 per cent for SEVO. During maintenance of anaesthesia at 1.0 MAC, SAP decreased significantly (P<0.001) without any significant change in HR. Although PE'CO2 increased significantly (P=0.001) despite an increase in fR, awake PE'CO2 values were unexpectedly low. Sinus arrhythmias were detected in two birds under SEVO anaesthesia. The times to tracheal intubation and to recovery were 2.5±0.7 and 6.4±1.7 minutes, respectively. Recovery was rapid and uneventful in all birds. In conclusion, SEVO is suitable for anaesthesia in pigeons.

  20. Electroencephalographic Changes Associated with Antinociceptive Actions of Lidocaine, Ketamine, Meloxicam, and Morphine Administration in Minimally Anaesthetized Dogs

    Directory of Open Access Journals (Sweden)

    Ubedullah Kaka

    2015-01-01

    Full Text Available Effects of ketamine and lidocaine on electroencephalographic (EEG changes were evaluated in minimally anaesthetized dogs, subjected to electric stimulus. Six dogs were subjected to six treatments in a crossover design with a washout period of one week. Dogs were subjected to intravenous boluses of lidocaine 2 mg/kg, ketamine 3 mg/kg, meloxicam 0.2 mg/kg, morphine 0.2 mg/kg and loading doses of lidocaine 2 mg/kg followed by continuous rate infusion (CRI of 50 and 100 mcg/kg/min, and ketamine 3 mg/kg followed by CRI of 10 and 50 mcg/kg/min. Electroencephalogram was recorded during electrical stimulation prior to any drug treatment (before treatment and during electrical stimulation following treatment with the drugs (after treatment under anaesthesia. Anaesthesia was induced with propofol and maintained with halothane at a stable concentration between 0.85 and 0.95%. Pretreatment median frequency was evidently increased (P<0.05 for all treatment groups. Lidocaine, ketamine, and morphine depressed the median frequency resulting from the posttreatment stimulation. The depression of median frequency suggested evident antinociceptive effects of these treatments in dogs. It is therefore concluded that lidocaine and ketamine can be used in the analgesic protocol for the postoperative pain management in dogs.

  1. Inhibitory effect of sodium cromoglycate on pulmonary responses to histamine administered after indomethacin in anaesthetized guinea-pigs.

    Science.gov (United States)

    Mitchell, H. W.

    1988-01-01

    1. Histamine (2-4 micrograms kg-1 i.v.) increased airways resistance (Raw) and decreased dynamic lung compliance (Cdyn) in urethane-anaesthetized guinea-pigs. The effects on Raw were almost abolished by atropine (0.1 mg kg-1 i.v.) and reduced by vagal cooling (11-16 degrees C). 2. Histamine-induced changes in Raw and Cdyn were significantly (P less than 0.05) enhanced by indomethacin (1 mg kg-1 i.v.). 3. In animals not treated with indomethacin, exposure to an aerosol containing sodium cromoglycate (0.01-2% for 30 s) failed to affect subsequent (3 min) histamine-induced bronchoconstriction. 4. Administration of an aerosol containing low (0.01-0.2%) concentrations of sodium cromoglycate had no effect on the enhanced responses (i.e. hyperreactivity) seen after indomethacin. However, more concentrated sodium cromoglycate aerosols (greater than 0.2%) reduced or abolished the hyperreactivity to histamine seen after indomethacin. 5. It was concluded that sodium cromoglycate can prevent the development of hyperreactivity to histamine, possibly by interacting with some mechanism utilized by both histamine and indomethacin in this model. PMID:3134970

  2. An evaluation of factors influencing the assessment time in a nurse practitioner-led anaesthetic pre-operative assessment clinic.

    Science.gov (United States)

    Hawes, R H; Andrzejowski, J C; Goodhart, I M; Berthoud, M C; Wiles, M D

    2016-03-01

    Elective patients undergoing anaesthetic pre-operative assessment are usually allocated the same period of time with a nurse practitioner, leading to potential inefficiencies in patient flow through the clinic. We prospectively collected data on 8519 patients attending a pre-operative assessment clinic. The data set were split into derivation and validation cohorts. Standard multiple regressions were used to construct a model in the derivation cohort, which was then tested in the validation cohort. Due to missing data, 2457 patients were not studied, leaving 5892 for analysis (3870 in the derivation cohort and 2022 in the validation cohort). The mean (SD) pre-operative assessment time was 46 (12) min. Age, ASA physical status, nurse practitioner and surgical specialty all influenced the time spent in pre-operative assessment. The predictive equations calculated using the derivation cohort, based on age and ASA physical status, correctly estimated duration of consultation to within 20% of the maximum predicted time in 74.2% of the validation cohort. We conclude that if age and ASA physical status are known before the pre-operative assessment consultation, it could allow appointment times to be allocated more accurately.

  3. A survey on the use of low flow anaesthesia and the choice of inhalational anaesthetic agents among anaesthesiologists of India

    Science.gov (United States)

    Amma, Rajasree Omanakutty; Ravindran, Subha; Koshy, Rachel Cherian; Jagathnath Krishna, KM

    2016-01-01

    Background and Aims: With the availability of modern workstations and heightened awareness on the environmental effects of waste anaesthesia gases, anaesthesiologists worldwide are practicing low flow anaesthesia (LFA). Although LFA is being practiced in India, hard evidence on the current practice of the same from anaesthesiologists practicing in India is lacking and hence, we conducted this survey. Methods: A questionnaire containing 16 questions was distributed among a subgroup of anaesthesiologists who attended the 2014 National Conference of Indian Society of Anaesthesiologists. The filled-in questionnaires were computed and analysed with SPSS version 11. Results: The response rate to the survey was 82%. About 73% of the respondents practiced LFA routinely, with 65% having workstations. Most of the anaesthesiologists used fresh gas flows <1.5 L/min with 45.1% using O2 concentrations at a range of 30–40%. ETCO2 monitoring was used routinely by most whereas use of agent analysers and bispectral index monitoring were restricted. The availability of scavenging system was also limited to only 33.5%. Majority preferred N2 O as carrier gas and sevoflurane as volatile agent of their choice. Conclusion: Our survey revealed that practice of LFA in India has numerous lacunae. Provision of better monitoring facilities, workstations as well as awareness regarding the environmental issues of waste anaesthetic gases need to be addressed.

  4. The bite of the honeybee: 2-heptanone secreted from honeybee mandibles during a bite acts as a local anaesthetic in insects and mammals.

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    Alexandros Papachristoforou

    Full Text Available Honeybees secrete 2-heptanone (2-H from their mandibular glands when they bite. Researchers have identified several possible functions: 2-H could act as an alarm pheromone to recruit guards and soldiers, it could act as a chemical marker, or it could have some other function. The actual role of 2-H in honeybee behaviour remains unresolved. In this study, we show that 2-H acts as an anaesthetic in small arthropods, such as wax moth larva (WML and Varroa mites, which are paralysed after a honeybee bite. We demonstrated that honeybee mandibles can penetrate the cuticle of WML, introducing less than one nanolitre of 2-H into the WML open circulatory system and causing instantaneous anaesthetization that lasts for a few minutes. The first indication that 2-H acts as a local anaesthetic was that its effect on larval response, inhibition and recovery is very similar to that of lidocaine. We compared the inhibitory effects of 2-H and lidocaine on voltage-gated sodium channels. Although both compounds blocked the hNav1.6 and hNav1.2 channels, lidocaine was slightly more effective, 2.82 times, on hNav.6. In contrast, when the two compounds were tested using an ex vivo preparation-the isolated rat sciatic nerve-the function of the two compounds was so similar that we were able to definitively classify 2-H as a local anaesthetic. Using the same method, we showed that 2-H has the fastest inhibitory effect of all alkyl-ketones tested, including the isomers 3- and 4-heptanone. This suggests that natural selection may have favoured 2-H over other, similar compounds because of the associated fitness advantages it confers. Our results reveal a previously unknown role of 2-H in honeybee defensive behaviour and due to its minor neurotoxicity show potential for developing a new local anaesthetic from a natural product, which could be used in human and veterinary medicine.

  5. Skin blood flow changes in anaesthetized humans: comparison between skin thermal clearance and finger pulse amplitude measurement.

    Science.gov (United States)

    Saumet, J L; Leftheriotis, G; Dittmar, A; Delhomme, G; Degoute, C S

    1986-01-01

    The effect of general anaesthesia on skin blood flow in the left hand, measured by a new non-invasive probe using the thermal clearance method was examined. A mercury silastic gauge was placed around the third left finger and the plethysmographic wave amplitude was recorded to measure changes in finger pulse amplitude. Heart rate (HR), mean arterial blood pressure (MABP) and skin temperature were also recorded. General anaesthesia was induced by droperidol and phenoperidine injection and propanidid infusion in eight female patients. Skin thermal clearance, plethysmographic wave amplitude, HR, MABP and skin temperature were 0.40 +/- 0.02 w X m-1 degree C-1, 9 +/- 1 mm, 98 +/- 5 beats X min-1, 12.50 +/- 0.93 kPa and 33.3 +/- 3.4 degrees C respectively. The minimal value of MABP was 9.58 +/- 1.06 kPa, whereas skin thermal clearance, plethysmographic wave amplitude, HR and skin temperature increased to 0.45 +/- 0.02 w X m-1 degree C-1, 29 +/- 3 mm, 110 +/- 4 beats X min-1 and 34.4 +/- 0.4 degrees C. Changes in skin thermal clearance correlated well with plethysmographic wave amplitude. Statistically significant changes in these two parameters occurred before significant change in HR, MABP or skin temperature. The results show that the new non-invasive probe using the thermal clearance method appears to be a useful device for measuring cutaneous microcirculation in anaesthetized humans, and responds more quickly than change in skin temperature, which is a delayed effect of skin blood flow change. Our results also show that the intensity of cutaneous vasodilatation induced by general anaesthesia did not relate to the vascular tone before anaesthesia.

  6. Effect of acid secretion blockade on acute gastric mucosal lesions induced by Tityus serrulatus scorpion toxin in anaesthetized rats.

    Science.gov (United States)

    Melo, Júnio Rios; de Araújo, Gnana Keith Marques; da Luz, Magda Maria Profeta; da Conceição, Sérgio Alexandre; Lisboa, Felipe Assis; Moraes-Santos, Tasso; Cunha-Melo, José Renan

    2006-10-01

    Scorpion venom (TX) promotes gastric acid and pepsin secretion leading to acute gastric mucosal lesions (AGML), when injected in animals. The goal of the present study was to observe the effects of acid gastric secretion blockers over the incidence of TX-induced AGML in vivo. To verify this model, we used male albino rats, fasted 18-20 h (n=122) and anaesthetized with urethane (1.4 g/kg, i.p.). Their trachea and left femoral vein were both cannulated; the first to avoid airway obstructions during scorpion intoxication and the second for administration of saline, TX and acid blockers. Following the surgical procedure, the animals were divided in 10 groups of at least 10 animals each. Control groups were injected with NaCl 0.9% 1 ml/kg (n=10) or TX 375 microg/kg (n=32). Test groups (n=10, each) received atropine 5 mg/kg, cimetidine 10mg/kg, ranitidine 2.5mg/kg, ranitidine 5mg/kg, omeprazol 1 mg/kg, omeprazol 4 mg/kg, octreotide 80 and octreotide 100 microg/kg 10 min before the TX was injected. After 1h of intoxication, the stomach was resected for macroscopic study and the gastric secretion was collected for volume, pH and acid output assessment. We observed that all blockers were able to completely or partially prevent the TX-induced acid secretion as well as the AGML (p<0.05). Our data suggest the TX-induced AGML can be prevented by different class of acid blockers injected before the intoxication.

  7. Central activation of the sympathetic nervous system including the adrenals in anaesthetized guinea pigs by the muscarinic agonist talsaclidine.

    Science.gov (United States)

    Walland, A; Pieper, M P

    1998-04-01

    Talsaclidine, a novel M1-receptor selective muscarinic agonist for cholinergic substitution therapy of Alzheimer's disease, activates the sympathetic nervous system in guinea pigs and dogs at the orthosympathic ganglia and the paraganglionic adrenals. Results from guinea pigs provide indirect evidence for an additional central site of action. The present investigation in anaesthetized and vagotomized guinea pigs intended to demonstrate central activation of the sympathetic nervous system directly by comparing the blood pressure effects of intracerebroventricular and intravenous injections of small doses of talsaclidine. Increasing doses of 0.2 and 0.6 mg/kg talsaclidine were injected alternately into the third cerebral ventricle and intravenously in 6 guinea pigs before and after blockade of peripheral muscarinic receptors with 1 mg/kg ipratropium bromide i.v. In another group of 6 animals the injections were given into the cisterna cerebellomedullaris using the same protocol. In both groups central administration of talsaclidine caused dose-related hypertension while intravenous injections were hypotensive. Ipratropium bromide, a peripheral antimuscarinic drug, reversed this hypotensive action of intravenous talsaclidine into hypertension, but did not inhibit the effects of central administration. In contrast, atropine, an antimuscarinic drug which passes the blood-brain barrier, abolished the effect of 0.6 mg/kg talsaclidine injected into the cisterna cerebellomedullaris of 8 guinea pigs. The hypertensive effect of a first injection of 0.6 mg/kg talsaclidine into the cisterna cerebellomedullaris of 6 guinea pigs was approximately twice as large as that of a second given 90 min after bilateral adrenalectomy. Sham operation in another 6 animals was not inhibitory. The results demonstrate that talsaclidine, a selective muscarinic M1-receptor agonist, activates central parts of the sympathetic nervous system, including central projections of the adrenals by an action

  8. Anaesthetic management of a 10-month-old white rhinoceros (Ceratotherium simum calf for emergency exploratory celiotomy

    Directory of Open Access Journals (Sweden)

    Gareth E. Zeiler

    2012-04-01

    Full Text Available A 10-month-old, 580 kg, hand-reared white rhinoceros (Ceratotherium simum calf was presented for emergency exploratory celiotomy. Anaesthesia was safely induced with three successive intravenous (IV boluses of diazepam (10 mg and ketamine (100 mg until the trachea could be intubated. Anaesthesia was adequately maintained with isoflurane-inoxygen (mean end-tidal isoflurane concentration of 1.1% ± 0.2% on a circle anaesthetic machine with carbon dioxide absorption and an intravenous infusion of ketamine and medetomidine at a mean rate of 0.02 mg/kg/min and 0.02 µg/kg/min, respectively. Mean values recorded during anaesthesia and surgery were heart rate (56.9 ± 11 beats/min, mean arterial blood pressure (6.16 kPa ± 1.75 kPa, end-tidal carbon dioxide concentration (6.23 kPa ± 0.30 kPa. Abdominal gas distension contributed to hypoventilation that resulted in hypercapnoea, confirmed by arterial blood gas analysis (PaCO2 14.69 kPa, which required controlled ventilation for correction. Blood volume was maintained with the intravenous infusion of a balanced electrolyte solution at 10 mL/kg/h and blood pressure supported with a continuous infusion of dobutamine and phenylephrine. Duration of anaesthesia was 3.5 h. It was concluded that anaesthesia was safely induced in a compromised white rhinoceros calf with a combination of diazepam and ketamine. A constant-rate infusion of medetomidine and ketamine allowed for a reduction in the dose of isoflurane required during maintenance of anaesthesia and improved intra-operative blood pressure management.

  9. Comparison between lignocaine hydrochloride and ropivacaine hydrochloride as lumbosacral epidural anaesthetic agents in goats undergoing laparoscopy assisted embryo transfer

    Directory of Open Access Journals (Sweden)

    Anubhav Khajuria

    2014-10-01

    Full Text Available Goats (n=12 undergoing laparoscopy assisted embryo transfer were randomly allotted to two groups (I and II and injected lignocaine hydrochloride (4mg/kg or ropivacaine hydrochloride (1mg/kg at the lumbosacral epidural space. The animals were held with raised hind quarters for first three minutes following injection. Immediately after induction of regional anaesthesia, they were restrained in dorsal recumbency in Trendelenburg position in a cradle. Laparoscopy was performed after creating pneumoperitoneum using filtered room air. The mean (± S.E induction time in animals of group I was significantly shorter (5.33 ± 0.61 min than those belonging to group II (12.66 ±1.99 min. Complete analgesia developed throughout the hind quarters and abdomen for 30 min and 60 min in group I and II animal’s respectively. Unlike animals of group I, group II goats continued to show moderate analgesia for 180 minutes. The motor activity returned after a lapse of 130.00 ± 12.64 min and 405.00 ± 46.31 min respectively. Occasional vocalization and struggling was noticed in two goats one from each group irrespective of the surgical manipulations during laparoscopy. The rectal temperature and respiration rates showed only non-significant increase, but the heart rate values were significantly higher (P < 0.5 up to 150 min in animals of both the groups when compared to their baseline values. From this study, it was concluded that both anaesthetic agents produced satisfactory regional anaesthesia in goats undergoing laparoscopy. However, considering the very long delay in regaining the hind limb motor activity, the use of ropivacaine may not be recommended for this purpose. Supplementation of sedative/tranquilizer with lumbosacral epidural anaesthesia needs evaluation.

  10. The effects of atrial natriuretic peptide and glucagon on proximal glomerulo-tubular balance in anaesthetized rats.

    Science.gov (United States)

    Harris, P J; Skinner, S L; Zhuo, J

    1988-08-01

    1. The renal actions of ANP (average dose 30 ng kg-1 min-1 and glucagon (50 ng kg-1 min-1) were compared using fractional lithium reabsorption as the index of proximal reabsorption in groups of seven rats. Doses were chosen to cause similar increases in glomerular filtration rate (GFR). Time controls were included. 2. Glucagon raised GFR 32% and absolute proximal reabsorption (APR) 26% producing 81% effective proximal glomerulo-tubular balance (GTB) which was not significantly different from the 100% expected for perfect GTB. ANP raised GFR 33% and APR 10% indicating only 30% effective GTB (P less than 0.01). This was a significantly different effect from glucagon (P less than 0.005). 3. Sodium output increased 10-fold with ANP and 3-fold with glucagon. Filtration fraction increased 33% (P less than 0.04) above the pre-treatment value with ANP but was unchanged with glucagon. Plasma renin concentration was suppressed similarly by each hormone (46 and 36%, P less than 0.05, compared with pre-treatment values). 4. Despite a change in peritubular physical factors favouring reabsorption, there was almost complete attenuation of the increase expected in APR with the ANP-induced increase in GFR. In contrast, a similar change in GFR with glucagon resulted in an almost parallel increase in APR demonstrating maintenance of proximal GTB. 5. It is concluded that in the anaesthetized rat, ANP but not glucagon profoundly inhibits the increase in proximal reabsorption that normally follows an increase in filtered load. Such an action would contribute to the more potent natriuretic activity of ANP compared with glucagon.

  11. Charged anaesthetics alter LM-fibroblast plasma-membrane enzymes by selective fluidization of inner or outer membrane leaflets.

    Science.gov (United States)

    Sweet, W D; Schroeder, F

    1986-10-15

    The functional consequences of the differences in lipid composition and structure between the two leaflets of the plasma membrane were investigated. Fluorescence of 1,6-diphenylhexa-1,3,5-triene(DPH), quenching, and differential polarized phase fluorimetry demonstrated selective fluidization by local anaesthetics of individual leaflets in isolated LM-cell plasma membranes. As measured by decreased limiting anisotropy of DPH fluorescence, cationic (prilocaine) and anionic (phenobarbital and pentobarbital) amphipaths preferentially fluidized the cytofacial and exofacial leaflets respectively. Unlike prilocaine, procaine, also a cation, fluidized both leaflets of these membranes equally. Pentobarbital stimulated 5'-nucleotidase between 0.1 and 5 mM and inhibited at higher concentrations, whereas phenobarbital only inhibited, at higher concentrations. Cationic drugs were ineffective. Two maxima of (Na+ + K+)-ATPase activation were obtained with both anionic drugs. Only one activation maximum was obtained with both cationic drugs. The maximum in activity below 1 mM for all four drugs clustered about a single limiting anisotropy value in the cytofacial leaflet, whereas there was no correlation between activity and limiting anisotropy in the exofacial leaflets. Therefore, although phenobarbital and pentobarbital below 1 mM fluidized the exofacial leaflet more than the cytofacial leaflet, the smaller fluidization in the cytofacial leaflet was functionally significant for (Na+ + K+)-ATPase. Mg2+-ATPase was stimulated at 1 mM-phenobarbital, unaffected by pentobarbital and slightly stimulated by both cationic drugs at concentrations fluidizing both leaflets. Thus the activity of (Na+ + K+)-ATPase was highly sensitive to selective fluidization of the leaflet containing its active site, whereas the other enzymes examined were little affected by fluidization of either leaflet.

  12. 5-Hydroxytryptamine-induced vasodilator responses in the hindquarters of the anaesthetized rat, involve beta2-adrenoceptors.

    Science.gov (United States)

    Calama, E; García, M; Jarque, M J; Morán, A; Martín, M L; San Román, L

    2003-10-01

    These studies were conducted to examine the role of the vasoactive mediators nitric oxide (NO) and adrenaline (epinephrine) in the serotonin (5-hydroxytryptamine; 5-HT)-induced vasodilator response in the hindquarter vascular bed of anaesthetized rats. Intra-arterial administration of doses of 5-HT in the range 0.12-25 ng kg(-1) produced a dose-independent vasodilator effect in the hindquarters. The selective 5-HT(1D/1B) receptor agonist, L-694,247 at intra-arterial doses of 0.0012-1000 ng kg(-1), as well as adrenaline (at doses of 0.05-50 ng kg(-1) i.a.), mimicked the dose-independent vasodilator effect induced by intra-arterial administration of 5-HT. Intravenous pre-treatment with the selective beta2-receptor antagonist ICI 118,551 (0.5 mg kg(-1)) blocked the vasodilator effect of 5-HT, adrenaline and L-694,247. Additionally, the inhibitor of NO synthase NG-nitro-L-arginine (L-NAME) (at a dose of 10 mg kg(-1) i.v.) blocked the vasodilator action of acetylcholine 300-3000 ng kg(-1)) but did not modify 5-HT-induced vasodilatation. The vasodilator effect produced by intra-arterial administration of 5-HT in the hindquarters was significantly inhibited both 30 min after denervation of the lumbar sympathetic chains and 1 h after bilateral adrenalectomy. Our data suggest that in the in-situ autoperfused hindquarters of the rat 5-HT-induced vasodilatation is mediated by a local 5-HT(1D) or 5-HT(1D/1B) activation, which in turn mediates the adrenal release of adrenaline, which then produces beta2-activation and vasodilatation.

  13. Acute effects of a sarin-like organophosphorus agent, bis(isopropyl methyl)phosphonate, on cardiovascular parameters in anaesthetized, artificially ventilated rats

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    Watanabe, Yoshimasa [Department of Pharmacology, Graduate School of Medical Sciences, Nagoya City University, Nagoya (Japan); Itoh, Takeo, E-mail: titoh@med.nagoya-cu.ac.jp [Department of Pharmacology, Graduate School of Medical Sciences, Nagoya City University, Nagoya (Japan); Shiraishi, Hiroaki [Department of Forensic Medicine, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima (Japan); Maeno, Yoshitaka [Department of Forensic Medical Science, Graduate School of Medical Sciences, Nagoya City University, Nagoya (Japan); Arima, Yosuke; Torikoshi, Aiko; Namera, Akira [Department of Forensic Medicine, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima (Japan); Makita, Ryosuke [Department of Nursing, Faculty of Health Sciences, Hiroshima Cosmopolitan University, Hiroshima (Japan); Yoshizumi, Masao [Department of Cardiovascular Physiology and Medicine, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima (Japan); Nagao, Masataka [Department of Forensic Medicine, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima (Japan)

    2013-10-01

    The organophosphorus compound sarin irreversibly inhibits acetylcholinesterase. We examined the acute cardiovascular effects of a sarin-like organophosphorus agent, bis(isopropyl methyl)phosphonate (BIMP), in anaesthetized, artificially ventilated rats. Intravenous administration of BIMP (0.8 mg/kg; the LD50 value) induced a long-lasting increase in blood pressure and tended to increase heart rate. In rats pretreated with the non-selective muscarinic-receptor antagonist atropine, BIMP significantly increased both heart rate and blood pressure. In atropine-treated rats, hexamethonium (antagonist of ganglionic nicotinic receptors) greatly attenuated the BIMP-induced increase in blood pressure without changing the BIMP-induced increase in heart rate. In rats treated with atropine plus hexamethonium, intravenous phentolamine (non-selective α-adrenergic receptor antagonist) plus propranolol (non-selective β-adrenergic receptor antagonist) completely blocked the BIMP-induced increases in blood pressure and heart rate. In atropine-treated rats, the reversible acetylcholinesterase inhibitor neostigmine (1 mg/kg) induced a transient increase in blood pressure, but had no effect on heart rate. These results suggest that in anaesthetized rats, BIMP induces powerful stimulation of sympathetic as well as parasympathetic nerves and thereby modulates heart rate and blood pressure. They may also indicate that an action independent of acetylcholinesterase inhibition contributes to the acute cardiovascular responses induced by BIMP. - Highlights: • A sarin-like agent BIMP markedly increased blood pressure in anaesthetized rats. • Muscarinic receptor blockade enhanced the BIMP-induced increase in blood pressure. • Ganglionic nicotinic receptor blockade attenuated the BIMP-induced response. • Blockade of α- as well as β-receptors attenuated the BIMP-induced response.

  14. Histamine release from basophil leukocytes in asthma patients after in vitro provocation with various neuromuscular blocking drugs and intravenous anaesthetic agents

    DEFF Research Database (Denmark)

    Guldager, H; Søndergaard, I

    1987-01-01

    Basophil histamine release is a relatively new investigation technique, which can be used in the diagnosis of anaphylactoid reactions. Our aim in this investigation was to determine reference values for asthma patients and normal subjects. Blood from eight asthmatic patients and eight normal...... subjects was tested for histamine release after in vitro provocation with various neuromuscular blocking drugs and intravenous anaesthetic agents. There was significantly higher histamine release for asthmatic patients than for normal subjects, P less than 0.001 (analysis of variance). This had no effect...

  15. Dose adjustment and application of intravenous anaesthetics in obese patients%肥胖患者静脉麻醉药应用及剂量调整

    Institute of Scientific and Technical Information of China (English)

    磨凯; 徐世元; 刘中杰; 李凤仙; 梁启波; 张庆国

    2013-01-01

    背景 肥胖患者麻醉药药代与药效动力学较体重正常人群个体差异更大,其心输出量与身体肌肉、脂肪等组织构成比的变化影响众多麻醉药物分布、消除规律,按总体重给药易致药物过量,按理想体重给药则可能剂量不足. 目的 阐述常用静脉麻醉药在肥胖患者中的药代与药效动力学特性,有助于此类患者合理用药,减少并发症. 内容 综述肥胖患者常用静脉麻醉药按总体重、理想体重、体表面积和瘦体重用药研究现状. 趋势 为避免肥胖患者肌松药术后残余作用所致并发症,非去极化肌松药按理想体重给药较合适,而大多数静脉麻醉药(包括阿片类药物)则适于按瘦体重给药.%Background Obese patients have greater inter-individual variations than the standard-size patients in the anesthetic pharmacokinetics and pharmacodynamics.In obese population,changes in cardiac output and alterations in body composition affect the distribution of numerous anaesthetics,therefore,administration of drugs based on total body weight could result in overdose,conversely,administration of drugs based on ideal body weight could result in an inadequate dose.Objective This review focuses on the pharmacokinetics and pharmacodynamics properties of intravenous anesthetic in obese patients in order to provide recommendation for rational application of intravenous anesthetic in obese patients and reduce complications.Content Discussing dosing scalars based on total body weight,ideal body weight,body surface area and lean body weight as well as its recent advances in clinical application of intravenous anaesthetics in the obese.Trend To avoid postoperative residual curarization,the ideal body weight might be appropriate for dosing scalar of the non-depolarizing neuromuscular blocking agents,whereas,lean body weight is the optimal dosing scalar for the majority of anaesthetic agents including opioids and anaesthetic-induction agents for

  16. Elimination of low steady-state concentrations of [5,6-H]prostaglandin E in the pulmonary and the systemic circulations of anaesthetized rats

    DEFF Research Database (Denmark)

    Bukhave, K.; Hansen, Harald S.

    1977-01-01

    The elimination of [H]prostaglandin E, in anaesthetized rats was studied by continuous intravenous or intraarterial infusions, producing steady-state concentrations at the level of endogenous prostaglandin E in mixed venous blood. Blood samples (0.5 ml) were collected from the carotid artery...... output and the rate of infusion, the fractional clearance of the lung and the systemic beds in the steady-state situation were estimated to 88.3 ± 3.2% and 54.1 ± 15.2%(mean ± S.D.), respectively. The hydrophobic metabolites were characterized chromatographically on Sephadex LH-20 columns, using...

  17. Increasing ketamine dose enhances the anaesthetic properties of ketamine-xylazine-midazolam combinations in growing pigs : short communication

    Directory of Open Access Journals (Sweden)

    R.A. Ajadi

    2008-05-01

    Full Text Available The influence of increasing the dosage of ketamine on anaesthesia induced by a combination of ketamine, xylazine and midazolam in pigs was determined by assessing the onset of action (OAN, duration of analgesia (DAN, anaesthesia time (ANT, and recovery time (RCT in 10 growing pigs (Mean weight: 18.2 ± 1.65 kg receiving either 10 mg / kg intramuscular (i.m injection of 10 % ketamine, 2 mg / kg i.m injection of 2 % xylazine and 0.25 mg / kg i.m injection of 0.1%midazolam (K10XM or 20 mg / kg i.m injection of ketamine and 2 mg / kg i.m injection of xylazine and 0.25 mg / kg i.m injection of 0.1 % midazolam (K20XM. In addition, the heart rates (HR, respiratory rates (RR and rectal temperatures (RT were determined immediately after drug administration and at 10 minute intervals over a period of 60 minutes. Analgesia was assessed by the response of the pigs to artery forceps applied at the interdigital space. Recovery was determined as pigs' ability to stand without ataxia. Data were expressed as mean ± SEM while anaesthetic indices were compared using Student's t-tests. AP value of 0.05 was accepted as significant in all cases. In this study, both the OAN and RCT were significantly (P < 0.05 shorter in K10XM (1.4 ± 0.2 min; 7.8 ± 2.2 min than in K20XM (2.2 ± 0.2; 18.6 ± 1.4 min respectively. Similarly, the duration of anaesthesia was significantly (P < 0.05 shorter in K10XM (55.4 ± 8.4 min than in K20XM (92.0 ± 13.6 min. The pigs that received K20XM combination had analgesia of duration of 41.4±12.6 min while those that received K10XM combination had no analgesia. However, the HR, RR, and RT were not significantly (P > 0.05 different between K10XM and K20XM. It was therefore concluded that the lower dose ketamine combination is better for the induction of anaesthesia, while the higher dose ketamine combination is preferable for surgery of short duration in pigs.

  18. Pre-surgical regional blocks in orthognathic surgery: prospective study evaluating their influence on the intraoperative use of anaesthetics and blood pressure control.

    Science.gov (United States)

    Chen, Y A; Rivera-Serrano, C M; Chen, C; Chen, Y R

    2016-06-01

    In orthognathic surgery, maxillary (CNV2) and mandibular (CNV3) divisions of the trigeminal nerve can be blocked successfully prior to surgery. In this study, it was hypothesized that regional blocks (nerve block over a particular region: bilateral CNV2 and CNV3 divisions of the trigeminal nerve) would decrease the total requirement for intraoperative anaesthetic agents and facilitate the process of hypotensive anaesthesia. Local anaesthesia containing 1/100,000 epinephrine and 10ml 0.5% levobupivacaine was injected into the planned incisions in 50 patients. Twenty-five patients (group A) underwent orthognathic surgery without regional blocks and another 25 patients (group B) underwent surgery with regional blocks. The anaesthetic protocol was the same in both groups and administered by a single anaesthesiologist. The mean arterial pressure was recorded at several points throughout the operation, as well as all the medications used. The blood loss and the amounts of medications administered were lower in group B than in group A. In patients receiving regional blocks, the amounts of fentanyl and nicardipine required were significantly lower. The use of pre-emptive anaesthesia in orthognathic surgery may reduce the overall amounts of medications required for hypotensive anaesthesia, facilitate the intraoperative control of blood pressure, and decrease intraoperative blood loss.

  19. Do we really know the pharmacodynamics of anaesthetics used in newborns, infants and children? A review of the experimental and clinical data on neurodegeneration.

    Science.gov (United States)

    Bartkowska-Śniatkowska, Alicja; Rosada-Kurasińska, Jowita; Zielińska, Marzena; Bienert, Agnieszka

    2014-01-01

    The practices of anaesthesiology and intensive therapy are difficult to imagine without sedation or general anaesthesia, regardless of whether the patient is a newborn, baby, child or adult. The relevant concerns for children are distinct from those for adults, primarily due to the effects of anatomical, physiological and pharmacokinetic-pharmacodynamic (PK/PD) differences, which become increasingly important in the brains of children as they develop. The process of central nervous system maturation in humans lasts for years, but its greatest activity (myelination and synaptogenesis) occurs during the fetal period and the first two years of life. Many experimental studies have demonstrated that exposure to anaesthetic drugs during this period can induce neurodegenerative changes in the central nervous systems of animals. The extrapolation of these results directly to humans must be performed with great caution, but anaesthesiologists around the world must begin to debate the safety of general anaesthesia in humans. Prospective trials should continue being carried out, and anaesthesia and surgery, delayed if possible among the smallest patients. The simultaneous use of different anaesthetics with the same potential neurotoxicities should also be avoided, potentially in favour of regional anaesthesia techniques, in this group of patients.

  20. General anaesthetics do not impair developmental expression of the KCC2 potassium-chloride cotransporter in neonatal rats during the brain growth spurt

    KAUST Repository

    Lacoh, Claudia Marvine

    2013-03-26

    BackgroundThe developmental transition from depolarizing to hyperpolarizing γ-aminobutyric acid-mediated neurotransmission is primarily mediated by an increase in the amount of the potassium-chloride cotransporter KCC2 during early postnatal life. However, it is not known whether early neuronal activity plays a modulatory role in the expression of total KCC2 mRNA and protein in the immature brain. As general anaesthetics are powerful modulators of neuronal activity, the purpose of this study was to explore how these drugs affect KCC2 expression during the brain growth spurt.MethodsWistar rat pups were exposed to either a single dose or 6 h of midazolam, propofol, or ketamine anaesthesia at postnatal days 0, 5, 10, or 15. KCC2 expression was assessed using immunoblotting, immunohistochemistry, or quantitative polymerase chain reaction analysis up to 3 days post-exposure in the medial prefrontal cortex.ResultsThere was a progressive and steep increase in the expression of KCC2 between birth and 2 weeks of age. Exposure to midazolam, propofol, or ketamine up to 6 h at any investigated stages of the brain growth spurt did not influence the expression of this cotransporter protein.ConclusionI.V. general anaesthetics do not seem to influence developmental expression of KCC2 during the brain growth spurt. © 2013 © The Author [2013].

  1. Developmental paediatric anaesthetic pharmacology

    DEFF Research Database (Denmark)

    Hansen, Tom Giedsing

    2015-01-01

    Safe and effective drug therapy in neonates, infants and children require detailed knowledge about the ontogeny of drug disposition and action as well how these interact with genetics and co-morbidity of children. Recent advances in developmental pharmacology in children follow the increased...

  2. Mucopolysaccharidoses and anaesthetic risks.

    Science.gov (United States)

    Sjøgren, P; Pedersen, T; Steinmetz, H

    1987-04-01

    The purpose of this review is to asses the current knowledge of mucopolysaccharidosis (MPS), with reference to the serious complications which may arise in connection with anaesthesia and operation. MPS consists of a heterogeneous group of hereditary diseases which are characterized by an abnormal accumulation of mucopolysaccharides, especially in cartilaginous and bone tissue. Because of their progressive and disabling nature, frequent surgical intervention is common, and is associated with a high degree of per- and postoperative risk. The clinical manifestations of MPS are frequently dwarfism, scaphocephaly, grotesque facial features with snub nose, hypertelorism, macroglossia and dental anomalies. The chest is deformed by pectus carinatum or excavatum, club-formed ribs and kyphosis with gibbus. Furthermore, cardiomegaly, abdomen pendens, hepatosplenomegaly, umbilical hernia, corneal clouding, conductive deafness and subnormal intelligence are common findings. Prior to operation, patients should be thoroughly evaluated through clinical examination and laboratory investigations. In particular, lung function should be optimized by lung physiotherapy and treatment of airway infections. When inducing general anaesthesia, spontaneous respiration is recommended until the patient has been intubated, as airway anomalies, bleeding and salivation may make intubation extremely difficult. Local or regional anaesthesia is often preferable, though age and mental status are relative contraindications. When used in combination with careful sedation, many problems may be overcome. Postoperatively, it is important to treat stagnation of secretions and airway infections with lung physiotherapy positive end-expiratory pressure, and antibiotics. In connection with anesthesia, it is vital to monitor the patient carefully before, during and after anaesthesia.

  3. Diabetic parturient - Anaesthetic implications

    Directory of Open Access Journals (Sweden)

    Nibedita Pani

    2010-01-01

    Full Text Available Pregnancy induces progressive changes in maternal carbohydrate metabolism. As pregnancy advances insulin resistance and diabetogenic stress due to placental hormones necessitate compensatory increase in insulin secretion. When this compensation is inadequate gestational diabetes develops. ′Gestational diabetes mellitus′ (GDM is defined as carbohydrate intolerance with onset or recognition during pregnancy. Women diagnosed to have GDM are at increased risk of future diabetes predominantly type 2 DM as are their children. Thus GDM offers an important opportunity for the development, testing and implementation of clinical strategies for diabetes prevention. Timely action taken now in screening all pregnant women for glucose intolerance, achieving euglycaemia in them and ensuring adequate nutrition may prevent in all probability, the vicious cycle of transmitting glucose intolerance from one generation to another. Given that diabetic mothers have proportionately larger babies it is likely that vaginal delivery will be more difficult than in the normal population, with a higher rate of instrumentally assisted delivery, episiotomy and conversion to urgent caesarean section. So an indwelling epidural catheter is a better choice for labour analgesia as well to use, should a caesarean delivery become necessary. Diabetes in pregnancy has potential serious adverse effects for both the mother and the neonate. Standardized multidisciplinary care including anaesthetists should be carried out obsessively throughout pregnancy. Diabetes is the most common endocrine disorder of pregnancy. In pregnancy, it has considerable cost and care demands and is associated with increased risks to the health of the mother and the outcome of the pregnancy. However, with careful and appropriate screening, multidisciplinary management and a motivated patient these risks can be minimized.

  4. Gastric mucosal electrical potential difference, pH, blood flow, and morphology during hypoxia and selective gastric ischaemia with and without allopurinol pretreatment in anaesthetized dogs

    DEFF Research Database (Denmark)

    Højgaard, L; Bülow, J B; Madsen, J

    1990-01-01

    Ischaemia has been implicated in the pathogenesis of gastric mucosal disorders. The aim of this investigation was to study the gastric mucosal electrical potential difference (PD), pH, blood flow and morphology during hypoxia, gastric ischaemia, and gastric ischaemia following inhibition of free...... radical formation with allopurinol. PD and pH were measured simultaneously with an intragastric microelectrode, and the PD values were corrected for the liquid junction potentials created by the intragastric pH variation. Blood flow was measured by the radiolabelled microsphere technique in 18...... anaesthetized dogs. Short general hypoxia and short ischaemia caused reversible declines in PD, increases in pH, and no morphological damage. Ischaemia for 1 h caused a significant decline in PD persistent after reperfusion, an increase in pH, and morphological PD, but after reperfusion PD was normalized. Gross...

  5. 局部麻醉剂引起的眼压改变%Changes in intraocular pressure after topical anaesthetic instillation

    Institute of Scientific and Technical Information of China (English)

    Javier A Montero; Jose M Ruiz-Moreno; Marta Fernandez-Munoz; M.Isabel Rodriguez-Palacios

    2006-01-01

    · AIM: To determine the influence of topical anaesthetic drops, age and central corneal thickness (CCT) in the determination of intraocular pressure (IOP) by non contact tonometry (NCT). · METHODS: Ninety-three eyes from 47 patients were examined for CCT and lOP by NCT before and after the instillation of topical anaesthetic drops.· RESULTS: Average age was 66.4 (SD 16, range 34 to 88years-of-age). Thirty one patients were female and 16 were male. Average basal IOP was 16.0 mmHg (SD 4.0, range 8.5to 26.1). IOP pressure one minute after topical anesthesia instillation was 15.0 mmHg (SD 3.8, range 7.7 to 26.7), and 14.9 mm Hg (SD 3.9, range 7.6 to 26.3) five minutes after the instillation. The differences were statistically significant for the 0 to 1 minute lapse (P=0.0007) and for the 0 to 5minute lapse (P=0.0003), but not for the 1 to 5 minute lapse (P=0.27) (Student's t test for paired data). Average CCT before topical anaesthetic drops was 565.4 microns. Simple linear regression analysis demonstrated absence of significant variation between age and IOP changes and between CCT and IOP changes,· CONCLUSION: Our study confirms that the instillation of topical anaesthetics causes a reduction in IOP, which is progressive during the first 5 minutes after instillation. This IOP reduction does not seem to be associated with basal CCT or age.%目的:确定局麻药,年龄和角膜中央厚度对非接触眼压计眼压测量值的影响.方法:记录47例93眼滴局麻药前后角膜中央厚度和非接触眼压计眼压测量值.结果:在47例中女31例,男16例;平均年龄66.4岁(标准差16,范围34~88岁);平均基础眼压16.0 mmHg(标准差4.0,范围8.5~26.1 mmHg).滴局麻药后1 min平均眼压16.0 mmHg(标准差3.8,范围7.7~26.7 mmHg),5 min平均眼压14.9 mmHg(标准差3.9,范围7.6~26.3).0~1 min(P=0.0007)和0~5 min(P=0.0003)的数值差异有统计学意义,1~5 min(P=0.27)的数值差异无统计学意义(配对资料t检验).滴局麻

  6. Differential effects of propofol and isoflurane on the relationship between EEG Narcotrend index and clinical stages of anaesthetic depth in sheep undergoing experimental cardiac surgery.

    Science.gov (United States)

    Otto, Klaus A

    2016-02-01

    The electroencephalogram (EEG) Narcotrend index (NI) has been shown to improve anaesthetic depth monitoring in isoflurane-anaesthetised sheep. Data obtained from 13 anaesthetised juvenile female sheep were analysed retrospectively in order to assess the relationship between clinical stages of anaesthesia (CS) and NI during both propofol and isoflurane anaesthesia. Polynomial regression analysis revealed no significant association between CS and NI for propofol (R = 0.374, R(2) = 0.140, P = 0.403) but for isoflurane anaesthesia (R = 0.548, R(2) = 0.301, P = 0.010) there was a significant relationship. Furthermore, a strong correlation existed between end-tidal isoflurane concentration (ISOET) and CS (r = -0.463, P = 0.008). A combination of assessment of clinical signs and analogous EEG patterns is recommended during propofol anaesthesia.

  7. The effects of midazolam and butorphanol, administered alone or combined, on the dose and quality of anaesthetic induction with alfaxalone in goats

    Directory of Open Access Journals (Sweden)

    T. Brighton Dzikiti

    2014-02-01

    Full Text Available Goats are rarely anaesthetised; consequently, scant information is available on the efficacy of anaesthetic drugs in this species. Alfaxalone is a relatively new anaesthetic agent, of which the efficacy in goats has not yet been studied. In this study, the sedative and alfaxalonesparing effects of midazolam and butorphanol, administered alone or concomitantly, in goats were assessed. Eight clinically healthy goats, four does and four wethers, were enlisted in a randomised crossover manner to receive intramuscular sedative treatments consisting of saline 0.05 mL/kg, or midazolam 0.30 mg/kg, or butorphanol 0.10 mg/kg, or a combination ofmidazolam 0.30 mg/kg with butorphanol 0.10 mg/kg before intravenous induction of general anaesthesia with alfaxalone. Following induction, the goats were immediately intubated and the quality of anaesthesia and basic physiological cardiorespiratory and blood-gas parameters were assessed until the goats had recovered from anaesthesia. The degree of sedation, quality of induction and recovery were scored. When compared with saline (3.00 mg/kg, midazolam,administered alone or with butorphanol, caused a statistically significant increased level of sedation and a reduction in the amount of alfaxalone required for induction (2.00 mg/kg and 1.70 mg/kg, respectively. Butorphanol alone (2.30 mg/kg did not cause significant changes in level of sedation or alfaxalone-induction dose. During induction and recovery, the goats were calm following all treatments, including the control group. Cardiorespiratory and blood gasparameters were maintained within clinically acceptable limits. The present study showed that midazolam, administered alone or combined with butorphanol, produces a degree of sedation that significantly reduces the dose of alfaxalone required for induction of general anaesthesia in goats, without causing any major adverse cardiorespiratory effects.

  8. Técnicas anestésicas injetáveis em capivaras (Hydrochoerus hydrochaeris, Linné Anaesthetic techniques in capybaras (Hydrochoerus hydrochaeris, Linné

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    Mariângela Lozano Cruz

    1998-09-01

    Full Text Available Neste experimento objetivou-se avaliar diferentes técnicas anestésicas em capivaras. Foram utilizadas 50 capivaras, sendo 23 machos e 27 fêmeas, adultas, de peso médio estimado em 36 ± 7kg. Foram realizados 3 grupos experimentais: G1(n=20 - xilazina (1mg/kg e quetamina (15mg/kg; G 2 (n=15 - midazolam (0.5mg/kg e quetamina (15mg/kg e G 3 (n=15 - romifidina (0,1mg/kg e quetamina (15mg/kg. Todas as drogas acima citadas foram associadas na mesma seringa e administradas pela via intramuscular com a utilização de dardos e zarabatana confeccionados artesanalmente. A freqüência cardíaca e respiratória e a temperatura retal foram avaliadas a cada 15 minutos, por até 60 minutos após a administração dos anestésicos. Também foi observado o período de latência, de analgesia e de recuperação. Cinco animais do grupo tratado com xilazina e quetamina apresentaram óbito, provavelmente relacionado com a alta temperatura ambiente. Os animais deste grupo apresentaram maiores períodos de analgesia e recuperação e o grupo de animais tratados com midazolam e quetamina, os menores períodos. Houve uma redução gradativa da freqüência cardíaca nos grupos l e 3 e de temperatura em todos os grupos. A freqüência respiratória manteve-se estável em todos os grupos. Com os três protocolos foi possível tatuar e colocar brincos nos animais, bem como realizar punção venosa, porém cuidados devem ser tomados quando do uso de xilazina em casos de temperatura ambiente elevada, bem como há necessidade de novos estudos para se melhor adequar a dose do midazolam em capivaras.The aim of this study was to investigate three anaesthetic techniques in capybaras. Twenty three male and 27 female adult capybaras weighing 36 ± 7 kg were divided in three groups: G 1(n =20 - xylazine (1mg/kg and ketamine (20mg/kg, G2 (n=l5 - midazolam (0,5mg/kg and ketamine (20mg/kg and G3 (n=15 - romifidine (0,1 mg/kg and ketamine (20mg/kg. All drugs were given

  9. Addition of sub-anaesthetic dose of ketamine reduces gag reflex during propofol based sedation for upper gastrointestinal endoscopy: A prospective randomised double-blind study

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    Manish Tandon

    2014-01-01

    Full Text Available Background and Aims: Gag reflex is unwanted during upper gastrointestinal endoscopy (UGIE. Experimental studies have demonstrated that N-methyl-D-aspartate receptor antagonism prevents gag reflex. We conducted a study to determine if sub-anaesthetic doses of ketamine, added to propofol, reduce the incidence of gag reflex. Methods: This prospective, randomised, double-blind and placebo-controlled study was done in a tertiary care hospital. A total of 270 patients undergoing UGIE, were randomised to propofol (P group (n = 135 or propofol plus ketamine (PK group (n = 135. All patients received propofol boluses titrated to Ramsay sedation score of not <4. Patients in PK group in addition received ketamine, 0.15 mg/kg immediately before the first-propofol dose. Top-up doses of propofol were given as required. Stata 11 software (StataCorp. was used to calculate the proportion of patients with gag reflex and the corresponding relative risk. Propofol consumed and time to recovery in the two groups was compared using Student′s t-test and Cox proportional hazards regression respectively. Results: Significantly, fewer patients in the PK group had gag reflex compared to the P group (3 vs. 23, risk ratio = 0.214, 95% confidence interval [CI], 0.07-0.62; P = 0.005. The incidence of hypotension (6 vs. 16, risk ratio = 0.519, 95% CI = 0.25-1.038; P = 0.06, number of required airway manoeuvres (4 vs. 19, risk ratio = 0.32, 95% CI = 0.13-0.74; P = 0.014, median time to recovery (4 min vs. 5 min, hazard ratio = 1.311, 95% CI = 1.029-1.671; P = 0.028 and propofol dose administered (152 mg vs. 167 mg, 95% CI = 4.74-24.55; P = 0.004 was also less in the PK group compared to the P group. Conclusion: Ketamine in sub-anaesthetic dose decreases gag reflex during UGIE.

  10. A case series discussing the anaesthetic management of pregnant patients with brain tumours [v2; ref status: indexed, http://f1000r.es/2hn

    Directory of Open Access Journals (Sweden)

    Alaa A Abd-Elsayed

    2013-12-01

    Full Text Available Pregnancy may aggravate the natural history of an intracranial tumour, and may even unmask a previously unknown diagnosis. Here we present a series of seven patients who had brain tumours during pregnancy. The aim of this case series is to characterize the current perioperative management and to suggest evidence based guidelines for the anaesthetic management of pregnant females with brain tumours. This is a retrospective study. Information on pregnant patients diagnosed with brain tumours that underwent caesarean section (CS and/or brain tumour resection from May 2003 through June 2008 was obtained from the Department of General Anaesthesia and the Rose Ella Burkhardt Brain Tumour & Neuro-Oncology Centre (BBTC at the Cleveland Clinic, OH, USA. The mean age was 34.5 years (range 29-40 years old. Six patients had glioma, two of whom had concomitant craniotomy and CS. Six cases had the tumour in the frontal lobe. Four cases were operated on under general anaesthesia and three underwent awake craniotomy. The neonatal outcomes of the six patients with elective or emergent delivery were six viable infants with normal Apgar scores. Pregnancy was terminated in the 7th patient. In conclusion, good knowledge of the variable anesthetic agents and their effects on the fetus is very important in managing those patients.

  11. Actions of robustoxin, a neurotoxic polypeptide from the venom of the male funnel-web spider (Atrax robustus), in anaesthetized monkeys.

    Science.gov (United States)

    Mylecharane, E J; Spence, I; Sheumack, D D; Claassens, R; Howden, M E

    1989-01-01

    Robustoxin, a polypeptide consisting of a chain of 42 amino acid residues in a known sequence, has been isolated by cation exchange chromatography from the crude venom of the male funnel-web spider (Atrax robustus). Physiological activity or toxicity in the venom fractions was detected by production of fasciculation in mouse phrenic nerve-hemidiaphragm preparations and by lethality in new-born mice. In the present experiments in Macaca fascicularis monkeys anaesthetized with pentobarbitone, robustoxin (5-30 micrograms/kg infused i.v. over 5 min) produced immediate disturbances in respiration (including dyspnoea and apnoea), blood pressure and heart rate followed by severe hypotension (mean systemic blood pressure less than 50 mmHg) or death due to respiratory and circulatory failure within 196 min. Robustoxin also produced lachrymation, salivation, generalized skeletal muscle fasciculation and a parallel increase in body temperature, and increased firing in skeletal motor and autonomic nerves. These effects closely resembled those produced by i.v. infusions over 5 min of 50 micrograms/kg of crude venom from male A. robustus spiders. Crude venom from female A. robustus spiders (500 micrograms/kg i.v. over 5 min) produced some of the effects elicited by robustoxin and crude venom from male spiders, but to a much less marked extent. It was concluded that robustoxin is responsible for the neurotoxic and lethal effects of human envenomation by male A. robustus spiders.

  12. Gastric mucosal electrical potential difference and blood flow during high FFA/albumin ratios in anaesthetized Göttingen mini-pigs

    DEFF Research Database (Denmark)

    Højgaard, L; Bülow, J B; Madsen, J;

    1988-01-01

    . The gastric blood flow was measured with the radioactive microsphere technique: at basal conditions, during high FFA/albumin ratios, and after normalization of the plasma lipids. The antrum p.d., expressed with gastric lumen negative, decreased during the increased FFA/albumin ratios; from -25 +/- 3 mV to -17......The gastric blood flow and the gastric mucosal potential difference (p.d.) was studied in anaesthetized Göttingen mini-pigs under normal conditions and during increased FFA/albumin ratios. The antrum mucosal p.d. was measured continuously with a newly developed intragastric microelectrode principle...... +/- 4 mV, (P less than 0.05). A further reduction to -12 +/- 3 mV (P less than 0.05) was observed during the normalization of the FFA/albumin ratios. The antrum and corpus mucosal blood flow values were reduced by 37 and 26% during the increased FFA/albumin ratios, and the gastric mucosal blood flow...

  13. Autonomic Nervous System Mediates the Hypotensive Effects of Aqueous and Residual Methanolic Extracts of Syzygium polyanthum (Wight Walp. var. polyanthum Leaves in Anaesthetized Rats

    Directory of Open Access Journals (Sweden)

    A. Ismail

    2013-01-01

    Full Text Available Syzygium polyanthum (Wight Walp. var. polyanthum leaves are consumed as a traditional Malay treatment of hypertension. This study investigates hypotensive potential of aqueous (AESP and residual methanolic (met-AESP extracts of S. polyanthum leaves and possible involvement of autonomic receptors. AESP and met-AESP (20 to 100 mg/kg were intravenously administered into anaesthetized Wistar-Kyoto (WKY and spontaneously hypertensive (SHR rats. Blood pressure and heart were monitored for 20 min. AESP and met-AESP induced significant dose-dependent hypotension, but only 100 mg/kg AESP caused mild bradycardia (n=5. AESP-induced hypotension was more potent than that of met-AESP in WKY. AESP has a faster onset time than that of met-AESP in both WKY and SHR. However, met-AESP-induced hypotension was more sustained than that of AESP in SHR. Blockages of autonomic ganglion and α-adrenergic receptors using hexamethonium and phentolamine (n=5 for each group partially attenuated AESP-induced hypotension, suggesting involvement of α-adrenergic receptors. Blockages of autonomic ganglion, β-adrenergic, cholinergic receptors, and nitric oxide production using hexamethonium, propranolol, atropine, and N-ω-nitro-l arginine methyl ester (L-NAME (n=5 for each group partially attenuated met-AESP-induced hypotension, suggesting involvement of β-adrenergic and cholinergic receptors via nitric oxide production.

  14. Autonomic Nervous System Mediates the Hypotensive Effects of Aqueous and Residual Methanolic Extracts of Syzygium polyanthum (Wight) Walp. var. polyanthum Leaves in Anaesthetized Rats.

    Science.gov (United States)

    Ismail, A; Mohamed, M; Sulaiman, S A; Wan Ahmad, W A N

    2013-01-01

    Syzygium polyanthum (Wight) Walp. var. polyanthum leaves are consumed as a traditional Malay treatment of hypertension. This study investigates hypotensive potential of aqueous (AESP) and residual methanolic (met-AESP) extracts of S. polyanthum leaves and possible involvement of autonomic receptors. AESP and met-AESP (20 to 100 mg/kg) were intravenously administered into anaesthetized Wistar-Kyoto (WKY) and spontaneously hypertensive (SHR) rats. Blood pressure and heart were monitored for 20 min. AESP and met-AESP induced significant dose-dependent hypotension, but only 100 mg/kg AESP caused mild bradycardia (n = 5). AESP-induced hypotension was more potent than that of met-AESP in WKY. AESP has a faster onset time than that of met-AESP in both WKY and SHR. However, met-AESP-induced hypotension was more sustained than that of AESP in SHR. Blockages of autonomic ganglion and α -adrenergic receptors using hexamethonium and phentolamine (n = 5 for each group) partially attenuated AESP-induced hypotension, suggesting involvement of α -adrenergic receptors. Blockages of autonomic ganglion, β -adrenergic, cholinergic receptors, and nitric oxide production using hexamethonium, propranolol, atropine, and N- ω -nitro-l arginine methyl ester (L-NAME) (n = 5 for each group) partially attenuated met-AESP-induced hypotension, suggesting involvement of β -adrenergic and cholinergic receptors via nitric oxide production.

  15. Time-frequency analysis of laser Doppler flowmetry signals recorded in response to a progressive pressure applied locally on anaesthetized healthy rats

    Energy Technology Data Exchange (ETDEWEB)

    Humeau, Anne [Groupe ISAIP-ESAIP, 18 rue du 8 mai 1945, BP 80022, 49180 Saint Barthelemy d' Anjou Cedex (France); Koitka, Audrey [Laboratoire de Physiologie et d' Explorations Vasculaires, Centre Hospitalier Universitaire d' Angers, 49033 Angers Cedex 01 (France); Abraham, Pierre [Laboratoire de Physiologie et d' Explorations Vasculaires, Centre Hospitalier Universitaire d' Angers, 49033 Angers Cedex 01 (France); Saumet, Jean-Louis [Laboratoire de Physiologie et d' Explorations Vasculaires, Centre Hospitalier Universitaire d' Angers, 49033 Angers Cedex 01 (France); L' Huillier, Jean-Pierre [Ecole Nationale Superieure d' Arts et Metiers (ENSAM), Laboratoire Procedes-Materiaux-Instrumentation (LPMI), 2 boulevard du Ronceray, BP 3525, 49035 Angers Cedex (France)

    2004-03-07

    The laser Doppler flowmetry technique has recently been used to report a significant transient increase of the cutaneous blood flow signal, in response to a local non-noxious pressure applied progressively on the skin of both healthy humans and rats. This phenomenon is not entirely understood yet. In the present work, a time-frequency analysis is applied to signals recorded on anaesthetized healthy rats, at rest and during a cutaneous pressure-induced vasodilation (PIV). The comparison, at rest and during PIV, of the scalogram relative energies and scalogram relative amplitudes in five bands, corresponding to five characteristic frequencies, shows an increased contribution for the endothelial related metabolic activity in PIV signals, till 400 s after the beginning of the progressive pressure application. The other subsystems (heart, respiration, myogenic and neurogenic activities) contribute relatively less during PIV than at rest. The differences are statistically significant for all the relative activities in the interval 0-200 s following the beginning of the pressure. These results and others obtained on patients, such as diabetics, could increase the understanding of some cutaneous pathologies involved in various neurological diseases and in the pathophysiology of decubitus ulcers.

  16. Effect of anaesthetics and dichlorodifluoromethane on the viability of the cells of Escherichia coli and the activities of some of its enzymes

    Energy Technology Data Exchange (ETDEWEB)

    Laverty, D.M.; Fennema, O.

    1985-01-01

    Three anaesthetics (halothane, CF/sub 3/CHClBr; Ethrane, F/sub 2/ HCOF/sub 2/CCHClF; cyclopropane) and one other halogenated, short-chain hydrocarbon (F-12, Cl/sub 2/F/sub 2/C) were tested under various conditions to determine their effects on the viability of cells of Escherichia coli and the activities of some of its enzymes. When any of the test chemicals were applied for 60 min at concentrations slightly in excess of saturation, the number of surviving cells decreased substantially, with halothane being the most biocidal of the four chemicals and F-12 the least. Three enzymes (malate dehydrogenase, MD; NADH dehydrogenase; glyceraldehyde-3-phosphate dehydrogenase, GPD) were tested for activity after treatment of E. coli with the test chemicals. In all instances, GPD was least resistant to inactivation and MD was most resistant. Halothane was most inhibitory followed in order by Ethrane, cyclopropane and F-12. Treatment of E. coli with halothane for 60 min at 23 degrees C and a concentration slightly in excess of saturation, resulted in nearly complete inhibition of all three enzymes.

  17. 近日节律对麻醉药物作用的影响%Effect of circadian rhythms on the action of anaesthetic agents

    Institute of Scientific and Technical Information of China (English)

    曾海波; 尚游; 袁世荧

    2010-01-01

    多数麻醉医生认为,人体是一个非常稳定的有机体.事实上,机体的许多方面因为受到生物节律的影响而会表现出周期性的变化.近日节律是一种重要的生物节律,对动植物乃至人都有诸多重要的影响,这其中也包括对麻醉药物作用的影响.因此,在从事科学研究和临床工作时,近日节律对麻醉药物作用的这种影响不容忽视.%Many anaesthetists assume that humans are homeostatic organisms but in reality we show periodic variations in nearly all facets of our physiology and behaviour, influenced by biologic rhythms. Circadian rhythms is an important biologic rhythm which can affect animals, plants and human beings. Also it make effects on anesthetics, The effects of circadian rhythms should be considered in scientific research of anaesthetic drugs and works of clinical practice of anaesthesia.

  18. Clove oil as anaesthetic for juveniles of matrinxã Brycon cephalus (Gunther, 1869 Óleo de cravo como anestésico para juvenis de matrinxã Brycon cephalus (Gunther, 1869

    Directory of Open Access Journals (Sweden)

    Luis Antônio Kioshi Aoki Inoue

    2003-10-01

    Full Text Available Many chemicals have been used as anaesthetics in fish farms and fish biology laboratories to keep the fish immobilized during handling procedures and to prevent accidents and animal stress. In Brazil, tricaine methane sulfonate (MS 222, quinaldine sulfate, benzocaine, and phenoxyethanol are the most common fish anaesthetics used to prevent fish stress during handling, but many side effects such as body and gill irritations, corneal damage and general risks of intoxication have been reported. Clove oil is a natural product proposed as an alternative fish anaesthetic by many researchers and it has been used in many countries with great economic advantages and no apparent toxic properties. In this work, we assessed the suitability of clove oil to anaesthetize matrinxã. Sixty-three juveniles of matrinxã were exposed to seven anaesthetic batches of clove oil (pharmaceutical grade namely 18, 20, 30, 40, 50, 60, and 70 mg/L. The times to reach total loss of equilibrium and to recover the upright position were measured. Clove oil concentration about 40 mg/L was enough to anaesthetize the fish in approximately one minute and the recovery time was independent in regard to anaesthetic concentration.Diversos produtos químicos têm sido empregados como anestésicos para peixes nas estações de piscicultura e laboratórios de biologia de peixes para a devida imobilização dos organismos, afim de se prevenir acidentes e ferimentos na superfície do corpo dos próprios peixes, que podem ficar susceptíveis a patógenos e taxas altas de mortalidade. A tricaina metano sulfonato (MS 222, a quinaldina, a benzocaina e o phenoxyethanol têm sido amplamente utilizados no Brasil, mas alguns efeitos colaterais são observados como perda de muco, irritação nas brânquias e olhos, e também alguns incômodos aos trabalhadores como a necessidade do uso de luvas. Dessa forma, o óleo de cravo é proposto como um anestésico alternativo por ser um produto natural de

  19. Simultaneous parasympathetic and sympathetic activation reveals altered autonomic control of heart rate, vascular tension and epinephrine release in anaesthetized hypertensive rats

    Directory of Open Access Journals (Sweden)

    Torill eBerg

    2011-11-01

    Full Text Available Sympathetic hyperactivity and parasympathetic insufficiency characterize blood pressure control in genetic hypertension, but is difficult to demonstrate experimentally in anesthetized rats. Here we present a pharmacological approach to activate sympathetic and parasympathetic nerves simultaneously, and identify their contribution. Anaesthetized normotensive (WKY and spontaneously hypertensive rats (SHR were injected i.v. with 4-aminopyridine (4-AP, a voltage-sensitive K+ channel inhibitor. Blood pressure was recorded through a femoral artery catheter, cardiac output and heart rate (HR through an ascending aorta flow probe. Total peripheral vascular resistance (TPVR was calculated. 4-AP induced an immediate, atropine- and hexamethonium-sensitive bradycardia in WKY, and in strains, a subsequent, sustained tachycardia, and norepinephrine but not epinephrine release. The tachycardia was eliminated by reserpine, nadolol or right vagal nerve stimulation, but not adrenalectomy, scopolamine or hexamethonium. 4-AP-induced, atropine-sensitive bradycardia was observed in reserpinized or nadolol-treated SHR, where atropine also increased the late HR-response. 4-AP increased TPVR, transiently in WKY but sustained in SHR. Yohimbine but not phentolamine prevented TPVR down-regulation in WKY. Reserpine, phentolamine and prazosin eliminated the late vasoconstriction in SHR. Plasma epinephrine overflow increased in nadolol-treated SHR. Conclusions: 4-AP activated parasympathetic ganglion transmission and peripheral, sympathetic nerve norepinephrine release. The sympathetic component dominated the HR-response to 4-AP in SHR. α2-adrenceptor-dependent vasodilatation opposed norepinephrine-induced α1-adrenergic vasoconstriction in WKY, but not in SHR. A βAR-activated, probably vagal afferent mechanism, hampered adrenal epinephrine secretion in SHR. Thus, 4-AP exposed mechanisms, which contribute to hypertension, and may allow identification of the factors

  20. Effect of intravenous dexmedetomidine on haemodynamic responses to laryngoscopy, tracheal intubation and anaesthetic and analgesic requirements: a randomized double-blind clinical efficacy study

    Directory of Open Access Journals (Sweden)

    Madhusudan M

    2016-10-01

    Full Text Available Background: Dexmedetomidine is an alpha 2-adrenergic receptor agonist that provides sedation, anxiolysis, hypnosis, analgesia, and sympatholysis. The present study is aimed to assess the efficacy of dexmedetomidine in attenuating sympathoadrenal response to laryngoscopy and tracheal intubation and to analyse its effect on intraoperative anaesthetic and analgesic requirements. Methods: Sixty patients were randomized to receive either dexmedetomidine 1µg/kg (Group D or 10 mL of 0.9% saline (Group S over 10 minutes before induction of anaesthesia and after standard induction procedure the same study drug infusions were continued. Blood pressure, heart rate (HR and Ramsay sedation score (RSS were monitored at fixed time interval after study drug infusion and anaesthesia induction. Results: After study drug administration the changes in HR and blood pressure was statistically significant between the groups (p = <0.001 at all-time intervals during study period. There was 50% reduction in thiopentone requirements in Group D in comparison to Group S (p<0.001. The intraoperative additional dose of morphine requirement was less in Group D in comparison to Group S to maintain the steady haemodynamics (p<0.001. Statistically significant difference was noticed in Group D regarding RSS at 5 min and 10 min after study drug infusion (p=0.025 and p=0.001 respectively and again at 30 min after extubation (p= 0.002 when compared with Group S. Conclusions: Our observations suggest that dexmedetomidine was effective in attenuating the heart rate and blood pressure rise during laryngoscopy and intubation, and decrease the thiopentone and morphine requirements intraoperatively.

  1. Behavioural Responses of Heterobranchus longifilis Juveniles. Val (Pisces: 1840 Exposed to Freeze–dried Bark Extract of Tephrosia vogelii as an Anaesthetic

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    S.G. Solomon

    2014-03-01

    Full Text Available This study evaluates the anaesthetic properties of freeze-dried leaf extract of Tephrosia vogelii on the African catfish Heterobranchus longifilis juveniles. Experimental fish of Mean weight 115.00 were obtained from River Benue at Makurdi, Nigeria and acclimatized at the hatchery of University of Agriculture Makurdi for two weeks. Four H. longifilis were selected randomly for both control and treatment groups. Each treatment fish was weighed and injected intramuscularly 0.05ml of the extract at concentrations of 0.01, 0.02, 0.03, 0.04, 0.05 and 0.06g/l using a 2ml heparinized syringe. The result showed that H. longifilis in treatment group passed sequentially through the first three stages of anaesthesia but could not attain total loss of equilibrium (stage 4 of anaesthesia. The result showed that treatment group of fishes passed sequentially through the first three stages of anaesthesia but could not attain total loss of equilibrium (stage 4 of anaesthsia. Behavioural responses included mucus secretion, slow and erratic swimming, excrement discharge, increase in opercular beat rate, strong retention of reflex action, partial loss of equilibrium and colour change. The induction time showed a declining pattern with increasing concentration of the extract in the treatment levels with significant differences (P0.05. The most effective concentration was 0.06g/l with an induction time of 32.00±1.76 seconds and a recovery time of 182.00±3.46 minutes. The result of this study revealed that the freeze-dried bark extract of T. vogelii can be used as a tranquilizer for transporting fish over average distances, biopsy and morphological evaluation.

  2. Anaesthetic management of emergency pacemaker implantation in a case of neonatal lupus erythematosus with complete congenital heart block & severe respiratory distress

    Directory of Open Access Journals (Sweden)

    Usha Kiran

    2007-01-01

    Full Text Available An 8-week old 3-kilogram male baby was brought to this tertiary care hospital with respiratory distress, marked tracheal tug, poor feeding and a heart rate of 46/minute. The child had been referred from a peripheral hospital as a case of neonatal lupus with complete congenital heart block. The mother was seropositive for systemic lupus erythematosus with a history of two abortions. Evaluation on admission revealed a heart rate between 40-60/ minute, respiratory rate 40-50/ minute, inspiratory stridor, bilateral crepitations, chest retrac-tion and a marked tracheal tug that improved with prone positioning. Electrocardiography and echocardiography confirmed complete congenital heart block with cardiomegaly and mild left ventricular dysfunction. Keeping in view the impending congestive heart failure, possible early cardiomyopathy and the bad obstetric history ur-gent pacemaker implantation was planned to allow early recovery of the child. The anaesthetic risk was high due to the heart block, ventricular dysfunction, laryngomalacia, severe tracheal tug and anticipated difficult weaning from controlled ventilation. General anaesthesia was administered with endotracheal tube and con-trolled ventilation using ketamine, rocuronium and sufentanil. For patient safety invasive monitoring was pro-vided and external pacing was kept standby. Epicardial pacemaker leads were implanted onto the left ventricu-lar wall through a left anterior 6th intercostal space thoracotomy. The child was electively ventilated for two post operative days. The tracheal tug and secretions gradually subsided over 2 weeks with oxygen, antibiotics, steroids, bronchodilators and physiotherapy. At the time of discharge from hospital 2 weeks after the implant the child was feeding well, tracheal tug was minimal and the lungs were clear.

  3. Effect of lidocaine-prilocaine eutectic mixture of local anaesthetic cream compared with oral sucrose or both in alleviating pain in neonatal circumcision procedure

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    Reem Al Qahtani

    2014-01-01

    Full Text Available Background: Neonatal circumcision is one of the oldest and most frequently performed surgical procedures on males. Newborns demonstrate strong endogenous reaction to pain and therefore modalities are being explored for optimum pain relief during circumcision. Pediatric nurses have a vital role for the use of these modalities and minimising the pain response during the neonatal minor procedures. Aim: The aim of this study was to assess the effectiveness of eutectic mixture of local anaesthetic (EMLA cream compared with oral sucrose and both in alleviating pain in neonatal circumcision. Materials and Methods: This study was conducted in the Day Care Surgery Department of Maternity and Children Hospital, Dammam City, KSA. 90 full-term newborn males who underwent circumcision were divided randomly into three groups (30 each. Each group was assigned to receive a different type of analgesics such as EMLA cream (Group A, oral sucrose (Group B or combination of EMLA cream and oral sucrose (Group C. Neonatal pain agitation and sedation scale (N-PASS was used 5 min before, during and 5 min after the circumcision procedure to assess the neonatal response to pain. Results: N-PASS scores were significantly lower in Group C (median Group C = 5.2, Group A = 5.8, Group B = 8.5; P< 0.001. The endogenous response to pain in terms of escalation of heart rate and reduction in O 2 saturation were minimal among Group C (P < 0.0001. Duration of crying was comparable among all the groups. Conclusion: The combination of sucrose and EMLA cream revealed a higher analgesic effect and minimal adverse response to pain than either EMLA cream or sucrose alone during neonatal circumcision.

  4. A case series discussing the anaesthetic management of pregnant patients with brain tumours [v1; ref status: indexed, http://f1000r.es/y7

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    Alaa A Abd-Elsayed

    2013-03-01

    Full Text Available Pregnancy may aggravate the natural history of an intracranial tumour, and may even unmask a previously unknown diagnosis. Here we present a series of seven patients who had brain tumours during pregnancy. The aim of this case series is to characterize the current perioperative management and to suggest evidence based guidelines for the anaesthetic management of pregnant females with brain tumours. This is a retrospective study. Information on pregnant patients diagnosed with brain tumours that underwent caesarean section (CS and/or brain tumour resection from May 2003 through June 2008 was obtained from the Department of General Anaesthesia and the Rose Ella Burkhardt Brain Tumour & Neuro-Oncology Centre (BBTC at the Cleveland Clinic, OH, USA. The mean age was 34.5 years (range 29-40 years old. Six patients had glioma, two of whom had concomitant craniotomy and CS. Six cases had the tumour in the frontal lobe. Four cases were operated on under general anaesthesia and three underwent awake craniotomy. The neonatal outcomes of the six patients with elective or emergent delivery were six viable infants with normal Apgar scores. Pregnancy was terminated in the 7th patient. In conclusion, management of brain tumours in pregnant women is mainly reliant on case reports and the doctor’s personal experience. Therefore, close communication between the neurosurgeon, neuroanaesthetist, obstetrician and the patient is crucial. General anaesthesia, propofol, dexmedetomidine and remifentanil were used in our study and were safe. Although this may not agree with previous studies, desflurane and isoflurane were used in our patients with no detectable complications.

  5. Modulation of the vagal bradycardia evoked by stimulation of upper airway receptors by central 5-HT1 receptors in anaesthetized rabbits

    Science.gov (United States)

    Dando, Simon B; Skinner, Matthew R; Jordan, David; Ramage, Andrew G

    1998-01-01

    The effects of central application of 5-HT1A and 5-HT1B/1D receptor ligands on the reflex bradycardia, apnoea, renal sympathoexcitation and pressor response evoked by stimulating upper airway receptors with smoke in atenolol-pretreated anaesthetized rabbits were studied.Intracisternal administration of the 5-HT1A receptor antagonists WAY-100635 (100 μg kg−1) and (−)pindolol (100 μg kg−1) significantly reduced the smoke-induced bradycardia, attenuated the pressor response and in the case of (−)pindolol, sympathetic nerve activity. The same dose of WAY-100635 i.v. was without effect.Buspirone (200 μg kg−1, i.c.) potentiated the reflex bradycardia. This action was prevented if the animals were pretreated with WAY-100635 (100 μg kg−1, i.v.)(+)8-OH-DPAT (25 μg kg−1, i.c.) attenuated the evoked bradycardia, pressor response, apnoea and renal sympathoexcitation. The attenuation of the apnoea and renal sympathoexcitation, but not the bradycardia or pressor response was prevented in animals pretreated with WAY-100635 (100 μg kg−1, i.v.). The attenuation of the reflex bradycardia and the reduction in the renal sympathoexcitation were reduced by pretreatment with the 5-HT1B/1D receptor antagonist GR127935 (100 μg kg−1, i.v.).In WAY-100635 (100 μg kg−1, i.v.) pretreated animals, sumatriptan (a 5-HT1B/1D receptor agonist) reduced the reflex bradycardia and the pressor response. The 5-HT1B/1D receptor antagonist GR127935 (20 μg kg−1, i.c. or 100 μg kg−1, i.v.) had no effect on the reflex responses.In conclusion, the present data are consistent with the hypothesis that activation of central 5-HT1A receptors potentiate whilst activation of 5-HT1B/1D receptors attenuate the reflex activation of cardiac preganglionic vagal motoneurones evoked by stimulation of upper airway receptors with smoke in rabbits. PMID:9786516

  6. Anaesthetic complications in plastic surgery

    Directory of Open Access Journals (Sweden)

    Soumya Sankar Nath

    2013-01-01

    Full Text Available Anaesthesia related complications in plastic surgeries are fortunately rare, but potentially catastrophic. Maintaining patient safety in the operating room is a major concern of anaesthesiologists, surgeons, hospitals and surgical facilities. Circumventing preventable complications is essential and pressure to avoid these complications in cosmetic surgery is increasing. Key aspects of patient safety in the operating room are outlined, including patient positioning, airway management and issues related to some specific conditions, essential for minimizing post-operative morbidity. Risks associated with extremes of age in the plastic surgery population, may be minimised by a better understanding of the physiologic changes as well as the pre-operative and post-operative considerations in caring for this special group of patients. An understanding of the anaesthesiologist′s concerns during paediatric plastic surgical procedures can facilitate the coordination of efforts between the multiple services involved in the care of these children. Finally, the reader will have a better understanding of the perioperative care of unique populations including the morbidly obese and the elderly. Attention to detail in these aspects of patient safety can help avoid unnecessary complication and significantly improve the patients′ experience and surgical outcome.

  7. Anaesthetic Management of Chemodectoma Excision

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    Dr. Babita Gupta

    2007-04-01

    Full Text Available Carotid body tumours (CBTs or chemodectoma are rare non- chromaffin paragangliomas arising from the chemoreceptor cells found at the carotid bifurcation. About 1000 cases have been reported in the literature

  8. Anaesthetic complications in plastic surgery.

    Science.gov (United States)

    Nath, Soumya Sankar; Roy, Debashis; Ansari, Farrukh; Pawar, Sundeep T

    2013-05-01

    Anaesthesia related complications in plastic surgeries are fortunately rare, but potentially catastrophic. Maintaining patient safety in the operating room is a major concern of anaesthesiologists, surgeons, hospitals and surgical facilities. Circumventing preventable complications is essential and pressure to avoid these complications in cosmetic surgery is increasing. Key aspects of patient safety in the operating room are outlined, including patient positioning, airway management and issues related to some specific conditions, essential for minimizing post-operative morbidity. Risks associated with extremes of age in the plastic surgery population, may be minimised by a better understanding of the physiologic changes as well as the pre-operative and post-operative considerations in caring for this special group of patients. An understanding of the anaesthesiologist's concerns during paediatric plastic surgical procedures can facilitate the coordination of efforts between the multiple services involved in the care of these children. Finally, the reader will have a better understanding of the perioperative care of unique populations including the morbidly obese and the elderly. Attention to detail in these aspects of patient safety can help avoid unnecessary complication and significantly improve the patients' experience and surgical outcome.

  9. Mucopolysaccharidoses -An Adventurous Anaesthetic Encounter

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    Madhuri S Kurdi

    2008-01-01

    Full Text Available Cases of Mucopolysaccharidoses (MPS, though rare, may pose many challenges for the anaesthesiologist. Maintaining the airway may be extremely difficult even in the most experienced hands. We present here, two breath taking airway securing experiences-one emergency and the other elective- in a 10 year old child of Mucopolysaccharidoses (MPS who presented to us for repair of an irreducible umbilical hernia.

  10. Anaesthetic management of giant encephalocele

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    Rajeev Kumar

    2015-12-01

    Full Text Available One of the several challenges to the anaesthesiologists, is management of child with difficult airway. Management of even normal airway in a neonate is different and complex as compared to airway of two year old child and that of adult. Definition of the difficult airway is related solely to tracheal intubation or problems with mask ventilation1.Among the different causes of difficult airway cranio facial and neoplastic anomalies are very common. We present a case report of difficult airway management in encephalocele patient. [Int J Res Med Sci 2015; 3(12.000: 3889-3892

  11. Utilização do eugenol como anestésico para o manejo de juvenis de Pintado (Pseudoplatystoma corruscans = The use of eugenol as an anaesthetic for the handling of Pintado juveniles (Pseudoplatystoma corruscans

    Directory of Open Access Journals (Sweden)

    Luiz Vítor Oliveira Vidal

    2006-07-01

    Full Text Available Neste trabalho, foi avaliada a eficiência do eugenol como anestésico em juvenis de pintado (Pseudoplatystoma corruscans através de ensaios. No primeiro, os peixes (n=6 foram individualmente expostos a concentrações de 25, 50, 75, 100 mg L-1 de eugenol durante 10 minutos e os parâmetros de observação estabelecidos foram: perda de equilíbrio, efeito calmante e redução do movimento opercular. No segundo ensaio, foram utilizadas as concentrações de 50, 75, 100 mg L-1 de eugenol, em que os animais foram mantidos na água com anestésico até atingirem o estágio IV de anestesia: perda total de equilíbrio, do tônus muscular e redução dos movimentos operculares. A recuperação foi conduzida em um aquário, contendo 10 litros de água livre de anestésico, com aeração constante. Após os dois ensaios, foi constatada a eficiência do eugenol como substância anestésica em juvenis de pintado, sendo a concentração de 50 mg L-1 considerada a mais adequada para procedimentos usuais no manejo desses animais em piscicultura.In this work the efficacy of eugenol as an anaesthetic in Pintado juveniles (Pseudoplatystoma corruscans was evaluated by two experimental assays. In the first one, the animals (n=6 were exposed for 10 minutes to four concentrations of eugenol (25; 50; 75; 100 mg L-1. The observed behavioral patterns were: loss of equilibrium, sedative effect and reduction of opercular movement. In the secondassay, the concentrations of 50; 75; 100 mg L-1 of eugenol were tested. The animals were maintained in the anaesthetic bath until they reached the stage of anaesthesia IV: total loss of equilibrium, muscle tonus and reduction of opercular movement. The recovery wasconducted in an aquarium containing 10 liters of anaesthetic free water, with constant aeration. The efficacy of clove oil as an anaestetics for Pintado juveniles were demonstrated after the assays and the 50 mg L-1 concentration was defined as the most adequate to usual

  12. Obesidad y cirugía bariátrica: implicaciones anestésicas Obesity and bariatric surgery: anaesthetic implications

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    L. Á. Fernández Meré

    2004-02-01

    , with the subsequent impact on health-related expenditure, particularly in developed countries. The main peculiarity of obesity is its association with numerous pathologies (respiratory disease, cardiovascular problems, endocrinological or metabolic disorders, etc. that leads it to be related with high levels of mortality and morbidity, affecting both the quality and duration of the life of sufferers. The attempts to prevent obesity and, when these fail, the treatments that can be resorted to cover many aspects: behavioural, dietary and medical. But these are frequently doomed to failure because of their potentially very demanding nature, at which times, after complying with certain minimal requirements and a detailed assessment, it is possible to move on to the next step: bariatric surgery. This is a part of the therapeutic armoury that is enjoying a constant boom, with very favourable results that mean the physiopathology of this condition should be known in greater detail by all of the multidisciplinary team dealing with the problem: GPs, endocrinologists, psychiatrists, general surgeons and anaesthesiologists, with the latter being involved in all of the peri-surgical activity (pre-, intra- and post-operative stages, in the reanimation units. From the standpoint of anaesthesia (the focus of this paper as it is the least well-known of those mentioned, obese individuals are at a disadvantage with respect to other non-obese patients as the process is complicated and the risk increases. With this review of the subject, it is intended to recall the physiopathological changes produced by obesity as well as the anaesthetic implications within the framework of bariatric surgery, so as to achieve the most favourable possible results from the surgery.

  13. 硬膜外联合腰麻在泌尿科微创手术中的应用效果观察%The application effect of Epidural combined with lumbar anaesthetizing in urological minimally invasive surgery

    Institute of Scientific and Technical Information of China (English)

    袁春梅; 罗明; 谢伦雄; 罗小玲

    2015-01-01

    目的:为了探讨硬膜外联合腰麻在泌尿科微创手术中的应用效果。方法选取156例泌尿科微创手术患者为研究对象,随机对患者进行分组,分成硬-腰联合麻醉组和连续硬膜外麻醉组。对两组患者的麻醉起效时间、用药总量以及临床整体麻醉效果进行观察和比较。结果(1)硬-腰联合麻醉组患者的麻醉起效时间短于连续硬膜外麻醉组,麻醉药物用量少于连续硬膜外麻醉组;(2)硬-腰联合麻醉组患者的麻醉效果优秀比例显著高于连续硬膜外麻醉组。结论临床针对泌尿科实施微创手术的过程中,采用硬膜外联合腰麻的临床麻醉效果显著,是临床应用于泌尿科微创手术中的理想麻醉方式之一。%Objective To investigate the application of epidural combined with lumbar anaesthetizing in urological minimally invasive surgery.Methods Chose 156 cases of urological minimally invasive surgery patients as the research object, and randomly divided into hard -waist joint anesthesia group and continuous epidural anesthesia group.Total anesthesia working time in patients, medication and clinical overall anaesthesia effect were observed and compared.Results Hard -waist joint anesthesia group present short effective time than continuous epidural anesthesia group, however, the dosage of anesthetic was less than the continuous epidural anesthesia group.Good proportion of anesthesia effect in Hard -waist joint anesthesia group was significantly higher than continuous epidural anesthesia group.Conclusions Epidural combined with lumbar anaesthetizing is an ideal anesthesia method in clinical minimally invasive surgery.

  14. The C-terminal extension of exendin-4 provides additional metabolic stability when added to GLP-1, while there is minimal effect of truncating exendin-4 in anaesthetized pigs

    DEFF Research Database (Denmark)

    Simonsen, L; Holst, Jens Juul; Madsen, K;

    2013-01-01

    The most striking sequence difference between glucagon-like peptide-1 (GLP-1)(2) and the longer-acting GLP-1 receptor agonist, exendin-4 (Ex-4),(3) is the nine-amino acid COOH-terminal extension of Ex-4. We investigated the contribution of this extension to the survival time of Ex-4. We assessed...... the overall metabolism of GLP-1, Ex-4, a COOH-terminally extended GLP-1 peptide (GLP-1+Ex(31-39); GLP-Ex),(4) and a COOH-terminally truncated exendin peptide (Ex(1-30)) in anaesthetized, catheterized pigs, with focus on the extraction across the kidneys and a peripheral tissue (a hindleg, representing muscle......, adipose- and connective tissue). Peptide analysis was carried out with assays against the mid-region of the peptides, whereby the role of dipeptidyl peptidase-4 (DPP-4)(5) mediated NH(2)-terminal degradation could be disregarded. The half-life of GLP-1 was significantly increased when the COOH...

  15. 3种麻醉剂对兔Oddi括约肌肌电运动的影响%Effect of 3 Kinds of Anaesthetics on the Myoelectric Motility of Sphincter of oddi in Rabbits

    Institute of Scientific and Technical Information of China (English)

    刘永康; 李智华; 王冰洋; 何谦; 王小军; 董家鸿

    2009-01-01

    目的:研究麻醉剂速眠新、氯胺酮、戊巴比妥钠对兔Oddi括约肌(SO)肌电运动的影响.方法:取家兔24只,采用改良的Thomas法间置空肠建立SO肌电运动检测通道,术后10 d时将存活的16只随机分为3组,分别静脉注射速眠新(n=6)、氯胺酮(n=5)、戊巴比妥钠(n=5),在清醒状态及麻醉起效后5 min各组耳缘静脉注射胆囊收缩素(CCK)20、100 ng·kg~(-1)(2次给药至少间隔3 min),期间连续记录3种麻醉剂给药前、后及CCK给予后的SO肌电运动,以运动指数及其增幅、兴奋效应持续时间等指标表示,同时以未加麻醉剂时给予CCK前、后的肌电运动为对照.结果:与给予麻醉剂前比较,速眠新和氯胺酮组给药后SO肌电运动指数明显增加(P<0.05),而戊巴比妥钠组变化不明显;与对照组比较,CCK使速眠新和氯胺酮组SO肌电运动指数增幅降低,戊巴比妥钠组运动指数增幅增加、兴奋效应持续时间延长(P<0.05).结论:3种麻醉剂对兔SO肌电运动均有影响,以速眠新和氯胺酮的影响较大,戊巴比妥钠影响相对较小.%OBJECTIVE: To explore the influence of sumianxin, ketamine and sodium pentobarbital on the myoelectric motility of Sphincter of Oddi (SO) . METHODS: 24 adult rabbits were used in this study, and the access to the myoelectric motility recording was achieved by interposition of jejunum stump with modified Thomas method. The survived rabbits were divided into 3 groups after 10 days' recovery time, each group was anesthetized with sumianxin(n = 6), ketamine(n = 5), and sodium pentobarbital(n = 5), respectively. Cholecystokinin (CCK, 20、100 ng ·kg~(-1)) was injected in conscious state and after the rabbits were completely anesthetized 5 min was recorded (the interval between CCK injections was at least 3 min) .The change of myoelctric motility were recorded before and after CCK application without anaesthetics, and the enhancement of motility index and change of effective

  16. 不同麻醉方案对幕上肿瘤切除术后患者麻醉复苏的影响%Effect of different anaesthetic methods on the anesthesia recovery of patients after supratentorial tumor resction

    Institute of Scientific and Technical Information of China (English)

    孙燕; 谢先丰; 徐勇; 张璟瑜

    2016-01-01

    目的::比较2种不同麻醉方案对幕上肿瘤切除术患者麻醉复苏的影响。方法:66例患者随机分为2组,分别在脑电双频指数( BIS)指导下使用丙泊酚-瑞芬太尼麻醉( PR组)和七氟烷-舒芬太尼麻醉( SS组)。评估患者术后自主呼吸恢复时间、拔管时间和对简单指令有反应的时间。同时记录患者改良镇静评分≤1分、格拉斯哥昏迷评分=15分、疼痛VAS评分0.05)。 SS组患者术后Aldrete评分=10分、简易精神状态量表=30分和格拉斯哥昏迷评分=15分时间均早于PR组患者(P0.05)。结论:在BIS指导下,行幕上肿瘤切除术患者使用七氟烷-舒芬太尼麻醉和丙泊酚-瑞芬太尼麻醉后苏醒时间无明显不同,七氟烷-舒芬太尼麻醉有加快此类患者神经功能恢复的趋势。%Objective:To compare the effects of two different anaesthetic methods on the anesthesia recovery of patients after supratentorial tumor resction. Methods:Sixty-six patients were randomly divided into the propofol-remifentanil ( PR group ) and sevoflurane-sufentanil( SS group) . The PR group and SS group were anaesthetized using propofol-remifentanil and sevoflurane-sufentanil under the bispectral index( BIS) monitor,respectively. The time of the spontanous breathing recovering,extubation and response in two groups were evaluated after operation. The time at Simplified Sedation Score(SSS) less than or equal to 1,Glasgow Coma Scale(GCS) equal to 15,Pain Visual Analogue Scale(PVAS) less than 4,Mini-mENTAL sTATE(MMS) equal to 30 and Aldrete Score(AS) equal to 10 in two groups were recorded. Results:The differences of the spontanous breathing recovering time,extubation time and response time between two group were not statistically significant(P>0. 05). The time at the postoperative AS equal to 10,MMS equal to 30 and GCS equal to 15 in SS group was sooner than those in PR group(P0. 05). Conclusions:The anesthesia recovery time between the propofol

  17. Effects of Salvianolic Acid B Injection on Hemodynamic Ariables in Anaesthetized Open-chest Dogs in Vivo%丹酚酸B静脉注射对麻醉犬血流动力学的影响

    Institute of Scientific and Technical Information of China (English)

    张良; 喻斌; 袁冬平; 徐立; 沈祥春; 方泰惠

    2009-01-01

    OBJECTIVE To investigate hemodynamic ariables in anaesthetized open-chest dogs after the intravenous injection of salvianolic acid B. METHODS The hemodynamic ariables of open-chest dogs were observed after intravenous CBF and decreased LVEDP of the experimental dogs. And these test results in experimental group were significantly different from those in control group at some time points. CONCLUSIONS SAL-B has effect of improving cardiac function, which indicates SAL-B has a well perspective of clinical value.%目的 观察注射用丹酚酸B对麻醉犬血流动力学的作用.方法 分别以0.8,1.6,3.2.0mg·kg-1原料(低、中、高剂量)静脉注射给予麻醉开胸犬,观察给药后血压与心率、心输出量与冠脉流量(CBF)、左室内压等血流动力学指标的变化.结果 丹酚酸B 3.2 mg·kg-1组对舒张压(DAP)、平均动脉压(MAP)有降压作用,对心率(HR)有减慢趋势,在给药后30 min内与对照组比较差异显著;丹酚酸B高剂量组能明显增加CBF,在给药后15 min内与对照组比较差异显著;丹酚酸B高剂量组能明显降低左心室舒张末期压力(LVEDP),在给药后15 min内与对照组比较差异显著.结论 丹酚酸B注射途径给药能改善麻醉犬血流动力学,调节心脏的功能,具有一定的临床治疗作用.

  18. An/Aesthetics : A Lecture-Performance

    NARCIS (Netherlands)

    Garcia, Luis-Manuel; LaBelle, Brandon

    2014-01-01

    What is an experience? Seemingly numb due to the overload of information, stimuli, and sensory possibilities that characterize our contemporary world, where experiences are packaged, sold, and consumed, the question of “aesthetics” emerges with ever greater urgency today. What is good and beautiful,

  19. Broken safety pin in bronchus - Anaesthetic considerations

    Directory of Open Access Journals (Sweden)

    Roona Shad

    2012-01-01

    Full Text Available Safety pins are not commonly aspirated objects in infants and form only a small fraction of all the metallic foreign body (FB which accounts for 4.4% of all foreign bodies found in tracheobronchial tree. Bronchoscopy procedure has various complications, in addition to failure to remove FB due to its impaction, especially with metallic pointed objects ending up in open surgical removal. Infant with inhaled foreign body are always a challenge to anaesthetist. We had one such case of broken safety pin impacted in the wall of right bronchus of an infant with failure to remove on repeated attempts at rigid bronchoscopy.

  20. Broken safety pin in bronchus - Anaesthetic considerations.

    Science.gov (United States)

    Shad, Roona; Agarwal, Aditya

    2012-11-01

    Safety pins are not commonly aspirated objects in infants and form only a small fraction of all the metallic foreign body (FB) which accounts for 4.4% of all foreign bodies found in tracheobronchial tree. Bronchoscopy procedure has various complications, in addition to failure to remove FB due to its impaction, especially with metallic pointed objects ending up in open surgical removal. Infant with inhaled foreign body are always a challenge to anaesthetist. We had one such case of broken safety pin impacted in the wall of right bronchus of an infant with failure to remove on repeated attempts at rigid bronchoscopy.

  1. Anaesthetic management of nesidioblastosis in a newborn.

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    Soares A

    1996-01-01

    Full Text Available This report details the management of a newborn with nesidioblastosis who underwent a 95% pancreatectomy under general anaesthesia. The baby presented with hypoglycemic convulsions, due to hyperinsulinism, and was treated with 12.5% dextrose infusions, glucagon and anticonvulsants. Intraoperatively and postoperatively the baby remained hyperglycemic. A postoperative osmotic diuresis necessitated the use of insulin for brief period. The infant remained euglycemic and convulsion free, following discontinuation of the dextrose infusions and starting of oral feeds. Recovery was uneventful.

  2. Anaesthetic management in Gorlin-Goltz syndrome

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    Kundan S Gosavi

    2012-01-01

    Full Text Available Gorlin-Goltz syndrome is a rare autosomal-dominant syndrome related to mutation in " Patched" tumour suppressor gene on chromosome 9. Basocellular carcinomas, odontogenic keratocysts, palmar and/or plantar pits and ectopic calcifications of the falx cerebri are its major features, along with more than 100 minor features. Odontogenic cysts, notorious for recurrence, can make endotracheal intubation difficult, requiring modification of the standard intubation technique. We report such a case managed successfully by awake fibreoptic intubation. Direct laryngoscopy under anaesthesia later confirmed that it was a good decision.

  3. [Anaesthetic management of a child with hemoglobinopathy].

    Science.gov (United States)

    Rhondali, O; Pouyau, A; Bonnard, C; Chassard, D

    2013-12-01

    Perioperative management of a child with sickle-cell disease requires close collaboration between hematologist, surgeon and anesthetist. The level of preoperative preparation must consider both the surgical risk and the impact of the disease. Preoperative hydration and blood transfusion are the most important part of preoperative management. Anesthetic technique is not as important as preoperative preparation, management of stress and anxiety, and optimization of intraoperative physiological parameters (oxygenation, acid-base balance, tissue perfusion, normothermia). Pain management must be optimal for these children with increased needs of analgesic. Preoperative assessment of a child with thalassemia must include evaluation of the impact of chronic hemolytic anemia and iron overload induced by repeated transfusions. The most important factor in the management of a child with glucose-6-phosphate dehydrogenase deficiency is to avoid exposure to oxidative stressors. Outpatients should be informed of the risk of hemolytic crisis, and free hemoglobin in the urine should lead to discontinuation of drugs associated with hemolysis and to maintenance of urine output to prevent acute renal failure.

  4. Post-anaesthetic emergence delirium in adults

    DEFF Research Database (Denmark)

    Munk, L; Andersen, G; Møller, A M

    2016-01-01

    BACKGROUND: Emergence delirium (ED) after general anaesthesia (GA) is a well-known phenomenon, yet the risk factors are still unclear. The aims of this study were to determine the incidence and independent predictors of ED and secondly to determine to which degree ED has any relevant, clinical...

  5. Influence on elderly patients with lung cancer anaesthetized with sevoflurane and propofol%七氟烷和丙泊酚麻醉对老年肺癌患者的影响

    Institute of Scientific and Technical Information of China (English)

    张安传; 尹鸿; 张传汉

    2015-01-01

    目的:探讨七氟烷和丙泊酚麻醉对老年肺癌的影响。方法:选取2011年3月-2013年3月106例老年肺癌手术患者为研究对象,分成2组,分别予七氟烷和丙泊酚麻醉,观察治疗后相关指标的变化。结果:治疗后两组睁眼时间、拔管时间、语言答应时间比较差异有统计学意义(P <0.05)。MMSE 评分,两组治疗前、治疗8 d 后比较差异无统计学意义(P >0.05)。而术后 d1、术后 d3比较两组差异有统计学意义(P <0.05)。S100β,两组术前、术后30min 比较差异无统计学意义(P >0.05),而术后 d1、术后 d2比较两组差异有统计学意义(P <0.05)。结论:七氟烷和丙泊酚麻醉对老年肺癌术后认知功能均有一定影响,但七氟烷影响较小。%Objective:To investigate clinical effects of elderly patients with lung cancer anaesthetized with sevoflu-rane and propofol.Methods:All 106 elderly patients with lung cancer treated with surgery from March 2011 to March 2013 were selected,divided into two groups.One group was given sevoflurane,the other group given propofol.Related indicators were observed.Results:After treatment,the eye -opening time,extrication time,promised spent languages were significantly different between two groups(P <0.05).MMSE score was not significantly different between two groups before and after 8 day treatment,but there were significant differences between two groups after 1 day and 3 day treatment.S100βwere not significantly different between two groups before and after 30min treatment,but there were significant differences between two groups after 1 day and 2 day treatment(P <0.05).Conclusion:Sevoflurane and propofol anesthesia on postoperative cognitive function in elderly lung cancer have some impact,but the impact was lower for sevoflurane.

  6. Utilização do eugenol como anestésico para o manejo de juvenis de Pintado (Pseudoplatystoma corruscans - DOI: 10.4025/actascibiolsci.v28i3.400 The use of eugenol as an anaesthetic for the handling of Pintado juveniles (Pseudoplatystoma corruscans - DOI: 10.4025/actascibiolsci.v28i3.400

    Directory of Open Access Journals (Sweden)

    Gustavo Rodamilans de Mecêdo

    2007-11-01

    Full Text Available Neste trabalho, foi avaliada a eficiência do eugenol como anestésico em juvenis de pintado (Pseudoplatystoma corruscans através de ensaios. No primeiro, os peixes (n=6 foram individualmente expostos a concentrações de 25, 50, 75, 100 mg L-1 de eugenol durante 10 minutos e os parâmetros de observação estabelecidos foram: perda de equilíbrio, efeito calmante e redução do movimento opercular. No segundo ensaio, foram utilizadas as concentrações de 50, 75, 100 mg L-1 de eugenol, em que os animais foram mantidos na água com anestésico até atingirem o estágio IV de anestesia: perda total de equilíbrio, do tônus muscular e redução dos movimentos operculares. A recuperação foi conduzida em um aquário, contendo 10 litros de água livre de anestésico, com aeração constante. Após os dois ensaios, foi constatada a eficiência do eugenol como substância anestésica em juvenis de pintado, sendo a concentração de 50 mg L-1 considerada a mais adequada para procedimentos usuais no manejo desses animais em piscicultura.In this work the efficacy of eugenol as an anaesthetic in Pintado juveniles (Pseudoplatystoma corruscans was evaluated by two experimental assays. In the first one, the animals (n=6 were exposed for 10 minutes to four concentrations of eugenol (25; 50; 75; 100 mg L-1. The observed behavioral patterns were: loss of equilibrium, sedative effect and reduction of opercular movement. In the second assay, the concentrations of 50; 75; 100 mg L-1 of eugenol were tested. The animals were maintained in the anaesthetic bath until they reached the stage of anaesthesia IV: total loss of equilibrium, muscle tonus and reduction of opercular movement. The recovery was conducted in an aquarium containing 10 liters of anaesthetic free water, with constant aeration. The efficacy of clove oil as an anaestetics for Pintado juveniles were demonstrated after the assays and the 50 mg L-1 concentration was defined as the most adequate to

  7. Anaesthesia effect of two anaesthetic chemicals, 2-phenoxyethanol and benzocaine, on the winged pearl oyster (Pteria penguin (Roiding))%苯佐卡因和乙二醇苯醚对企鹅珍珠贝麻醉效果的研究

    Institute of Scientific and Technical Information of China (English)

    万正平; 王梅芳; 李双波; 余祥勇

    2012-01-01

    为了寻找企鹅珍珠贝Pteria penguin(Rtiding)植核时安全与有效的麻醉方法,本实验比较了乙二醇苯醚和苯佐卡因对企鹅珍珠贝植核时的麻醉效果。结果表明,海水温度在25℃时,φ=0.1%,0.2%,0.3%的乙二醇苯醚与P=500,800,1000mg·L-1的苯佐卡因都有麻醉效果;随着麻醉剂用量的增加,企鹅珍珠贝麻醉所需时间减少,复苏时间变长;在一定剂量下,随水温的上升(21—27℃),麻醉和复苏时间均减少;妒:0.2%的乙二醇苯醚、P=800mg·L-1和1000mg·L-1的苯佐卡因对企鹅珍珠贝均具有较好的麻醉效果,30min内的麻醉效果均达到100%,麻醉贝复苏快,且1周后均存活。%Anaesthetics, as a means of reducing stress reaction, may have a role in the pearl seeding process. Anaesthetic chemicals were identified to facilitate the safe and effective anesthetization of wing pearl oysters ( Pteria penguin (Rtiding) ) in seeding. Two anaesthetic chemicals, 2-phenoxyethanol and henzocaine, were assessed for their ability to relax the wing pearl oyster. These reagents of different concentrations were added into containers of the oysters to observe their reactions at the temperatures ranging from 21,23, 25 and 27 ℃. At 25 ℃ 2-phenoxyethanol of 0.1% -0. 3% (v/v) and benzocaine of 500, 800, 1 000 mg·L-1 appeared promising. And 2-phenoxyethanol and benzocaine were selected to determine their effects on the time to relaxation and to recovery and on survival of the oysters after 7 days of relaxation. It was found that as anesthetic concentrations of the reagents increased, the time to relaxation of the oysters decreased while the time to recovery tended to increase. Increased duration of exposure to the relaxants increased the time to recovery. When the temperature increased both the time to relaxation and to recovery of the oysters decreased. The highest proportion of the relaxed oysters ( 100%

  8. LOCAL ANAESTHETIC SYSTEMIC TOXICITY: CURRENT CONCEPTS AND MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Lakshmi

    2014-03-01

    Full Text Available Local anesthetics are one of the most commonly used drugs in the field of medicine. Local anesthetics are widely used to induce anesthesia and analgesia for surgical procedures and pain management. Local an aesthetic systemic toxicity (LAST is a rare but potentially fatal complication of regional anesthesia and has been recognized and reported since the late1800s. This narrative review summarizes the pharmacology of local anesthetics, clinical manifestations of systemic toxicity associated with these agents, necessary preventive measures and recent treatment strategies

  9. Scoliosis correction in children-anaesthetic challenge: A case report

    Directory of Open Access Journals (Sweden)

    Amarjeet D Patil, Sivashankar KR, Arpan Sashankar, Shikha A Malhotra

    2014-03-01

    Full Text Available Kyphoscoliosis is a challenging surgery to surgeons but even more challenging to anaesthesiologist to give anaesthesia and maintain it throughout the surgery and post operative pain relief and ventilation. Here we are describing the case of 3 years old male child weighing 9kg for surgical correction of spine deformity with instrumentation.

  10. Secrets of safe laparoscopic surgery: Anaesthetic and surgical considerations

    Directory of Open Access Journals (Sweden)

    Srivastava Arati

    2010-01-01

    Full Text Available In recent years, laparoscopic surgery has gained popularity in clinical practice. The key element in laparoscopic surgery is creation of pneumoperitoneum and carbon dioxide is commonly used for insufflation. This pneumoperitoneum perils the normal cardiopulmonary system to a considerable extent. Every laparoscopic surgeon should understand the consequences of pneumoperitoneum; so that its untoward effects can be averted. Pneumoperitoneum increases pressure on diaphragm, leading to its cephalic displacement and thereby decreasing venous return, which can be aggravated by the position of patient during surgery. There is no absolute contraindication of laparoscopic surgery, though we can anticipate some problems in conditions like obesity, pregnancy and previous abdominal surgery. This review discusses some aspects of the pathophysiology of carbon dioxide induced pneumoperitoneum, its consequences as well as strategies to counteract them. Also, we propose certain guidelines for safe laparoscopic surgery.

  11. A New Era of Local Anaesthetic Agent: Centbucridine

    Directory of Open Access Journals (Sweden)

    Swapnil S. Bumb

    2013-11-01

    Full Text Available One century after the clinical introduction of cocaine,local anesthesia remains the most important method of pain control in dentistry. Many local anesthetics have been marketed since 1884, and it is likely that attempts to produce drugs that enhance anesthetic efficacy, reduce systemic and local toxicity, and increase nociceptive selectivity, will continue.Centbucridine is a non-ester, non-amide group LA and has not been comprehensively studied in the dental setting and the objective was to compare it to Lignocaine. This was a randomized study comparing the onset time, duration, depth and cardiovascular parameters between Centbucridine (0.5% and Lignocaine (2%.The study was conducted in the department of oral and maxillofacial surgery of our dental college in on patients attending for the extraction of lower molars.

  12. Congenital Cervical Teratoma: Anaesthetic Management (The EXIT Procedure

    Directory of Open Access Journals (Sweden)

    Ferruh Bilgin

    2009-01-01

    Full Text Available Ex utero intrapartum treatment (EXIT is a procedure performed during caesarean section with preservation of fetal-placental circulation, which allows the safe handling of fetal airways with risk of airways obstruction. This report aimed at describing a case of anaesthesia for EXIT in a fetus with cervical teratoma. A 30-year-old woman, 70 kg, 160 cm, gravida 2, para 1, was followed because of polyhydramniosis diagnosed at 24 weeks′ gestation. During a routine ultrasonographic examination at 35 weeks′ gestation, it was noticed that the fetus had a tumoral mass on the anterior neck, the mass had cystic and calcified components and with a size of was 10 x 6 x5 cm. The patient with physical status ASA I, was submitted to caesarean section under general anaesthesia with mechanically controlled ventilation for exutero intrapartum treatment (EXIT. Anaesthesia was induced in rapid sequence with fentanyl, propofol and rocuronium and was maintained with isoflurane in 2.5 at 3 % in O 2 and N 2 O (50%. After hysterotomy, fetus was partially released assuring uterus-placental circulation, followed by fetal laryngoscopy and tracheal intuba-tion. The infant was intubated with an uncuffed, size 2.5 endotracheal tube. Excision of the mass was performed under general anaesthesia. After surgical intervention, on the fourth postoperative day, the infant was extubated and the newborn was discharged to the pediatric neonatal unit and on the seventh day postoperatively to home without complications. Major recommendations for EXIT are maternal-fetal safety, uterine relaxation to maintain uterine volume and uterus-placental circulation, and fetal immobility to help airway handling. We report one case of cervical teratoma managed successfully with EXIT procedure.

  13. Anaesthetic challenges in a patient presenting with huge neck teratoma

    Directory of Open Access Journals (Sweden)

    Gaurav Jain

    2013-01-01

    Full Text Available Paediatric airway management is a great challenge even for an experienced anaesthesiologist. Difficult airway in huge cervical teratoma further exaggerates the complexity. This case report is intended at describing the intubation difficulties that were confronted during the airway management of a three year old girl presenting with huge neck teratoma and respiratory distress. This patient was successfully intubated with uncuffed endotracheal tubes in second attempt under inhalational anaesthesia with halothane and spontaneous ventilation. This case exemplifies the importance of careful preoperative workup of an anticipated difficult airway in paediatric patients with neck swelling to minimize any perioperative complications.

  14. Anaesthetic management of a patient with hereditary angioedema

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    Nergis Ataol

    2015-12-01

    Full Text Available Hereditary angioedema is a rare autosomal dominant disorder caused by reduced activity of the C1 esterase inhibitor. Patients with hereditary angioedema are clinically characterized by recurrent episodes of swelling of the extremities, face, trunk, airways and abdominal organs. Attacks may occur either spontaneously or following trauma, stress, surgery, infections and hormonal fluctuations. The most common cause of death is asphyxia related to laryngeal edema. Giving C1 esterase inhibitor is the most effective method of treatment. Also fresh frozen plasma, androgen steroids, quinine pathway inhibitors, antifibrinolytics and bradykinin receptor antagonists can be used as treatment. In this paper, the anesthetic management of a patient with hereditary angioedema undergoing inguinal hernia repair surgery is reported.

  15. Use of digital nerve blocks to provide anaesthetic relief.

    Science.gov (United States)

    Summers, Anthony

    2011-09-01

    This article discusses the various techniques that nurses can use to perform digital nerve blocks, which are some of the most common procedures undertaken by emergency practitioners treating patients with finger injuries. In covering the advantages and disadvantages of each technique, it focuses primarily on the digits of the hand, but the techniques can also be performed on toes.

  16. Fetal Hydantoin Syndrome and Its Anaesthetic Implications: A Case Report

    Directory of Open Access Journals (Sweden)

    Ranju Singh

    2012-01-01

    Full Text Available Fetal hydantoin syndrome is a rare disorder that is believed to be caused by exposure of a fetus to the anticonvulsant drug phenytoin. The classic features of fetal hydantoin syndrome include craniofacial anomalies, prenatal and postnatal growth deficiencies, underdeveloped nails of the fingers and toes, and mental retardation. Less frequently observed anomalies include cleft lip and palate, microcephaly, ocular defects, cardiovascular anomalies, hypospadias, umbilical and inguinal hernias, and significant developmental delays. Anaesthesia for incidental surgery in such a patient poses unique challenges for the anesthesiologist. We report the successful management of a 4-year-old male child with fetal hydantoin syndrome, cleft palate, spina bifida, atrial septal defect, and dextrocardia for tibialis anterior lengthening under subarachnoid block.

  17. Anaesthetic and Intensive Care Management of Traumatic Cervical Spine Injury

    Directory of Open Access Journals (Sweden)

    G S Umamaheswara Rao

    2008-01-01

    Full Text Available Trauma to the cervical spine may have devastating consequences. Timely interventions are essential to prevent avoidable neurological deterioration. In the initial stabilization of patients with acute cervical spine injuries, physiological disturbances, especially those involving cardiac and respiratory function require careful attention. Early surgery, which facilitates rapid mobi-lization of the patient, is fraught with important management considerations in the intraopoerative period and the subsequent critical care. Airway management poses a crucial challenge at this stage. Those patients who survive the injury with quadriplegia or quadriparesis may present themselves for incidental surgical procedures. Chronic systemic manifestations in these patients require attention in providing anaesthesia and postoperative care at this stage. The current review provides an insight into the physiological disturbances and the management issues in both acute and chronic phases of traumatic cervical spine injury.

  18. Administering an eye anaesthetic: principles, techniques, and complications

    Directory of Open Access Journals (Sweden)

    Ahmed Fahmi

    2008-03-01

    Full Text Available The trigeminal nerve carries the sensory innervation of the eye and adnexa in three divisions: ophthalmic, maxillary, and mandibular. The sensory fibres of the eye and adnexa are found in the ophthalmic division – with the exception of a portion of the sensory input from the lower lid, which is carried by the maxillary division. Blocking the sensory fibres provides anaesthesia so that no pain is felt.The motor supply of the extraocular muscles and levator palpebrae superioris is carried by the oculomotor (III, trochlear (IV, and abducens (VI nerves. Paralysing these muscles by blocking their motor supply provides akinesia so that the eye does not move during surgery.The motor supply of the orbicularis oculi, which is responsible for the gentle and forcible closure of the eye, is carried by the facial nerve (VII. Blocking these fibres will provide better surgical exposure. It also reduces the risk of forcing out the ocular contents if the patient tries to close his eyelids forcibly after the surgeon opens the globe.

  19. Defining an anaesthetic curriculum for medical undergraduates. A Delphi study.

    LENUS (Irish Health Repository)

    Rohan, Denise

    2009-01-01

    Anaesthesia is commonly taught to medical students. The duration and content of such teaching varies however and no consensus exists as to what constitutes an optimal curriculum. Anaesthetists possess the necessary knowledge and skills and operate in clinical settings suitable to provide training for medical undergraduates, especially in areas where deficiencies have been identified. This Delphi study was directed towards developing a consensus on an optimal anaesthesia, intensive care and pain medicine curriculum for medical undergraduates.

  20. Interaction between inhalational anaesthetics and enoximone on isolated heart muscle.

    Science.gov (United States)

    Miralles, F S; Carceles, M D; Laorden, M L

    1993-07-01

    1. The present study describes the effects of halothane or isoflurane on enoximone activity in the isolated left atria of the rat. 2. Concentration-response curves were obtained for the positive inotropic effects of enoximone on electrically stimulated left atria. 3. Enoximone significantly (P < 0.01) increased the contractile force (56% maximum) with all the concentrations tested (10(-9) -10(-3) M). 4. When halothane (1.5% v/v) was present in the organ bath, the maximum effect obtained with enoximone (9%) was significantly lower than that obtained with enoximone alone. 5. Similar results were obtained with enoximone in the presence of halothane plus diltiazem. Isoflurane (1.5% v/v) did not significantly modify the maximum effect obtained with enoximone alone. 6. The administration of diltiazem antagonized the positive inotropic effects of enoximone in the presence of isoflurane or halothane. 7. These results shows that halothane, but not isoflurane, decreased the potency of enoximone on the isolated left atria and suggests that this effect may be mediated by the blocking of the influx of extracellular calcium through voltage-dependent calcium channels inhibited by diltiazem.

  1. ANAESTHETIC MANAGEMENT OF A ECTOPIC PREGNANCY PATIENT WITH ORGANOPHOSPHOROUS POISONING

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    Gopal Reddy

    2015-01-01

    Full Text Available Organophosphorus poisoning is the most common poisoning in India because of its easy availability. Anaesthesiologists may come across rarely to give anaesthesia for emergency life - saving surgeries. Problems while anaesthetising an emergency patient following organophosphorous poisoning are many. Necessary precautions are to be taken while anaesthetising the patient. During anaesthesia many drugs are used which are linked with acetylcholine, cholinesterase and other cardio - vascul ar effects.

  2. Anaesthetic challenges in a patient with mitochondrial cytopathy undergoing surgery

    Directory of Open Access Journals (Sweden)

    D N Dhananjay

    2007-01-01

    Full Text Available This article will highlight certain basic aspects in the management of a case of mitochondrial cytopathy that is unknown to most of us. Clinical condition of the patient is the most important aspect in the management, as the patients with mild disease may be at lower risk for complications while those with severe disease are at a higher risk. We managed a 45year old lady posted for incisional hernia repair

  3. Forum. Femoral neck surgery using a local anaesthetic technique.

    Science.gov (United States)

    Howard, C B; Mackie, I G; Fairclough, J; Austin, T R

    1983-10-01

    Thirty cases of femoral sub-capital fractures, Garden grades 1-4, were reduced and internally fixed with crossed Garden screws using femoral nerve block. In addition, sedation and analgesia was provided by low dose ketamine and diazepam. No deaths or other complications occurred in these patients. In a similar group of patients who received spinal analgesia in the same unit under similar conditions there was one death and two cerebrovascular accidents.

  4. LUDWIG’S ANGINA AND ANAESTHETIC DIFFICULTIES: A CASE REPORT

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    Sarda Devi

    2015-04-01

    Full Text Available Patients with deep neck infections present challenging airways for an anesthesiologist . Ludwig’s angina is potentially lethal, rapidly spreading cellulitis involving the floor of the mouth and neck. Without aggressive management it often results in life th reatening upper airway obstruction. Securing the airway remains the top priority in treatment of Ludwig’s angina. Although awake fibreoptic intubation remains the ideal method for securing the airway, but it is not available in every set up, so all feasibl e options of securing the airway should be prepared. We present a case successfully managed at our hospital with a brief review of airway management options.

  5. Anaesthetic management in a case of huge plunging ranula

    Science.gov (United States)

    Sheet, Jagabandhu; Mandal, Anamitra; Sengupta, Swapnadeep; Jana, Debaleena; Mukherji, Sudakshina; Swaika, Sarbari

    2014-01-01

    Plunging ranula is a rare form of mucous retention cyst arising from submandibular and sublingual salivary glands, which may occasionally become huge occupying the whole of the floor of the mouth and extending into the neck, thus, restricting the neck movement as well as disfiguring the normal airway anatomy. Without fiberoptic assistance, blind or retrograde nasal intubation remains valuable choices in this type of situation. Here, we present a case of successful management of airway by blind nasal intubation in a patient posted for excision of a huge plunging ranula. PMID:25886120

  6. Public Health Aspects of Paediatric Dental Treatment under General Anaesthetic

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    William Murray Thomson

    2016-06-01

    Full Text Available Early childhood caries (ECC has negative psychosocial effects on children, with chronic pain, changed eating habits, disrupted sleep and altered growth very common, and it disrupts the day-to-day lives of their families. The treatment of young children with ECC places a considerable burden on health systems, with a considerable amount having to be provided under general anaesthesia (GA, which is resource-intensive. Justifying its use requires evidence of the efficacy of treatment in improving the lives of affected children and their families. This paper discusses the available evidence and then makes some suggestions for a research agenda.

  7. Comparación del efecto anestésico del aceite de clavo, solución salina y solución coloidal en juveniles de Chirostoma jordani (Woolman, 1894 Comparison of anaesthetic effect of clove oil, saline solution and colloidal solution in juvenile Chirostoma jordani (Woolman, 1894

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    G Vázquez

    2013-01-01

    disease and high mortality rates. The objective of this study was to compare the anaesthetic effects of clove oil, saline solution and colloidal solution (Pentabiocare on juvenile Chirostoma jordani. 18 C. jordani specimens aged two months old were used for each treatment. Treatments consisted on clove oil at four concentrations (5, 8, 13 and 25 µL/L, saline solution at 7 g/L and colloidal solution at 5 mL/L. The anaesthesia stages and recovery time of fish were recorded during a six hour period. High concentrations of clove oil and prolonged exposure to it were associated with deep stages of anaesthesia. Clove oil in a concentration of 25 µL/L induced fish to stage three and after three hours of being exposed they entered stage five, while those sedated with saline and colloidal solutions were induced to stage one and showed the longest sedation times (six hours. Recovery time in juveniles when using 25 µL/L clove oil concentration was extended to 3,006.0 ± 5.3 seconds, while fish exposed to saline and colloidal solution showed a recovery of opercular rhythm, responsiveness to external stimuli and active swimming within 60 to 180 seconds. The results indicated that colloidal and saline solution kept the C. jordani juveniles in a state of light sedation during a six hours period with brief intervals of recovery. The use of clove oil at 5 and 13 µL/L doses induced juveniles to light and deep anaesthesia stages, respectively, with a recovery time under 420 seconds.

  8. Effect of warming anaesthetic solutions on pain during dental injection. A randomized clinical trial.

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    Pedro Christian Aravena

    2015-10-01

    Full Text Available Objective: To determine the effectiveness of warming anesthetic solutions on pain produced during the administration of anesthesia in maxillary dental infiltration technique. Material and Methods: A double-blind cross-over clinical study was designed. Fifty-six volunteer students (mean age 23.1±2.71 years of the Dental School at Universidad Austral de Chile (Valdivia, Chile participated in the study. Subjects were given 0.9ml of 2% lidocaine with 1:100.000 epinephrine (Alphacaine®; Nova DFL - Brazil by two punctions at buccal vestibule of lateral incisor. Warm anesthesia at 42°C (107.6°F was administered in a hemi-arch; and after one week anesthesia at room temperature (21°C; 69.8°F and at a standardized speed was administered at the contralateral side. The intensity of pain felt during injection was registered and compared using visual analog scale (VAS of 100mm (Wilcoxon test p<0.05. Results: The use of anesthesia at room temperature caused a VAS-pain intensity of 34.2±16.6mm, and anesthesia at 42°C a VAS-pain intensity of 15.7±17.4mm (p<0.0001. Conclusion: The use of anesthesia at 42°C resulted in a significantly lower pain intensity perception during injection compared with the use of anesthesia at room temperature during maxillary infiltration technique.

  9. Use of gelatin-thrombin matrix haemostatic sealant in neurosurgery: Anaesthetic implications and review of literature

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    Puneet Khanna

    2015-01-01

    Full Text Available The topical haemostatic agents have been developed to be used as adjunctive measures to promote haemostasis. These include bone wax, absorbable gel sponges, microfibrillar collagen, oxidised regenerated cellulose, gelatin sponges with thrombin, gelatin-thrombin matrix sealant or fibrin sealants. Gelatin-thrombin matrix sealant is a mixture of a bovine-derived gelatin matrix and human-derived thrombin component that are mixed together at the time of use. This agent has been found to be more effective haemostat than thrombin-soaked gelatine sponges. The possible adverse effects of this can be transmission of diseases from human or bovine sources, allergic reactions, thromboembolism, disseminated intravascular coagulopathy (DIC, perilesional oedema, and compression of neural tissue. Although it is used routinely in the operating room, there is little literature available on the perioperative implications with use of intraoperative gelatin-thrombin matrix sealant. Here, we present clinical report of 20 neurosurgical patients where the sealant was used and literature in view of current evidence has been reviewed.

  10. Anaesthetic Management of a Neuroectodermal Tumor of Infancy: A Rare Case Report

    Science.gov (United States)

    Ubale, Pravin; Baldwa, Namita; Gujjar, Pinakin

    2017-01-01

    Melanotic neuroectodermal tumor of infancy is a relatively uncommon osteolytic-pigmented neoplasm that primarily affects the jaws of infants. We report a 5-month-old male child who presented with a swelling in the right upper tooth region of upper jaw in which we face difficult mask ventilation as well as difficult intubation. Wide surgical excision was performed under general anesthesia. The uneventful course of anesthesia in the presented case was due to the thorough systemic evaluation and careful anesthetic strategy. Patients of congenital epulis continue to pose challenge to anesthesiologist as a consequence of the potential difficult mask ventilation and intubation. We hereby present a case of congenital epulis repair using diode laser under general anesthesia.

  11. Robotic invasion of operation theatre and associated anaesthetic issues: A review

    OpenAIRE

    Kakar, Prem N.; Jyotirmoy Das; Preeti Mittal Roy; Vijaya Pant

    2011-01-01

    A Robotic device is a powered, computer controlled manipulator with artificial sensing that can be reprogrammed to move and position tools to carry out a wide range of tasks. Robots and Telemanipulators were first developed by the National Aeronautics and Space Administration (NASA) for use in space exploration. Today′s medical robotic systems were the brainchild of the United States Department of Defence′s desire to decrease war casualties with the development of ′telerobotic surgery′. The ′...

  12. A CASE OF CONGENITAL LOBAR EMPHYSEMA: CHALLENGES IN DIAGNOSIS AND IN ANAESTHETIC MANAGEMENT

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    Swati Bisht

    2015-01-01

    Full Text Available Congenital lobar emphysema (CLE is a rare clinical entity presenting as acute respiratory distress in infants. Its diagnosis is difficult as clinically and radio logically it mimics pneumonia or pneumothorax. Its early recognition and management with thoracotomy is lifesa ving. Inhalation induction is preferred and spontaneous ventilation should be maintained until either the chest is opened or one lung ventilation of the contralateral lung is achieved. In this case report, we describe the challenges faced in the anaestheti c management of this condition

  13. [Legal characteristics of expert opinions of anaesthetic cases of the North German Arbitration Board].

    Science.gov (United States)

    Schaffartzik, Walter; Hachenberg, Thomas; Kols, Kerstin; Neu, Johann

    2016-05-01

    The Arbitration Board for Medical Liability Issues of the State Medical Councils of Northern Germany in Hannover (North German Arbitration Board, NGAB) settles about 100 cases in the area of anaesthesiology per year. In these proceedings the patient carries the burden of proof. I. e. the patient has to prove that its health damage was caused by a medical error. Nevertheless, for individual cases the NGAB examines also whether facilitation of the burden of proof can be granted to the patient. This article exemplifies cases, for which the NGAB recognized such facilitation of the burden of proof. In each of these cases, the NGAB asserted the damage claim.

  14. The Food Contaminant Mycotoxin Deoxynivalenol Inhibits the Swallowing Reflex in Anaesthetized Rats.

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    Anne Abysique

    Full Text Available Deoxynivalenol (DON, one of the most abundant mycotoxins found on cereals, is known to be implicated in acute and chronic illnesses in both humans and animals. Among the symptoms, anorexia, reduction of weight gain and decreased nutrition efficiency were described, but the mechanisms underlying these effects on feeding behavior are not yet totally understood. Swallowing is a major motor component of ingestive behavior which allows the propulsion of the alimentary bolus from the mouth to the esophagus. To better understand DON effects on ingestive behaviour, we have studied its effects on rhythmic swallowing in the rat, after intravenous and central administration. Repetitive electrical stimulation of the superior laryngeal nerve or of the tractus solitarius, induces rhythmic swallowing that can be recorded using electromyographic electrodes inserted in sublingual muscles. Here we provide the first demonstration that, after intravenous and central administration, DON strongly inhibits the swallowing reflex with a short latency and in a dose dependent manner. Moreover, using c-Fos staining, a strong neuronal activation was observed in the solitary tract nucleus which contains the central pattern generator of swallowing and in the area postrema after DON intravenous injection. Our data show that DON modifies swallowing and interferes with central neuronal networks dedicated to food intake regulation.

  15. The Food Contaminant Mycotoxin Deoxynivalenol Inhibits the Swallowing Reflex in Anaesthetized Rats.

    Science.gov (United States)

    Abysique, Anne; Tardivel, Catherine; Troadec, Jean-Denis; Félix, Bernadette

    2015-01-01

    Deoxynivalenol (DON), one of the most abundant mycotoxins found on cereals, is known to be implicated in acute and chronic illnesses in both humans and animals. Among the symptoms, anorexia, reduction of weight gain and decreased nutrition efficiency were described, but the mechanisms underlying these effects on feeding behavior are not yet totally understood. Swallowing is a major motor component of ingestive behavior which allows the propulsion of the alimentary bolus from the mouth to the esophagus. To better understand DON effects on ingestive behaviour, we have studied its effects on rhythmic swallowing in the rat, after intravenous and central administration. Repetitive electrical stimulation of the superior laryngeal nerve or of the tractus solitarius, induces rhythmic swallowing that can be recorded using electromyographic electrodes inserted in sublingual muscles. Here we provide the first demonstration that, after intravenous and central administration, DON strongly inhibits the swallowing reflex with a short latency and in a dose dependent manner. Moreover, using c-Fos staining, a strong neuronal activation was observed in the solitary tract nucleus which contains the central pattern generator of swallowing and in the area postrema after DON intravenous injection. Our data show that DON modifies swallowing and interferes with central neuronal networks dedicated to food intake regulation.

  16. A retrospective study of anaesthetic management of foreign bodies in airway- a two & half years experience

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    Jyoti V Kulkarni

    2007-01-01

    In 17 % patients foreign body was located in subglottic region, in 59 % patients FB was in right main bronchus and in 24% patients it was in left main bronchus. In 33 % patients bronchoscopy was done within 72 hours of appearance of symptoms while in 51% patients bronchoscopy was done after 72 hours to one week of appearance of symptoms. In 16% patients bronchoscopy was done after one week. Twenty percent patients required tracheostomy and 3% patients required bronchodilators, nebuliza-tion and ventilatory support in immediate post operative period. All patients were managed under general anaesthesia using ketamine, suxamethonium, oxygen and halothane. All patients were ventilated through side arm of ventilating bronchoscope.All patients were discharged from hospital & no death was reported.

  17. Intraincisional vs intraperitoneal infiltration of local anaesthetic for controlling early post-laparoscopic cholecystectomy pain

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    Gouda M El-labban

    2011-01-01

    Full Text Available Background: The study was designed to compare the effect of intraincisional vs intraperitoneal infiltration of levobupivacaine 0.25% on post-operative pain in laparoscopic cholecystectomy. Materials and Methods: This randomised controlled study was carried out on 189 patients who underwent laparoscopic cholecystectomy. Group 1 was the control group and did not receive either intraperitoneal or intraincisional levobupivacaine. Group 2 was assigned to receive local infiltration (intraincisional of 20 ml solution of levobupivacaine 0.25%, while Group 3 received 20 ml solution of levobupivacaine 0.25% intraperitoneally. Post-operative pain was recorded for 24 hours post-operatively. Results: Post-operative abdominal pain was significantly lower with intraincisional infiltration of levobupivacaine 0.25% in group 2. This difference was reported from 30 minutes till 24 hours post-operatively. Right shoulder pain showed significantly lower incidence in group 2 and group 3 compared to control group. Although statistically insignificant, shoulder pain was less in group 3 than group 2. Conclusion: Intraincisional infiltration of levobupivacaine is more effective than intraperitoneal route in controlling post-operative abdominal pain. It decreases the need for rescue analgesia.

  18. Anaesthetic Consideration in Macroglossia Due to Lymphangioma of Tongue: A Case Report

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    Anurag Tewari

    2009-01-01

    Full Text Available Successful airway management of an infant or child with macroglossia prerequisites recognition of a potential airway problem. We describe our experience with a debilitated 13-year-old girl who presented with severe macroglo-ssia, secondary to lymphangioma of the tongue. Along with the social discomfort she had inability to speak, eat or drink properly and exposure-induced dryness. Such patients are a challenge for the anaesthesiologists due to the anticipated difficult intubation associated with the oral mucosa occupying lesion. It also becomes pertinent to rule out any of the associated congenital anomalies. The importance of a thorough preoperative evaluation and attention to difficult intubation and maintenance of airway is emphasized. We endeavor to review the available literature regard-ing patient′s perioperative management of such patients.

  19. Anaesthetic Consideration in Macroglossia Due to Lymphangioma of Tongue: A Case Report

    Science.gov (United States)

    Tewari, Anurag; Munjal, Munish; Kamakshi; Garg, Shuchita; Sood, Dinesh; Katyal, Sunil

    2009-01-01

    Summary Successful airway management of an infant or child with macroglossia prerequisites recognition of a potential airway problem. We describe our experience with a debilitated 13-year-old girl who presented with severe macroglossia, secondary to lymphangioma of the tongue. Along with the social discomfort she had inability to speak, eat or drink properly and exposure-induced dryness. Such patients are a challenge for the anaesthesiologists due to the anticipated difficult intubation associated with the oral mucosa occupying lesion. It also becomes pertinent to rule out any of the associated congenital anomalies. The importance of a thorough preoperative evaluation and attention to difficult intubation and maintenance of airway is emphasized. We endeavor to review the available literature regarding patient's perioperative management of such patients. PMID:20640084

  20. Effects of different general anaesthetic techniques on immune responses in patients undergoing surgery for tongue cancer.

    Science.gov (United States)

    Zhang, T; Fan, Y; Liu, K; Wang, Y

    2014-03-01

    The aim of this study was to investigate the effects of different general anaesthesia techniques on immune responses in patients undergoing surgery for tongue cancer. Sixty American Society of Anesthesiologists physical status 1 or 2 patients undergoing elective reconstructive surgery for tongue cancer were randomised to three groups. Group 1 received propofol induction and maintenance (TIVA), group 2 received propofol induction and sevoflurane maintenance (MIXED) and group 3 received sevoflurane induction and maintenance (SEVO). All patients received an infusion of remifentanil. Blood samples were obtained at eight time-points: 30 minutes before induction (T0); one hour (T1), three hours (T2) and five hours (T3) after induction; at the end of the operation (T4); and 24 hours (T5), 48 hours (T6) and 72 hours (T7) after operation. The T lymphocyte subsets (including CD3(+) cells, CD3(+)CD4(+) cells and CD3(+)CD8(+)cells) and CD4(+)/CD8(+) ratio, natural killer cells and B lymphocytes were analysed by flow cytometry. All immunological indicators except CD3(+)CD8(+) cells were significantly decreased in all groups at T1~T5 compared to T0 (P <0.05). The percentages of CD3(+) cells, CD3(+)CD4(+) cells and natural killer cells, and the CD4(+)/CD8(+) ratios were significantly lower in the MIXED groups and SEVO groups but not the TIVA group at T6 as compared with T0 (P <0.05). There were minor but statistically significant differences in the percentages of CD3(+) cells, CD3(+)CD4(+) cells and natural killer cells, and the CD4(+)/CD8(+) ratios between the SEVO group and the TIVA group at T2approxT6 (P <0.05). These findings suggest that propofol has slightly less effect on cellular immune responses than sevoflurane.

  1. Anaesthetic management of a child with congenital afibrinogenemia - A rare inherited coagulation disorder

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    Sham Sunder Goyal

    2011-01-01

    Full Text Available Congenital afibrinogenemia is a very rare autosomal recessive disorder, results from mutation that affects plasma fibrinogen concentration. It is frequently associated with bleeding diathesis of varying severity. We describe the case of a 10-year-old child diagnosed of congenital afibrinogenemia who presented to hospital with subperiosteal haematoma and was posted for incision and drainage. Replacement therapy is the mainstay of treatment of bleeding episodes in this patient and plasma-derived fibrinogen concentrate is the agent of choice. Cryoprecipitate and fresh frozen plasma are alternative treatments. Appropriate amount of cryoprecipitate were transfused pre-operatively to the child. Individuals with congenital afibrinogenemia should be managed by a comprehensive bleeding disorder care team experienced in diagnosing and managing inherited bleeding disorders. Anaesthesiologist, surgeons and haematologist should work like a unit to manage the surgical emergencies.

  2. [The DGAI training module 2 in anaesthetic focussed sonography: vascular sonography].

    Science.gov (United States)

    Trautner, Herbert; Markus, Christian K; Steinhübel, Bernhard; Schwemmer, Ulrich; Greim, Clemens-Alexander; Brederlau, Jörg

    2011-11-01

    Modul 2 will provide the theory and practical training of the sonographically guided puncture of central and peripheral veins and arteries. In doing so patients of all age groups are taken into consideration. Combined with the content of the other modules this series of workshops, which was initiated by our society, might be a first step in defining a new core competency of our specialty. The confident use of ultrasound in vascular puncture sharpens our dedicated professional competence and will contribute to continuously improve the quality and safety of anaesthesiologic patient care.

  3. The effect of transversus abdominis plane block or local anaesthetic infiltration in inguinal hernia repair

    DEFF Research Database (Denmark)

    Petersen, Pernille Lykke; Mathiesen, Ole; Stjernholm, Pia;

    2013-01-01

    measure was pain scores while coughing between group TAP and group placebo calculated as area under the curve for the first 24 h (AUC24 h). Secondary outcomes were pain scores while coughing and at rest, opioid consumption and side effects in groups TAP, infiltration and placebo. RESULTS: Visual analogue...... pain scores while coughing and at rest demonstrated no difference between groups. Pain scores in groups infiltration, TAP and placebo were 19 versus 22 versus 15 mm at rest (P = 1.00) and 37 versus 41 versus 37 mm while coughing (P = 1.00). Pain scores at 6 h (AUC6 h) were significantly lower in group...

  4. The effect of exogenous apelin on the secretion of pancreatic juice in anaesthetized rats.

    Science.gov (United States)

    Kapica, M; Jankowska, A; Antushevich, H; Pietrzak, P; Bierla, J B; Dembinski, A; Zabielski, R

    2012-02-01

    Apelin is known to stimulate cholecystokinin (CCK) and inhibit insulin release, however the mechanisms on pancreatic secretion remain unclear. The present study aimed to determine the expression of apelin and apelin receptor in the pancreas by immunofluorescence studies and the effect of exogenous apelin on the secretion of pancreatic juice in anesthetized rats. Pancreatic-biliary juice (P-BJ) was collected from Wistar rats treated with apelin (10, 20 and 50 nmol/kg b.w., boluses given every 30 min intravenously or intraduodenaly). The same apelin doses were administered to rats subjected to intraduodenal tarazapide, capsaicin or vagotomy. Pancreatic blood flow was measured by a laser doppler flowmeter. Direct effects of apelin were tested on dispersed acinar cells. Apelin receptor was expressed on acinar cells, pancreatic duct and islets cells, whereas apelin in pancreatic acini, but not in the islets. Intravenous apelin decreased P-BJ volume, protein and trypsin outputs in a dose-dependent manner. In contrast, intraduodenal apelin stimulated P-BJ secretion. Pharmacological block of mucosal CCK(1) receptor by tarazepide, vagotomy and capsaicin pretreatment abolished the effects of intravenous and intraduodenal apelin on P-BJ volume, protein and tryspin outputs. Apelin decreased the pancreatic blood flow. Apelin at 10(-6) M increased the release of amylase from non-stimulated and CCK-8-stimulated acinar cells. In conclusion, apelin can affect the exocrine pancreas through a complex mechanism involving local blood flow regulation and is driven by vagal nerves.

  5. A simple method of monitoring carbon dioxide output in anaesthetized patients.

    Science.gov (United States)

    Christensen, K N

    1977-01-01

    The mean CO2 output during anaesthesia in paralyzed patients can be monitored by continuous capnographic analysis of the total exhaled gases, the latter being mechanically integrated by pumice canisters. The gas is evacuated from the Hafnia A circuit via an ejector flowmeter. The results are not influenced by the flow rates employed.

  6. ANAESTHETIC MANAGEMENT OF A CASE OF CONGENITAL LOBAR EMPHYSEMA IN A NEONATE: A CASE REPORT

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    Yerramsetti Atchyutha

    2014-11-01

    Full Text Available Congenital lobar emphysema (CLE is a congenital anomaly of the lower respiratory tract characterized by over inflation of alveoli of the one or more lobes of the lung. CLE is potentially reversible, though possibly life threatening cause of respiratory distress in the neonate. We are presenting a 2 week old baby who presented with sudden onset of respiratory distress related to CLE affecting the upper lobe of left lung. Lobectomy was performed under general anesthesia with one lung ventilation. The anesthetic challenges and management of this case are discussed here.

  7. [Airways and respiratory function: preoperative screening--anaesthetic and intensive care aspects and considerations].

    Science.gov (United States)

    Reber, Adrian

    2009-07-01

    The risk factors for respiratory complications can broadly be classified as patient-related or procedure-related factors. Knowledge about pathophysiological and pharmacological aspects of the patients' condition is essential for their safe care during preoperative assessment, intra-operative management and, if necessary, postoperative intensive care. A good understanding of the risk factors leading to the development of postoperative respiratory complications should result in the implementation of perioperative strategies designed to prevent their occurrence and reduce severity. Special information regarding airway and lung aspects as well as cases involving different types of anaesthesia and surgical procedures are also discussed.

  8. The effect of ketanserin on post-anaesthetic vasoconstriction and shivering.

    Science.gov (United States)

    Nalda, M A; Gomar, C; Luis, M

    1985-09-01

    Two homogeneous groups of 20 healthy women submitted to elective gynaecological surgery, who presented after anaesthesia with peripheral vasoconstriction and shivering, were included in a randomized, double-blind study. The first group received 10 mg ketanserin, a new pure antagonist of serotoninergic S2 receptors. The second group received 10 ml saline as placebo. Blood pressure, heart rate, pulse wave amplitude, and rectal and cutaneous temperatures were measured before and 5, 15 and 30 min after treatment. Vasoconstriction, shivering and discomfort were classified as intense, moderate or absent at these times. Venous and arterial blood gases were determined before and 15 min after treatment. Blood pressure and heart rate decreased slightly after ketanserin administration and this decrease was statistically significant. Increases in rectal temperature were similar in both groups. Peripheral temperature, measured in the big toe, significantly decreased in the placebo group but did not change after ketanserin. Vasoconstriction, shivering, discomfort and pulse wave amplitude improved significantly following ketanserin. We conclude that ketanserin may be effective in treating this post-operative complication, the possible mechanism being the vasodilatation it causes; a central serotoninergic blockade could also be implied.

  9. Anaesthetic Management of Parturient with Acute Atrial Fibrillation for Emergency Caesarean Section

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    Madhu Gupta

    2013-01-01

    Full Text Available A 31-year-antenatal lady with critical mitral stenosis presented for emergency caesarean section with fetal distress. She had acute onset atrial fibrillation. She was given a combined spinal epidural (CSE anaesthesia and her arrhythmia was successfully managed after delivery of the baby with intravenous calcium channel blocker. Mitral stenosis is the most common valvular heart disease complicating pregnancy in developing countries. The physiological changes during pregnancy may exacerbate their cardiac symptoms. They may present with complications like congestive cardiac failure, atrial fibrillation, or pulmonary thromboembolism during the antenatal, intrapartum, or postpartum period. Here we discuss the management of parturient woman with high maternal and fetal risk presenting for emergency caesarean. The merits of regional anaesthesia and the importance of invasive monitoring are also discussed.

  10. Disruption of neocortical lamina V neuronal bursts by serotonin in urethane anaesthetized rats.

    Science.gov (United States)

    George, M J; Mridha, K A

    1989-03-01

    Time-shared high speed cyclic voltametry using carbon fibre multibarrelled microelectrodes was used to monitor the concentration of 5-Hydroxytryptamine administered by iontophoresis to locations in lamina V of Sm l neocortex and to record spontaneous neuronal spike activity. In the absence of 5-Hydroxytryptamine at any one recording location the firing of two or more individual units was seen to be synchronized so that the pattern of multi-unit activity consisted of synchronized clusters of spike activity interspersed with period of neuronal silence. The repetition rate of such clusters of neuronal activity was seen to be between 0.5 and 4Hz. Maximum concentrations of 2.7 x 10(-7) M 5-Hydroxytryptamine produced by iontophoresis disrupted synchronized neuronal cluster activity. 5-Hydroxytryptamine at a concentration of 6.2 x 10(-8) M resulted in a greater than 50% inhibition of activity for 47 single units but a change in firing pattern from cluster restricted high frequency activity to a continuous mode of firing for a separate population of 11 units. Intraperitoneal administration of P-Chloroamphetamine produced similar changes of neuronal firing and hence loss of synchrony.

  11. NEUROLOGICAL SEQUELAE FOLLOWING ANAESTHETIC RECOVERY AFTER BILATERAL TOTAL KNEE REPLACEMENT – TWO CASE REPORTS

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    Harpreet

    2016-03-01

    Full Text Available BACKGROUND Thromboembolism is a common and serious complication of joint replacement surgery. Cognitive decline occurs in 5-29% of patients, undergoing major orthopaedic surgery. Many studies show that systemic embolism may occur in the absence of venous-arterial shunts leading to cognitive dysfunction and neurological sequelae. METHODS We present two cases of neurological consequences occurring post bilateral TKR. Cases were successfully done under Combined Spinal Epidural Anaesthesia. Steroids were not used intraoperatively. RESULTS Both cases had neurological complications following completion of surgery. First case had posterior circulation TIA while the other had a right upper motor neuron facial palsy. CONCLUSION We suspect both as cases of cerebral fat microembolism in the absence of any venous-arterial shunt.

  12. ANAESTHETIC MANAGEMENT IN A PATIENT WITH ARNOLD-CHI ARI MALFORMATION TYPE I AND SYRINGOMYELIA

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    Kartika

    2013-04-01

    Full Text Available ABSTRACT: Syringomyelia is an unusual neurological condition characterised by the the presence of cystic cavity in the spinal cord resultin g in neurological manifestations. Here, we report a safe anesthetic management of patient with Arnold-Ch iari malformation type I and syringomyelia posted for foramen magnum decompression . INTRODUCTION: Arnold-Chiari malformation (ACM is a developmental malformation characterised by downward displacement of cerebellar tonsils into spinal canal due to reduced capacity of the posterior fossa. ACM may be complicate d by other malformations like Platybasia, basilar invagination and occipitalization although S yringomyelia (SM is most commonly seen. [1] There are four types of ACM; types I – IV. Type I ACM manifests with headaches, neck pain, and mild co-ordination problems mostly asymptomatic a nd discovered on brain or cervical spine MRI scans. It has adult onset characterised by downward displacement of cerebellar tonsils and medulla through the foramen magnum. [2] Syringomyelia is an unusual neurological condition characterised by the presence of fluid filled cystic cavity or syrinx within the spin al cord. Ollivies d’ Angers (1827 coined the term syringomyelia from two greek words meaning “ch annel” and “marroin”. [3] It has a prevalence of 8.4 per 100,000 and occurs more frequen tly in men than in women in the third or fourth decade of life. Rarely, it may develop in chi ldhood or late adulthood. [4

  13. Drug distribution in spinal cord during administration with spinal loop dialysis probes in anaesthetized rats

    DEFF Research Database (Denmark)

    Uustalu, Maria; Abelson, Klas S P

    2007-01-01

    ]Epibatidine in concentrations of 1, 10 and 100 nM was dissolved in Ringer's solution and administered through the dialysis membrane into the dorsal region of the cervical spinal cord. First, the outflow of [(3)H]epibatidine from the probe into the spinal cord was examined with respect to different concentrations and changes...

  14. Analgesic, Anxiolytic and Anaesthetic Effects of Melatonin: New Potential Uses in Pediatrics

    Directory of Open Access Journals (Sweden)

    Lucia Marseglia

    2015-01-01

    Full Text Available Exogenous melatonin is used in a number of situations, first and foremost in the treatment of sleep disorders and jet leg. However, the hypnotic, antinociceptive, and anticonvulsant properties of melatonin endow this neurohormone with the profile of a drug that modulates effects of anesthetic agents, supporting its potential use at different stages during anesthetic procedures, in both adults and children. In light of these properties, melatonin has been administered to children undergoing diagnostic procedures requiring sedation or general anesthesia, such as magnetic resonance imaging, auditory brainstem response tests and electroencephalogram. Controversial data support the use of melatonin as anxiolytic and antinociceptive agents in pediatric patients undergoing surgery. The aim of this review was to evaluate available evidence relating to efficacy and safety of melatonin as an analgesic and as a sedative agent in children. Melatonin and its analogs may have a role in antinociceptive therapies and as an alternative to midazolam in premedication of adults and children, although its effectiveness is still controversial and available data are clearly incomplete.

  15. Effects of six anaesthetic agents on UDP-glucuronic acid and other nucleotides in rat liver.

    Science.gov (United States)

    Christensson, P I; Eriksson, G

    1985-08-01

    Anaesthesia affects the liver nucleotide pool. It was the aim of the present study to examine how anaesthesia for 60 min with pentobarbital, ketamin + diazepam, halothane, enflurane and isoflurane may influence the nucleotide pool in the rat liver, studied with isotachophoresis. It was found that none of the agents gave both safe and reproducible anaesthesia without affecting the nucleotide pools or affecting the experiments in some other way. Halothane and isoflurane were the two best alternatives with respect to both efficiency and safety. Isoflurane may be preferable since it gives a higher energy charge.

  16. A Novel Anaesthetical Approach to Patients with Brugada Syndrome in Neurosurgery

    Directory of Open Access Journals (Sweden)

    Pietro Paolo Martorano

    2013-01-01

    Full Text Available Brugada syndrome (BrS is one of the most common causes of sudden death in young people. It usually presents with life-threatening arrhythmias in subjects without remarkable medical history. The need for surgical treatment may unmask BrS in otherwise asymptomatic patients. The best anaesthesiological treatment in such cases is matter of debate. We report a case of neurosurgical treatment of cerebello pontine angle (CPA tumor in a BrS patient, performed under total intravenous anesthesia (TIVA with target controlled infusion (TCI modalities, using midazolam plus remifentanil and rocuronium, without recordings of intraoperative ECG alterations in the intraoperative period and postoperative complications.

  17. Needle-related ultrasound artifacts and their importance in anaesthetic practice.

    Science.gov (United States)

    Reusz, G; Sarkany, P; Gal, J; Csomos, A

    2014-05-01

    Real-time ultrasound guidance for any intervention relies on visualization of needle advancement towards a target. Unfortunately, correct identification of the needle tip is not straightforward, as artifacts always distort the image. The ultrasonic appearance of the needle is often degraded by reverberation, comet tail, side-lobe, beam-width, or bayonet artifacts, which can easily confuse an unprepared operator. Furthermore, the typical needle image, that is, a dot or a straight line (out-of-plane and in-plane approaches, respectively), is also a result of artifacts that hide the real dimensions of the needle. Knowledge and correct interpretation of these artifacts is important for safe practice and is paramount to success when precise needle manipulation is mandatory, for example, when the target is small. In this review, authors discuss the most important needle-related artifacts and provide a physical explanation focusing on implications for everyday practice. Recent advances that allow increased needle visualization and reduction of artifacts are also discussed.

  18. Anaesthetic Management of Myasthenia Gravis with Thymic Mass in Facial Trauma

    OpenAIRE

    2010-01-01

    Myasthenia gravis is an immunologic disorder characterised by polyclonal antibodies directed against nicotinic acetylcholine receptors at postneuromuscular junction. This case describes perioperative management of a patient suffering facial trauma with underlying myasthenia gravis with thymic mass

  19. From collection to museum: the development of the Geoffrey Kaye Museum of Anaesthetic History.

    Science.gov (United States)

    Triarico, E

    2008-07-01

    Located at the Australian and New Zealand College of Anaesthetists (ANZCA) headquarters in Melbourne, Victoria, this internationally significant collection was founded in 1935 by renowned Australian anaesthetist Dr Geoffrey Kaye (1903 to 1986). Although it has always been referred to as a museum, it lacked the necessary management structure and infrastructure to meet museum standards. In March 2003, the first full-time professionally trained Museum Curator Ms Elizabeth Triarico, was employed by ANZCA to work with the Honorary Curator Dr Rod Westhorpe, and the Honorary Assistant Curator; Dr Christine Ball, to build on past achievements and to develop the collection into an accessible and relevant modern museum. Ms Triarico has extensive museum management experience with emphasis on management of major projects, collection management, strategic planning, marketing, interpretation and exhibition development. This paper outlines the management issues and innovative strategies involved in developing this important collection into a professionally managed museum based on best practice standards. It illustrates the benefits of introducing a clear vision and an agreed longterm management plan based on Museums Australia (Victoria) Museum Accreditation Program guidelines.

  20. Recovery at the post anaesthetic care unit after breast cancer surgery

    DEFF Research Database (Denmark)

    Gärtner, Rune; Callesen, Torben; Kroman, Niels Thorndahl

    2010-01-01

    Extant literature shows that women having undergone breast cancer surgery have substantial problems at the post-anaesthesia care unit (PACU). Based on nursing reports and elements of the discharge scoring system recommended by The Danish Society of Anaesthesiology and Intensive Care Medicine...

  1. The ultrasound guided psoas-compartment-block fundamentals and technique for a new regional anaesthetic procedure

    CERN Document Server

    Kirchmair, L P M

    2001-01-01

    Ultrasound (US) has proven to be an useful adjunct during the performance of peripheral nerve blocks. This study is the first dealing with the application of US guidance for the psoas-compartment-block which is used to achieve lumbar plexus blockades. A pilot study was carried out to establish the US anatomy of the lumbar paravertebral region and its blood vessels. Moreover, suitable transducers and US frequencies were assessed. The feasibility of US imaging of the psoas-compartment was studied on healthy volunteers (N=21) of varying body types (normal weight: N= 13; overweight: N=5; obese: N=3) in a first volunteer study. Additionally, the skin-plexus distances were measured. A second volunteer study (N=21) was carried out to investigate the US anatomy of the paravertebral blood vessels by means of power Doppler sonography. The technique of an US guided approach to the psoas-compartment was tested on embalmed cadavers (N=10) at the levels L2/L3, L3/L4 and L4/L5. Accuracy and safety of this technique were ver...

  2. Efficacy of sodium bicarbonate as anaesthetic for yellow seahorse, Hippocampus kuda (Bleeker, 1852)

    Digital Repository Service at National Institute of Oceanography (India)

    Pawar, H.B.; Ingole, B.S.; Sreepada, R.A.

    for traditional Chinese medicine (Qian et al. 2008). The H. kuda has fairly smooth appearance and often exhibits a yellow pale colour, traits that are preferred by overseas markets of live aquarium and souvenir trades on a global scale (Marichamy et al. 1993...; Vincent 1996; Lourie et al. 1999). The H. kuda had been exploited extensively from wild for several years in India mainly for the traditional Chinese medicine market. Seahorse aquaculture has received widespread attention due to concerns over decline...

  3. Balanced anaesthetic approach in a late-term gravid cow undergoing metacarpal fracture repair

    OpenAIRE

    2011-01-01

    An 800 kg Swiss cow, eighth months gravid, was presented for anaesthesia to repair metacarpal fracture. The cow was premedicated with intravenous isoxsuprine, butorphanol, ketoprofen, and xylazine IM and induced with ketamine and diazepam IV. In lateral recumbency, the trachea was intubated, and isoflurane in oxygen and air was administered. Despite a ring block with lidocaine, purposeful movement happened, and xylazine 0.02 mg kg−1 h−1 and ketamine 0.6 mg kg−1 h−1 constant rate infusion was ...

  4. Balanced Anaesthetic Approach in a Late-Term Gravid Cow Undergoing Metacarpal Fracture Repair

    OpenAIRE

    2011-01-01

    An 800 kg Swiss cow, eighth months gravid, was presented for anaesthesia to repair metacarpal fracture. The cow was premedicated with intravenous isoxsuprine, butorphanol, ketoprofen, and xylazine IM and induced with ketamine and diazepam IV. In lateral recumbency, the trachea was intubated, and isoflurane in oxygen and air was administered. Despite a ring block with lidocaine, purposeful movement happened, and xylazine 0.02 mg kg−1 h−1 and ketamine 0.6 mg kg−1 h−1 constant rate infusion was ...

  5. Balanced Anaesthetic Approach in a Late-Term Gravid Cow Undergoing Metacarpal Fracture Repair

    Directory of Open Access Journals (Sweden)

    Olga Martin Jurado

    2011-01-01

    Full Text Available An 800 kg Swiss cow, eighth months gravid, was presented for anaesthesia to repair metacarpal fracture. The cow was premedicated with intravenous isoxsuprine, butorphanol, ketoprofen, and xylazine IM and induced with ketamine and diazepam IV. In lateral recumbency, the trachea was intubated, and isoflurane in oxygen and air was administered. Despite a ring block with lidocaine, purposeful movement happened, and xylazine 0.02 mg kg−1 h−1 and ketamine 0.6 mg kg−1 h−1 constant rate infusion was started. During anaesthesia, slight hypercapnia and hypoxaemia developed. Total time of xylazine and ketamine infusion was 3.5 hours. Total anaesthesia time was 4.5 hours. For recovery of anaesthesia, isoflurane was discontinued, and in sternal recumbency, the trachea was extubated when the cow swallowed. Paralysis of the left radial nerve occurred, and the cow was supported to stand up after 2 hours. The radial nerve paralysis resolved within three days. A healthy calf was born at term. This is the first paper that describes the successful use of adjunctive xylazine and ketamine infusion to isoflurane anaesthesia in a late-term gravid cow undergoing fracture repair during 4.5 hours.

  6. INTRACAVERNOSAL USE OF ADRENALIN TO INTERRUPT ANAESTHETIC PENILE ERECTION DURING TRANSURETHRAL SURGERY

    Directory of Open Access Journals (Sweden)

    Nirupma Bansal

    2016-07-01

    Full Text Available BACKGROUND AND OBJECTIVES Intraoperative penile erection is uncommon, but troublesome problem associated with anaesthesia in patients undergoing transurethral surgery. Many methods and drugs have been used in past to solve this problem. Our objective was to find the incidence of intraoperative penile erection and to study the use of intracavernosal injection of adrenalin to solve this problem. Adrenalin is a strong sympathomimetic and an essentially present drug in the operation theatre besides being cheaper. MATERIAL AND METHODS We studied patients who underwent transurethral procedures from March 2007 to March 2009 at Nepalgunj Medical College and Teaching Hospital, Kohalpur, Nepal. During this period, three patients developed penile erection following anaesthesia. Out of those three patients, use of intracavernosal adrenalin was studied in two patients in whom masterly inactivity did not resolve the problem. RESULT In one of the patients, detumescence occurred with masterly inactivity and two patients were administered 5µg intracavernosal adrenalin. Detumescence occurred within two minutes without any cardiovascular side effects and procedures could be completed without any complication. CONCLUSION Using intracavernosal adrenalin is safe and effective in treating intraoperative penile erection

  7. Toxicokinetics of tabun enantiomers in anaesthetized swine after intravenous tabun administration.

    Science.gov (United States)

    Tenberken, O; Mikler, J; Hill, I; Weatherby, K; Thiermann, H; Worek, F; Reiter, G

    2010-10-05

    In the present study, we report the first in vivo toxicokinetic study of tabun (O-ethyl-N,N-dimethylphosphoramidocyanidate). The toxicokinetics of the enantiomers of tabun were investigated in anesthetized swine after intravenous administration of 3xLD(50) (161.4mug/kg) tabun. Blood samples were taken for gas chromatographic-mass spectrometric determination of the tabun enantiomers and for measurement of the activity of red blood cell acetylcholinesterase (AChE) and plasma butyrylcholinesterase (BChE). The tabun enantiomers could be quantified in swine blood to a minimum concentration of 3.0pg/ml (18.5pM) and could be detected to a minimum concentration of 1.0pg/ml (6.2pM). The concentration-time profiles of both tabun enantiomers were best described by a bi-exponential equation. The elimination of (+)-tabun and (-)-tabun were comparable in the initial phase. In the terminal phase a remarkable difference was found, with terminal half lives of 11.5min for (+)-tabun and 23.1min for (-)-tabun. (+)-Tabun showed a markedly longer persistence in vivo than (+)-enantiomers of other G-type nerve agents and could be detected in all swine at least up to 30min post-injection, (-)-tabun at least up to 90min post-injection. These results demonstrate a rather rapid elimination of tabun enantiomers in vivo and may provide a toxicokinetic basis for the further development and optimization of medical countermeasures against this nerve agent.

  8. Anaesthetic consideration for caesarean delivery of a parturient without ′The Master Gland′

    Directory of Open Access Journals (Sweden)

    Tuhin Mistry

    2015-01-01

    Full Text Available We are presenting the management of a patient posted for elective caesarean delivery who conceived after ovulation induction and in vitro fertilisation, 20 years after postsurgical hypopituitarism. She had uneventful pregnancy and delivered a healthy baby by caesarean section under general anaesthesia.

  9. Electrocardiogram assessment in non-anaesthetized clinically healthy agouti (Dasyprocta primnolopha, Wagler 1831

    Directory of Open Access Journals (Sweden)

    Anaemilia das N. Diniz

    2013-12-01

    Full Text Available The agouti is one of the most intensely hunted species throughout the Amazon and the semiarid regions of north-eastern Brazil. Considering the current tendency of wild animal management in captivity, the objective of this study was to determine heart reference values for agouti raised in captivity, based on electrocardiographic assessments (ECG. Adult agouti were selected without clinical signs of heart disease (n=30. The animals were restrained physically and then the ECG was performed. Standardized measurements were taken to establish the statistical analysis of the data. Analysis of the QRS complex showed values compatible with previous reports in peer animals and the limited data available for other wild and exotic species, except for the T wave that showed similar amplitude to the R wave in all the animals studied. The data obtained provided the first reference values for ECG tracings in agouti, contributing to a better understanding of heart electrophysiology in identifying myocardial pathology in these animals.

  10. Changing patterns in volatile anaesthetic agent consumption over seven years in Victorian public hospitals.

    Science.gov (United States)

    Weinberg, L; Tay, S; Aykanat, V; Segal, R; Tan, C O; Peyton, P; McNicol, L; Story, D A

    2014-09-01

    Evidence-based choices of volatile agents can increase health cost efficiencies. In this pharmaco-economic study, we evaluated the trends and costs of volatile agent use in Australian public hospitals. The total number of volatile agent (isoflurane, sevoflurane and desflurane) bottles ordered and inflation-adjusted costs were collected from 65 Victorian public hospitals from 2005 to 2011. Environmental costs were measured through the 100-year global warming potential index as carbon dioxide equivalents. During this time period, the aggregate inflation-adjusted expenditure was $39,209,878. Time series analysis showed that bottles of isoflurane ordered decreased by 419/year (99% confidence interval (CI): -603 to -235); costs decreased by $56,017/year (99% CI: -$93,243 to -$18,791). Bottles of sevoflurane increased by 1,330/year (99% CI: 1141 to 1,519); costs decreased by $423,3573/year (99% CI: -$720,030 to -112,783). Bottles of desflurane increased by 726/year (99% CI: 288 to 1,164); costs increased by $171,578/year (99% CI: $136,951 to $206,205). The amount of calculated greenhouse gas emissions released into the atmosphere over this period was 37,000 tonnes of carbon dioxide equivalents, with isoflurane contributing 6%, sevoflurane 17%, and desflurane 77% of this total. In conclusion, isoflurane is no longer being used in the majority of Victorian public hospitals, with sevoflurane and desflurane remaining as the primary volatile agents, utilised respectively at a ratio of 2.2 to 1, and costs at 0.8 to 1.

  11. Anaesthetics used for Wildlife%用于野生动物的麻醉剂

    Institute of Scientific and Technical Information of China (English)

    秦和生

    1985-01-01

    @@ 麻醉剂的研究与应用 早在四十年代,挥发性和气体药剂就用于哺乳动物的麻醉.一般是用乙醚或氯仿.这种方法的主要缺点是难以准确地控制吸入气体的量.

  12. In vitro effects of some anaesthetic drugs on lactoperoxidase enzyme activity.

    Science.gov (United States)

    Ozdemir, Hasan; Uğuz, Metin Tansu

    2005-10-01

    In vitro effects of ketamine and bupivacaine drugs on bovine lactoperoxidase (LPO; E.C. 1.11.1.7) enzyme activity were investigated. Lactoperoxidase was purified with Amberlite CG 50 resin, CM Sephadex C-50 ion-exchange chromatography, and Sephadex G-100 gel filtration chromatography from skimmed bovine milk. Rz(A412/A280) value for the purified LPO was found to be 0.8. Inhibition or activation effects of the drugs on LPO enzyme were determined using 2,2(1)-azino-bis (3-ethylbenzthiazoline-6 sulfonic acid) diammonium salt (ABTS) as a chromogenic substrate at pH = 6.0. The I50 values of ketamine and bupivacaine were 0.29 mM and 0.155 mM, respectively and the K(i) constants for ketamine and bupivacaine were 0.019 +/- 0.031 and 0.015 +/- 0.021 mM, respectively; they were non-competitive inhibitors.

  13. The Food Contaminant Mycotoxin Deoxynivalenol Inhibits the Swallowing Reflex in Anaesthetized Rats

    OpenAIRE

    Anne Abysique; Catherine Tardivel; Jean-Denis Troadec; Bernadette Félix

    2015-01-01

    International audience; Deoxynivalenol (DON), one of the most abundant mycotoxins found on cereals, is known to be implicated in acute and chronic illnesses in both humans and animals. Among the symptoms, anorexia, reduction of weight gain and decreased nutrition efficiency were described, but the mechanisms underlying these effects on feeding behavior are not yet totally understood. Swallowing is a major motor component of ingestive behavior which allows the propulsion of the alimentary bolu...

  14. Hypersensitivity to local anaesthetics--update and proposal of evaluation algorithm

    DEFF Research Database (Denmark)

    Thyssen, Jacob Pontoppidan; Menné, Torkil; Elberling, Jesper;

    2008-01-01

    of patients suspected with immediate- and delayed-type immune reactions. Literature was examined using PubMed-Medline, EMBASE, Biosis and Science Citation Index. Based on the literature, the proposed algorithm may safely and rapidly distinguish between immediate-type and delayed-type allergic immune reactions....

  15. Hepatic metabolism of anaesthetized growing pigs during acute portal infusion of volatile fatty acids and hydroxy-methyl butyrate

    DEFF Research Database (Denmark)

    Theil, Peter Kappel; Larsen, Uffe Krogh; Bjerre-Harpøth, Vibeke;

    2016-01-01

    intervals and analyzed for contents of paraamino- hippuric acid (PAH; blood flow marker) and plasma metabolites. Total VFA was infused at a rate of 0 mmol/h (background; Inf1, Inf6), 60 mmol/h (Inf2) or 120 mmol/h (Inf3 to Inf5). Infused VFA contained 70, 20, and 5% of acetate, propionate, and butyrate......, respectively, for Inf2 and Inf3, or 65%, 20%, and 10% of acetate, propionate, and butyrate, respectively, for Inf4 and Inf5. In addition, for Inf5, HMB was infused at 2 mmol/h. Statistical analysis included fixed effects of infusion and interaction between infusion and samplings within infusion while...... accounting for repeated measurements. A net hepatic uptake of propionate, butyrate, and lactate was observed, whereas the liver released acetate, glucose, and urea. The portal lactate absorption could not account for the net hepatic uptake of lactate, suggesting lactate originated from partial oxidation...

  16. Conscious sedation as an anaesthetic technique in patients undergoing nonthoracotomy placement of automatic implantable cardioverter defibrillator : an initial experience.

    Directory of Open Access Journals (Sweden)

    Singh V

    2004-01-01

    Full Text Available Six adult patients with life threatening recurrent ventricular arrhythmias who underwent non- thoracotomy placement of automatic implantable cardioverter defibrillator under conscious sedation are reported. Our clinical experience, patient satisfaction, recovery profile, complications and cardiologist perception about the technique of conscious sedation is presented and discussed.

  17. ANAESTHETIC MANAGEMENT OF A GERIATRIC PATIENT WITH PARKINSON`S DISEASE AND DIABETES MELLITUS POSTED FOR EMERGENCY LAPAROTOMY

    Directory of Open Access Journals (Sweden)

    Prajwal Patel

    2014-10-01

    Full Text Available Parkinson's disease (PD, one of the most common disabling neurological diseases, affects about 1% of the population over 60 years of age. It is a degenerative disease of the central nervous system caused by the loss of dopaminergic fibers in basal ganglia of the brain. PD is an important cause of perioperative morbidity and with an increasingly elderly population; it is being encountered with greater frequency in surgical patients. Here we report a case of 79year old male with Parkinsonism and diabetes mellitus posted for emergency laparotomy, which we managed successfully with general anesthesia.

  18. Hepatic metabolism of anaesthetized growing pigs during acute portal infusion of volatile fatty acids and hydroxy-methyl butyrate

    DEFF Research Database (Denmark)

    Theil, Peter Kappel; Larsen, Uffe Krogh; Bjerre-Harpøth, Vibeke

    2016-01-01

    ABSTRACT: The objective of the experiment was to study hepatic metabolism during infusion of volatile fatty acids (VFA) differing in amounts and composition or infusion of HMB. Three fasted (20 h) pigs (mean BW ± SE; 58 kg ± 1) were fitted with indwelling catheters in the portal vein, hepatic vein...... intervals and analyzed for contents of paraamino- hippuric acid (PAH; blood flow marker) and plasma metabolites. Total VFA was infused at a rate of 0 mmol/h (background; Inf1, Inf6), 60 mmol/h (Inf2) or 120 mmol/h (Inf3 to Inf5). Infused VFA contained 70, 20, and 5% of acetate, propionate, and butyrate......, respectively, for Inf2 and Inf3, or 65%, 20%, and 10% of acetate, propionate, and butyrate, respectively, for Inf4 and Inf5. In addition, for Inf5, HMB was infused at 2 mmol/h. Statistical analysis included fixed effects of infusion and interaction between infusion and samplings within infusion while...

  19. ANAESTHETIC MANAGEMENT OF A CASE OF TEMPOROMANDIBULAR JOINT ANKYLOSIS POSTED FOR BILATERAL BREAST SURGERY: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Athaluri Vishnu

    2014-07-01

    Full Text Available BACKGROUND: Temporomandibular joint (TMJ ankylosis is associated with partial or complete restriction of mouth opening and poses a significant problem to the anesthesiologist making the airway management very challenging. Alternative methods of securing the airway should be kept ready because conventional laryngoscopy and intubation are impossible. Thoracic epidural anesthesia (TEA is one of the options to avoid general anesthesia in this case. We aimed to manage a case of bilateral modified radical mastectomy with TMJ ankylosis solely under thoracic epidural anesthesia. METHODOLOGY: Female patient of 32 years of age, with bilateral TMJ ankylosis with no mouth opening was posted for bilateral breast surgery. Thoracic epidural was instituted at T4-T5 interspace and 18G epidural catheters was secured. Alternative airway management strategies were included in our plan if thoracic epidural fails. OBSERVATION: Adequate preparation of the patient, counseling about anesthetic plan of management, placement of epidural catheter by an experienced anesthesiologist helped in the successful management of this case. CONCLUSION: Regional anesthesia techniques are safer alternatives to provide intraoperative anesthesia with difficult airway for bilateral breast surgeries.

  20. ANAESTHETIC MANAGEMENT OF A PATIENT WITH WILSON’S DISEASE POSTED FOR EMERGENCY LSCS: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Kousalya

    2015-06-01

    Full Text Available Wilson’s disease (WD, or hepatolenticular degeneration, is a rare autosomal recessive disorder with a prevalence of 1:50,000 - 1:100,000 live births . 1 The genetic disorder causes a reduction in the synthesis of the copper transporting protein ceruloplasmin. Clinical presentation may vary from asymptomatic patients to those presenting with fulminant liver disease or neurological symptoms or psychiatric illness. The course of events in a pregnant patient depends upon the preconception status of the disease spectrum. The neuro - psychiatric illness and hepatorenal involvement in antenatal period may get worsene d. The risk of ascitis, Gatrointestinal bleeding and Varicial rupture is increased in pregnant women with pre - existing cirrhosis. Elevated serum copper levels are associated with post - partum depression (PPD. Copper accumulation may lead to erythrocyte hemolysis resulting in Coombs negative haemolytic anaemia (10 – 15%. There is also an increased risk of Hypertensive disorders in Pregnancy, HELLP syndrome and placental abruption. The disease status at the time of presentation for surgery should determine the mode of Anaesthesia, intraoperative management and post - operative care. Hepatic dysfunction can cause delayed recovery with General anaesthesia. Pre - existing neuro psychological problems may get aggravated by the hypnotic and sedative drugs. Excessive copper may interfere with neuromuscular transmission. Pre - existing neurological deficiency must be documented before attempting an Epidural or a subarachnoid block. We report a case of a primigravida with previously diagnosed Wilson’s disease initially presented with neurological symptoms and muscular weakness in the lower limbs. Though treated for 3yrs with trientene and zinc, she was on irregular treatment when posted for Emergency Caesarean section. After a proper Preanesthetic evaluation of the patient, LSCS was conducted under subarachnoid block. A good intra operative and post - operative monitoring resulted in good maternal and neonatal outcome. We conclude that regional anaesthesia can be safely administered for Caesarean delivery in patients with Wilson’s disease.

  1. Electrical potential difference across the stomach wall and gastric morphology in anaesthetized pigs after intravenous administration of cytotoxic drugs

    DEFF Research Database (Denmark)

    Fabrin, B.; Højgaard, L.; Olesen, H.P.;

    1991-01-01

    Oncologi, cytotoxic drugs, electrical potential difference, medicin, cander, gastric, side effects, chemotherapy......Oncologi, cytotoxic drugs, electrical potential difference, medicin, cander, gastric, side effects, chemotherapy...

  2. Effects of a local anaesthetic and NSAID in castration of piglets, on the acute pain responses, growth and mortality

    NARCIS (Netherlands)

    Kluivers-Poodt, M.; Houx, B.B.; Robben, S.R.; Koop, G.; Lambooij, E.; Hellebrekers, L.J.

    2012-01-01

    The present study addresses the questions whether on-farm use of local anaesthesia with lidocaine leads to a reduction in pain responses during castration, and whether the non-steroidal anti-inflammatory drug meloxicam improves technical performance after castration of piglets. Five treatments were

  3. No proarrhythmic properties of the antibiotics Moxifloxacin or Azithromycin in anaesthetized dogs with chronic-AV block

    DEFF Research Database (Denmark)

    Thomsen, Morten Bækgaard; Beekman, J D M; Attevelt, N J M;

    2006-01-01

    The therapeutically available quinolone antibiotic moxifloxacin has been used as a positive control for prolonging the QT interval in both clinical and non-clinical studies designed to assess the potential of new drugs to delay cardiac repolarization. Despite moxifloxacin prolonging QT, it has...

  4. Laryngeal Mask Airway in Paediatric Anaesthetic Practice%喉罩在小儿麻醉中的应用

    Institute of Scientific and Technical Information of China (English)

    孙彭龄; 严晓娣; 刘虎; 袁红斌

    2008-01-01

    目的 探讨喉罩与气管导管在小儿麻醉中的使用方法及利弊.方法 选择40例择期手术患儿随机分为两组,即喉罩组(LMA组,20例)和气管插管组(TT组,20例),全麻诱导给予咪达唑仑0.05 mg/kg,芬太尼2.0 ug/kg,丙泊酚1.0 mg/kg,司可林1.0 mg/kg,在药物完全起效后行LMA和TT置入.分别记录两组患儿麻醉诱导前、LMA(TT)置入前、置入后以及术后拔除LMA(TT)后的MAP、HR、SpO2的数值,并对置入LMA和TT的一次成功率进行比较.结果 两组患儿在麻醉诱导前及LMA(TT)置入前的MAP、HR、SpO2值相比较无显著差异(P>0.05),而在置入后和术后拔除LMA(TT)时LMA组的MAP、HR显著低于TT组(P<0.05).结论 喉罩通气装置使用简单、无创伤,对大多数成人和小儿都适用.若掌握好喉罩使用的适应证和禁忌证,在小儿麻醉中的应用值得推广.

  5. Emergency caesarean delivery in a patient with cerebral malaria-leptospira co infection: Anaesthetic and critical care considerations

    Directory of Open Access Journals (Sweden)

    Sukhen Samanta

    2014-01-01

    Full Text Available Malaria-leptospira co-infection is rarely detected. Emergency surgery in such patients has not been reported. We describe such a case of a 24-year-old primigravida at term pregnancy posted for emergency caesarean delivery who developed pulmonary haemorrhage, acute respiratory distress syndrome, acute kidney injury, and cerebral oedema. Here, we discuss the perioperative management, pain management (with transverse abdominis plane block, intensive care management (special reference to management of pulmonary haemorrhage with intra pulmonary factor VIIa and the role of plasmapheresis in leptospira related jaundice with renal failure.

  6. Multi-level approach to anaesthetic effects produced by sevoflurane or propofol in humans : 1. BIS and blink reflex

    NARCIS (Netherlands)

    Mourisse, J.; Lerou, J.; Struys, M.; Zwarts, M.; Booij, L.

    2007-01-01

    Background. The relative roles of forebrain and brainstem in producing adequate anaesthesia are unclear. Methods. We simultaneously analysed the effects of sevoflurane (Group S; n = 18) or propofol (Group P; n = 29) on the bispectral index (BIS) and the first component of the blink reflex (RI). The

  7. Multi-level approach to anaesthetic effects produced by sevoflurane or propofol in humans: 1. BIS and blink reflex.

    NARCIS (Netherlands)

    Mourisse, J.M.J.; Lerou, J.G.C.; Struys, M.; Zwarts, M.J.; Booij, L.H.D.J.

    2007-01-01

    BACKGROUND: The relative roles of forebrain and brainstem in producing adequate anaesthesia are unclear. METHODS: We simultaneously analysed the effects of sevoflurane (Group S; n = 18) or propofol (Group P; n = 29) on the bispectral index (BIS) and the first component of the blink reflex (R1). The

  8. Novel anaesthetic approach for surgical access and haemodynamic management during off-pump coronary artery bypass through a left thoracotomy

    Directory of Open Access Journals (Sweden)

    Madan Mohan Maddali

    2012-01-01

    Full Text Available For myocardial revascularization on a beating heart through a thoracotomy, a properly deployed endobronchial blocker (EBB provides ideal conditions for surgical access. In addition, adequate volume replacement to achieve optimal cardiac performance is a primary goal of haemodynamic management in patients undergoing off-pump coronary artery bypass grafting. To achieve both these ends, this case report describes the combined use of a left-sided EBB along with a volumetric pulmonary artery catheter in a patient who underwent a successful off-pump coronary artery bypass surgery through an anterolateral thoracotomy.

  9. Effective dose 50 of desflurane for laryngeal mask airway removal in anaesthetized children in cataract surgeries with subtenon block

    Directory of Open Access Journals (Sweden)

    Sameer Sethi

    2015-01-01

    Full Text Available Background: Quantification of the depth of desflurane anesthesia required for laryngeal mask airway (LMA removal in children has been done with the use of intravenous fentanyl or caudal anesthesia. This study aimed to determine the end-tidal concentration of desflurane required for LMA removal in children without the use of caudal or opioid analgesia in children undergoing elective cataract surgery. Materials and Methods: Our study enrolled 25 American Society of Anesthesiologists I and II children aged 2-10 years, undergoing elective cataract surgery. Anesthesia was induced with sevoflurane and oxygen/nitrous oxide using face mask and a size 2 LMA inserted. A subtenon block was administered in all children before surgical incision. Desflurane was used for maintenance of anesthesia. Predetermined end tidal concentration of desflurane was maintained for 10 min at the end of surgery before LMA removal was attempted. End tidal concentrations were increased/decreased using the Dixon up-down method (with 0.5% as a step size in the next patient depending on the previous patient′s response. Patient responses to LMA removal were classified as "movement" or "no movement." Results: 50% effective dose (ED 50 for successful removal of the LMA with desflurane in the presence of subtenon block was 3.6% (3.20-3.97% and that the 95% ED 95 was 4.648% (4.15-6.47%. Conclusion: Laryngeal mask airway removal can be successfully accomplished in 50% and 95% anesthetized children at 3.6% and 4.65% end-tidal desflurane concentration.

  10. Anaesthetic Bodies and the Absence of Feeling: Pain and Self-Mutilation in Later Nineteenth-Century Psychiatry

    Directory of Open Access Journals (Sweden)

    Sarah Chaney

    2012-12-01

    Full Text Available This paper addresses the overlapping ways in which self-inflicted injury was understood in relation to an absence of pain during the long nineteenth century, arguing that a clear distinction between bodily and mental suffering cannot be made in this period. The medical view that self-infliction of injury must necessarily be pathological is shown to have emerged from earlier philosophical approaches to pain. This was cemented by the formation of a somatic model of self-mutilation, based on the concept of cutaneous anaesthesia, particularly in the work of Wilhelm Griesinger in Germany. In contrast, the words of asylum patients provide a much broader spectrum of ways in which injuries might have been understood. Nonetheless, the meanings attributed generally emphasize self-mutilation as a response to physical, rather than emotional, pain, indicating the widespread nature of physical aetiologies of insanity. Such a somatic approach also permeated psychological models of self-inflicted injury in the late nineteenth and early twentieth centuries, as shown through examination of Richard von Krafft-Ebing’s concept of ‘sexual anaesthesia’, William James’s association of anaesthesia with the absence of emotion, and self-mutilation and fixed ideas in the work of Pierre Janet. The study of self-mutilation thus provides an interesting angle from which to explore the complexity of notions of body and mind, in relation to concepts of pain.

  11. Mean circulatory filling pressure during splanchnic nerve stimulation and whole-body hypoxia in the anaesthetized cat.

    Science.gov (United States)

    Bower, E A; O'Donnell, C P

    1991-01-01

    1. Mean circulatory filling pressure (MCFP) was measured in cats under chloralose anaesthesia by obstruction of blood flow in the pulmonary artery. Pressures in the aorta, hepatic portal vein and right atrium were recorded, and MCFP was estimated from the value at which all three pressures became equal when blood was pumped from aorta to vena cava during circulatory arrest. Simultaneous equality was not attained at MCFP values below 5 mmHg. 2. In cats ventilated by positive pressure after administration of gallamine, MCFP was 9.7 +/- 0.3 mmHg (n = 14). The values of MCFP measured in six cats before and after administration of gallamine did not differ significantly. Change of blood volume altered MCFP linearly over the range 5-21 mmHg. Noradrenaline (7.5 micrograms kg-1 min-1) increased MCFP from 9.3 +/- 0.9 to 16.5 +/- 0.6 mmHg (n = 4), and phentolamine (2 mg kg-1) reduced it to 5.6 +/- 0.3 mmHg (n = 5). 3. Changes in MCFP were evoked at different circulating blood volumes by stimulation of the splanchnic sympathetic nerves and by whole-body hypoxia. Ablation of all splanchnic nerves reduced MCFP from 9.4 +/- 0.5 to 7.1 +/- 0.3 mmHg (n = 5) and stimulation of their distal ends at 10 Hz increased it by 4.1 +/- 0.4 mmHg (n = 4); similar increments were obtained at different blood volumes and initial values of MCFP. 4. Hypoxia increased MCFP by 0.23 mmHg per 1 mmHg fall in arterial oxygen tension below Pa,O2 56 mmHg (r = -0.86; n = 24). Similar increments were obtained at different blood volumes and initial values of MCFP. Ablation of all splanchnic nerves reduced the increments by 60%, and administration of phentolamine abolished them.

  12. The effect of i.v. indomethacin on the gastric mucosal electrical potential difference and blood flow in anaesthetized dogs

    DEFF Research Database (Denmark)

    Højgaard, L; Ewald, H; Holm, I E

    1988-01-01

    Indomethacin inhibits prostaglandin synthesis and causes gastric mucosal damage. The correlation between the gastric mucosal function and gastric blood flow was investigated. The intragastric liquid junction corrected potential difference (PD) across the stomach wall was used to characterize...... reduction was seen after indomethacin. PD and flow reductions correlated (R = 0.92). As indomethacin given IV caused a parallel impairment of gastric mucosal function and blood flow, part of the indomethacin-related mucosal damaging effects might be due to the flow reduction....

  13. Anaesthetic Management of Renal Transplant Surgery in Patients of Dilated Cardiomyopathy with Ejection Fraction Less Than 40%

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    Divya Srivastava

    2014-01-01

    Full Text Available Cardiovascular disease (CVD is an important comorbidity of chronic kidney disease, and reducing cardiovascular events in this population is an important goal for the clinicians who care for chronic kidney disease patients. The high risk for CVD in transplant recipients is in part explained by the high prevalence of conventional CVD risk factors (e.g., diabetes, hypertension, and dyslipidemia in this patient population. Current transplant success allows recipients with previous contraindications to transplant to have access to this procedure with more frequency and safety. Herein we provide a series of eight patients with dilated cardiomyopathy with poor ejection fraction posted for live donor renal transplantation which was successfully performed under regional anesthesia with sedation.

  14. Post-operative recovery profile after laparoscopic cholecystectomy: a prospective, observational study of a multimodal anaesthetic regime

    DEFF Research Database (Denmark)

    Jensen, K; Kehlet, H; Lund, Claus Michael;

    2007-01-01

    intra-operatively, and in the PACU on demand (prn) administration of sufentanil, morphine, paracetamol, ondansetron, droperidol, oral fluids and oxygen (if SpO(2) Aldrete score. RESULTS: Protocol violations were moderate and occurred unsystematically, 8% had...

  15. Comparison of the effects of two intrathecal anaesthetic techniques for transurethral prostatectomy on haemodynamic and pulmonary function.

    LENUS (Irish Health Repository)

    Walsh, K H

    2012-02-03

    BACKGROUND AND OBJECTIVE: Transurethral prostatectomy is routinely performed under spinal anaesthesia. This technique can cause hypotension, which is particularly undesirable in the elderly. The objective was to compare spinal anaesthesia for transurethral prostatectomy using hyperbaric bupivacaine 15 mg (control group) and hyperbaric bupivacaine 10 mg (limiting spread by maintaining the upright position for 15 min) and fentanyl 25 microg (fentanyl group) in terms of haemodynamic and pulmonary function. METHODS: Thirty ASA I-III patients were randomly selected and underwent spinal anaesthesia with either hyperbaric bupivacaine 15 mg (immediately positioned supine) or hyperbaric bupivacaine 10 mg (upright for 15 min) and fentanyl 25 microg. RESULTS: The greatest changes in mean arterial pressure (P = 0.9), ephedrine requirements (P = 0.8) and mean maximum change in forced vital capacity (P = 0.5) were similar in both groups. CONCLUSIONS: The addition of fentanyl 25 microg to bupivacaine 10 mg and limiting the spread of the block does not improve either haemodynamic or pulmonary function compared with bupivacaine 15 mg in patients undergoing transurethral prostatectomy.

  16. Anaesthetic management of laparoscopic surgery for rectal cancer in patients of dilated cardiomyopathy with poor ejection fraction: a case report

    Science.gov (United States)

    Wu, Yao-Hua; Hu, Liang; Xia, Jin; Hao, Quan-Shui; Feng, Li; Xiang, Hong-Bing

    2015-01-01

    A patient with dilated cardiomyopathy with poor ejection fraction posted for laparoscopic surgery for rectal cancer which was successfully performed under general anesthesia with endotracheal intubation and mechanical ventilation was reported. Our observations strongly indicate that detailed preoperative assessment, watchful intraoperative monitoring, and skillful optimization of fluid status and hemodynamic play important role in the high risk patient under general anesthesia with endotracheal intubation and mechanical ventilation. PMID:26309623

  17. Vasodilator and vasoconstrictor responses induced by 5-hydroxytryptamine in the in situ blood autoperfused hindquarters of the anaesthetized rat.

    Science.gov (United States)

    Calama, E; Fernández, M M; Morán, A; Martín, M L; San Román, L

    2002-08-01

    In the present study we attempted to characterise the responses and receptors involved in the effects of 5-hydroxytryptamine (5-HT, serotonin) in in situ autoperfused rat hindquarters. Intra-arterial administration of the lowest doses of 5-HT used (0.12-12.5 ng/kg) induced vasodilator responses, whereas the highest doses (25-1000 ng/kg) produced vasoconstriction. The vasodilator effect was inhibited by methiothepin (a non-specific 5-HT(1,2,5,6,7) receptor antagonist) and by a 5-HT(1D/1B) receptor antagonist, i.e., 3-[4-(4-chlorophenyl)piperazin-1-yl]-1,1-diphenyl-2-propanolol (BRL 15572), but not by ritanserin (a selective 5-HT(2) receptor antagonist), 5-methyl-1-(3-pyridylcarbamoyl)-1,2,3,5-tetrahydropyrrolo[2,3-f] indole (SB 206553, a selective 5-HT(2B/2C) receptor antagonist) or mesulergine (a non-specific serotonergic antagonist that shows affinity to the 5-HT(7) receptor). This vasodilator effect was mimicked by administration of a selective 5-HT(1) receptor agonist - 5-carboxamidotryptamine (5-CT) - and by 2-[5-[3-(4-methylsulphonylamino)benzyl-1,2,4-1 H-indol-3-yl]ethanamine (L-694,247, a selective 5-HT(1D/1B) receptor agonist). Methiothepin, but not mesulergine, inhibited 5-CT-induced vasodilatation and the selective 5-HT(1D/1B) receptor antagonist (BRL 15572) inhibited the vasodilator action induced by L-694,247. The vasoconstrictor effect of 5-HT was significantly decreased by methiothepin, ritanserin and SB 206553, and was mimicked by alpha-methyl-5-HT (a selective 5-HT(2) receptor agonist) but not by administration of BW 723C86, a selective 5HT(2B) receptor agonist. Ritanserin, SB 206553 and spiperone (a non-specific 5-HT(1/2A) receptor antagonist) inhibited the alpha-methyl-5HT-induced vasoconstriction.Our data suggest that the vasodilator response induced by 5-HT in autoperfused rat hindquarters is mainly mediated by 5-HT(1D/1B) receptors, whereas the vasoconstrictor effect is mainly due to the activation of 5-HT(2A) receptors.

  18. Acute SGLT inhibition normalizes O2 tension in the renal cortex but causes hypoxia in the renal medulla in anaesthetized control and diabetic rats.

    Science.gov (United States)

    O'Neill, Julie; Fasching, Angelica; Pihl, Liselotte; Patinha, Daniela; Franzén, Stephanie; Palm, Fredrik

    2015-08-01

    Early stage diabetic nephropathy is characterized by glomerular hyperfiltration and reduced renal tissue Po2. Recent observations have indicated that increased tubular Na(+)-glucose linked transport (SGLT) plays a role in the development of diabetes-induced hyperfiltration. The aim of the present study was to determine how inhibition of SLGT impacts upon Po2 in the diabetic rat kidney. Diabetes was induced by streptozotocin in Sprague-Dawley rats 2 wk before experimentation. Renal hemodynamics, excretory function, and renal O2 homeostasis were measured in anesthetized control and diabetic rats during baseline and after acute SGLT inhibition using phlorizin (200 mg/kg ip). Baseline arterial pressure was similar in both groups and unaffected by SGLT inhibition. Diabetic animals displayed reduced baseline Po2 in both the cortex and medulla. SGLT inhibition improved cortical Po2 in the diabetic kidney, whereas it reduced medullary Po2 in both groups. SGLT inhibition reduced Na(+) transport efficiency [tubular Na(+) transport (TNa)/renal O2 consumption (Qo2)] in the control kidney, whereas the already reduced TNa/Qo2 in the diabetic kidney was unaffected by SGLT inhibition. In conclusion, these data demonstrate that when SGLT is inhibited, renal cortex Po2 in the diabetic rat kidney is normalized, which implies that increased proximal tubule transport contributes to the development of hypoxia in the diabetic kidney. The reduction in medullary Po2 in both control and diabetic kidneys during the inhibition of proximal Na(+) reabsorption suggests the redistribution of active Na(+) transport to less efficient nephron segments, such as the medullary thick ascending limb, which results in medullary hypoxia.

  19. Pharmacokinetics of epidurally administered nicomorphine with its metabolites and glucuronide conjugates in patients undergoing pulmonary surgery during combined epidural local anaesthetic block and general anaesthesia.

    Science.gov (United States)

    Koopman-Kimenai, P M; Vree, T B; Booij, L H; Hasenbos, M A

    1995-08-01

    After epidural administration of 15 mg 3, 6-dinicotinoylmorphine (nicomorphine) in 10 patients undergoing pulmonary surgery, the parent compound was quickly metabolized into the metabolites 6-mononicotinoylmorphine and morphine. The mean apparent half-lives (+/- SD) of elimination were 10 min (0.165 h +/- 0.053 h) for 3,6-dinicotinoylmorphine and 1.77 h +/- 1.23 h for 6-mononicotinoylmorphine. Morphine is subsequently metabolized into morphine-3-glucuronide and morphine-6-glucuronide. The apparent half-lives of morphine, morphine-3-glucuronide, and morphine-6-glucuronide are similar: 3.63 h +/- 1.63 h, 4.10 h +/- 0.57 h, and 4.20 h +/- 1.64 h respectively. The possible glucuronide conjugate of 6-mononicotinoylmorphine was not detected. The prodrug 3,6-dinicotinoylmorphine was biotransformed into three active compounds: 6-mononicotinoylmorphine, morphine, and morphine-6-glucuronide.

  20. The effects of L-carnitine and alpha-tocopherol on acid excretion defect during the acute ureteral obstruction in anaesthetized rats

    Directory of Open Access Journals (Sweden)

    Ashtiyani SC

    2010-01-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Ureteral obstruction has been shown to induce renal oxidative stress, suppressed energy metabolism and defected acid excretion. This study was aimed to examine the improving effects of L-carnitine, a facilitating cofactor for mitochondrial oxidation of fatty-acids as well as a scavenger of free-radicals, and a-tocopherol as the most potent antioxidant on these renal disorders at early hours following release of unilateral ureteral obstruction. "n"nMethods: The left ureter was ligated in 60 anaesthetised rats, L-carnitine, a-tocopherol, or their vehicles (normal saline and olive oil, respectively were injected (i.p. in four groups. Each rat was re-anesthetized and cannulated, and ureteral legation was released at exactly 24h after UUO-induction. A 30-min clearance period performed to separately collect urine from both kidneys. The collected urine and arterial blood samples were given to pH-gas analyzer and autoanalyzer, and malondialdehyde (MDA, ATP and ADP levels were assessed in preserved kidneys. There were also sham and control groups (n=8-10 in each."n"nResults: In the post-obstructed kidney of vehicle-treated groups with respect to the equivalent kidney of sham group, there were increases in MDA (p<0.001, ADP (p<0.01, urinary pH (p<0.001, absolute (p<0.05 and fractional bicarbonate excretions (p<0.01, but decreases in ATP, ATP/ADP (both p<0.001, and urinary PCO2 (p<0.01. a-tocopherol could normalize MDA level but did not affect the altered amounts of energy metabolic indices and acid-base excretions, while L-carnitine improved all of them except of decreased urinary PCO2."n"nConclusions: Increased bicarbonate-excretion in post-obstructed kidney is due to defected acid-secretion at collecting duct, which is not related to ureteral obstruction-induced renal oxidative stress and suppressed energy metabolism.

  1. Effects of acute administration of omeprazole or ranitidine on basal and vagally stimulated gastric acid secretion and alkalinization of the duodenum in anaesthetized cats.

    Science.gov (United States)

    Fändriks, L; Jönson, C

    1990-02-01

    Experiments were performed on acutely vagotomized cats during chloralose anaesthesia. In order to avoid sympathoadrenergic influences, the adrenal glands were ligated and the splanchnic nerves were cut bilaterally in all animals. The gastric lumen was perfused with saline and the H+ secretion was calculated from pH measurements in the perfusate. HCO3- secretion by the duodenal mucosa was titrated in situ. Omeprazole (4 mg kg-1 i.v., dissolved in PEG400, 40% w/v) did not influence basal or vagally induced HCO3- secretions, but inhibited by about 80% the H+ secretory response induced by electric vagal stimulation. Acute administration of ranitidine (5 mg kg-1 i.v.) transiently lowered arterial pressure, an effect which was followed by a sustained compensatory tachycardia. Ranitidine raised basal duodenal HCO3- secretion by 50% and inhibited vagally induced gastric H+ secretion by about 70%, whereas vagally induced HCO3- secretion was not influenced. The results suggest that vagal nerve stimulation raises the duodenal bicarbonate secretion via a mechanism independent of the level of gastric H+ secretion.

  2. Why are children still having preventable extractions under general anaesthetic? A service evaluation of the views of parents of a high caries risk group of children.

    Science.gov (United States)

    Olley, R C; Hosey, M T; Renton, T; Gallagher, J

    2011-04-23

    Introduction Despite overall improvements in oral health, the number of children admitted to hospital for extraction of teeth due to caries under general anaesthesia (GA) has been reported as increasing dramatically in England. The new UK government plans to transform NHS dentistry by improving oral health.Aim To evaluate the dental care received by children who required caries-related extractions under GA and obtain the views of their parents or guardians on their experiences of oral health services and the support they would like to improve their child's oral health, to inform future planning.Method An interview questionnaire was designed and piloted to collect data from a consecutive sample of 100 parents or guardians during their child's pre-operative assessment appointment. This took place at one London dental hospital between November 2009 and February 2010.Results Most children were either white (43%) or black British (41%); the average age was seven years (range 2-15, SD 3.1, SE 0.31) and the female:male ratio was 6:5. Most (84%) had experienced dental pain and 66% were referred by a general dental practitioner (GDP). A large proportion of parents or guardians (47%) reported previous dental treatment under GA in their children or child's sibling/s. Challenges discussed by parents in supporting their child's oral health included parenting skills, child behaviour, peer pressure, insufficient time, the dental system and no plans for continuing care for their child. Three out of four parents (74%) reported that they would like support for their child's oral health. Sixty percent of all parents supported school/nursery programmes and 55% supported an oral health programme during their pre-assessment clinic.Discussion These findings suggest that the oral health support received by high caries risk children is low. Health promotion programmes tailored to this cohort are necessary and our findings suggest that they would be welcomed by parents.

  3. Local anaesthetic wound infiltration after internal fixation of femoral neck fractures: a randomized, double-blind clinical trial in 33 patients

    DEFF Research Database (Denmark)

    Bech, Rune D; Lauritsen, Jens; Ovesen, Ole;

    2011-01-01

    at specific postoperative time-points and the daily consumption of opioid drugs needed for analgesia was registered. There was no significantly reduced consumption of standardized opioid rescue analgesics or pain in the study group receiving ropivacaine injections. Apart from a reduction in nausea...

  4. Benzocaína e eugenol como anestésicos para juvenis do pampo Trachinotus marginatus Benzocaine and eugenol as anaesthetics for pompano juvenile Trachinotus marginatus

    Directory of Open Access Journals (Sweden)

    Marcelo Hideo Okamoto

    2009-06-01

    Full Text Available O objetivo deste trabalho foi avaliar a eficácia da benzocaína e do eugenol como anestésicos para juvenis de Trachinotus marginatus. Foram testadas concentrações de 25, 50, 75, 100 e 150ppm de benzocaína e de 25, 37,5, 50, 62,5 e 75ppm de eugenol. Os testes foram realizados em aquários de vidro contendo 30l de água (salinidade 30‰ e temperatura 19°C. Os peixes (51,4±13,5g foram expostos individualmente às diferentes concentrações de cada anestésico (n=5 para cada concentração. Enquanto ainda anestesiados, eles foram medidos e pesados para posteriormente serem colocados em um aquário sem anestésico para recuperação. Posteriormente, os peixes foram colocados em um aquário sem anestésico para observação da recuperação. O tratamento estatístico dos resultados foi feito pela Análise de Variância (One-Way - ANOVA com 95% de significância e, quando encontradas diferenças significativas, o teste de Duncan foi aplicado. Os períodos para atingir a latência para os juvenis de pampos variaram entre 11min para a concentração de 25ppm e 2min na concentração de 150ppm para a benzocaína e de 10min (25ppm a 2min (75ppm para o eugenol. Os tempos de recuperação foram entre 3min para 25ppm e 14min para a concentração de 150ppm para a benzocaína e de 2min (25ppm a 8min (75ppm para o eugenol. A dose de 50ppm de benzocaína e eugenol proporcionou um período de latência e recuperação dentro da faixa considerada adequada (3mim para a latência e 5mim para a recuperação. Entretanto, é importante salientar que o custo da benzocaína para anestesiar juvenis de pampo é 1/3 inferior ao custo do eugenol.The aim of this experiment was to evaluate the efficacy of benzocaine and eugenol as anesthetics for Trachinotus marginatus juveniles. Five concentrations of benzocaine (25, 50, 75, 100, and 150ppm and eugenol (25, 37.5, 50, 62.5, and 75ppm were tested. The trials were conducted in glass aquariums filled with 30l seawater (salinity 30‰ and temperature 19°C. The fish (51.4±13.5g were individually exposed to different concentrations of each anesthetic (n=5 for each concentration. They were measured and weighed under anesthesia, and then returned to another aquarium without anesthetic for recovery. The results were evaluated using Analyses of Variance (One-Way - ANOVA followed by the test of Duncan (95% confidence level when necessary. Anesthesia time varied from approximately 11min (25ppm to 2min (150ppm for benzocaine, and from 10min (25ppm to 2min (75ppm for eugenol. Recovery time ranged from 3min (25ppm to 14min (150ppm for benzocaine and from 2min (25ppm to 8min (75ppm for eugenol. Benzocaine and eugenol, both at 50ppm, induce quick anesthesia and recovery (3mim for anesthesia and 5mim for recovery for juvenile Trachinotus marginatus, and therefore are considered efficient anesthetics for this species. However, it is important to emphasize that the cost of benzocaine is 1/3 lower than eugenol to anesthetize juvenile pompano.

  5. Multi-level approach to anaesthetic effects produced by sevoflurane or propofol in humans: 2. BIS and tetanic stimulus-induced withdrawal reflex.

    NARCIS (Netherlands)

    Mourisse, J.M.J.; Lerou, J.G.C.; Struys, M.; Zwarts, M.J.; Booij, L.H.D.J.

    2007-01-01

    BACKGROUND: General anaesthesia could be assessed at two sites: cortical structures and the spinal cord. However, the practicalities of measurement at these two sites differ substantially. METHODS: We simultaneously analysed effects of sevoflurane (Group S; n = 16) or propofol (Group P; n = 17) on b

  6. Comparing insertion characteristics on nasogastric tube placement by using GlideScopeTM visualization vs. MacIntosh laryngoscope assistance in anaesthetized and intubated patients

    Directory of Open Access Journals (Sweden)

    Wan Hafsah Wan Ibadullah

    2016-08-01

    Full Text Available Abstract Background and objective: This was a prospective, randomized clinical study to compare the success rate of nasogastric tube insertion by using GlideScopeTM visualization versus direct MacIntosh laryngoscope assistance in anesthetized and intubated patients. Methods: Ninety-six ASA I or II patients, aged 18-70 years were recruited and randomized into two groups using either technique. The time taken from insertion of the nasogastric tube from the nostril until the calculated length of tube had been inserted was recorded. The success rate of nasogastric tube insertion was evaluated in terms of successful insertion in the first attempt. Complications associated with the insertion techniques were recorded. Results: The results showed success rates of 74.5% in the GlideScopeTM Group as compared to 58.3% in the MacIntosh Group (p = 0.10. For the failed attempts, the nasogastric tube was successfully inserted in all cases using rescue techniques. The duration taken in the first attempt for both techniques was not statistically significant; Group A was 17.2 ± 9.3 s as compared to Group B, with a duration of 18.9 ± 13.0 s (p = 0.57. A total of 33 patients developed complications during insertion of the nasogastric tube, 39.4% in Group A and 60.6% in Group B (p = 0.15. The most common complications, which occurred, were coiling, followed by bleeding and kinking. Conclusion: This study showed that using the GlideScopeTM to facilitate nasogastric tube insertion was comparable to the use of the MacIntosh laryngoscope in terms of successful rate of insertion and complications.

  7. Validation of the unassisted, gum-elastic bougie-guided, laryngeal mask airway-ProSeal™ placement technique in anaesthetized patients

    Directory of Open Access Journals (Sweden)

    Aaron M Joffe

    2012-01-01

    Full Text Available Aims: The laryngeal mask airway-ProSeal™ can be inserted digitally, by introducer tool, or by railroading it over a bougie placed first in the patient′s oesophagus, which is highly successful, but as originally described, requires an assistant. An unassisted bougie-guided placement technique has also been described, but no data on its effectiveness have been reported. Methods: We reviewed data collected during a randomized, controlled trial comparing the air-Q® Intubating Laryngeal Airway and LMA-Proseal™, in which all LMA-Proseal™ devices were inserted using the unassisted (one-operator, bougie-guided placement technique. Results: Forty-eight devices were placed. All devices were placed successfully. Successful placement was achieved in 47 (98% patients on first attempt and in one (2% patient on the third attempt. Mean (SD time required for insertion establishing ventilation was 28 (11 s. Mean (SD airway seal pressure was 30 (6 cmH 2 O. Gross blood was found on four (8% devices upon removal, but no oropharyngeal injuries were noted on oral exam in the recovery unit prior to discharge. The most common complaints in recovery and 24 h post-operatively were sore throat [discharge: mild = 18/48 (38%; 24 h: mild = 9/38 (19%, moderate = 1/38 (3%] and pain on swallowing [discharge: mild = 7/48 (15%; 24 h: mild = 2/38 (6%]. Conclusions: Our data confirm that in experienced hands, bougie-guided placement of the LMA-Proseal™ without the aid of an assistant can be accomplished quickly and successfully without affecting the expected clinical performance of the device.

  8. Diagnosis and Prevetion of Anaesthetic Poision in Beautiful Horse%家畜美丽马醉木中毒的诊断及防治

    Institute of Scientific and Technical Information of China (English)

    张尔亮; 官米佳; 董亮; 严平; 阿都阿且; 马吉古机; 曲木都伍; 的木达

    2001-01-01

    @@ 美丽马醉木属于杜鹃花科马醉木属的常绿植物,主要生长于海拔2 000~2 600 m的山坡地,平均株高30~50cm,呈丛生长.草食家畜常因采食而导致中毒死亡.家畜中毒常发生于4~6月(发新枝和开花季节),在家畜中,绵羊最易发生,山羊次之,黄牛和马很少发生,外地引进家畜比本地家畜更易发生.由于该植物是一种含有剧毒的植物,羊口服致死量为300~500 g鲜叶量,小白鼠半数致死量LD50为119.18 mg/kg干叶量,故家畜往往呈急性中毒.国内外对马醉木属的其它植物引起的中毒有少量报道,但未见有对家畜美丽马醉木中毒诊断和防治的报道.经过我们多年来的研究与实践,现将家畜美丽马醉木中毒的诊断和防治报道如下.

  9. Anaesthesia for minimally invasive gastric and bowel surgery

    DEFF Research Database (Denmark)

    Lund, Claus

    2002-01-01

    eliminated anaesthetic drugs are, by virtue of their pharmacodynamic and pharmacokinetic profiles, optimal for use; combined with continuous thoracic epidurals with local anaesthetics and low-dose opioids, these drugs may permit reduction of various post-operative complications. Minimally invasive surgical...... and whether or not different anaesthetic regimens influence relevant morbidity parameters. In future documentation it is important that controlled, well-designed clinical studies evaluate how the advantages from multimodal anaesthetic techniques improve relevant surgical outcome....

  10. Methohexitone, propofol and etomidate in electroconvulsive therapy for depression: a naturalistic comparison study.

    LENUS (Irish Health Repository)

    Eranti, Savithasri V

    2009-02-01

    Methohexitone has been the most widely used anaesthetic for electroconvulsive therapy (ECT). However, recent scarcity and erratic availability has led to use of other anaesthetics with differing effects upon ECT. We compared treatment parameters and response to ECT in patients anaesthetised with different anaesthetics in a routine clinical setting.

  11. 天钩降压胶囊对麻醉Beagle犬血压及血流动力学的影响%Effects of Tiangou Jiangya capsule on hypertension and hemodynamics in anaesthetized dogs

    Institute of Scientific and Technical Information of China (English)

    李玉洁; 杨庆; 翁小刚; 陈颖; 周淑媛; 李丹; 朱晓新

    2011-01-01

    Objective; To evaluate the effects of Tiangou Jiangya capsule on blood pressure and hemodynamics in anesthetized Beagle dogs. Method; Anesthetized dogs were divided into five groups; Tiangou Jiangya capsule 3-dose groups as 1. 6, 3. 2, 6. 4 g ? Kg-1, positive control group was giving captopril, negative control was giving 0.5% CMC-Na, duodenal administration. The blood pressure and hemodynamic changes were observed. Result: The systolic blood pressure of middle-dose Tiangou Jiangya capsule group was significantly reduced at 30 min after administration. The systolic blood pressure (SAP) and diastolic blood pressure ( DAP) of high-dose group of Tiangou Jiangya capsule was significantly reduced at 15 min to 90 min after administration. High-dose Tiangou Jiangya capsule can also significantly reduce cardiac work (LVW) and total peripheral resistance (TPR). Tiangou Jiangya capsule had no significant effect on the other hemodynamic parameters and myocardial oxygen consumption. Conclusion; Tiangou Jiangya capsule has a significant effect on reducing blood pressure, which is related to the reducing total peripheral resistance and reducing cardiac work. The result can provide a reference to further clarify the Tiangou Jiangya capsule mechanism on reducing blood pressure.%目的:评价天钩降压胶囊对麻醉Beagle犬血压及血流动力学的影响.方法:天钩降压胶囊设置1.6,3.2,6.4g·kg-13个剂量组(按生药计),以卡托普利为阳性对照药,0.5% CMC-Na为阴性对照药,十二指肠给药,观察麻醉犬血压及血流动力学的变化.结果:天钩降压胶囊中剂量组给药30 min后麻醉犬收缩压(SAP)明显降低,高剂量组给药后15 min SAP,舒张压(DAP)即明显降低,作用维持至给药后90 min.给予天钩降压胶囊高剂量能明显降低心脏做功(LVW)和总外周阻力(TPR).天钩降压胶囊对其他血流动力学指标及心肌耗氧量无明显影响.结论:天钩降压胶囊具有明显降压作用,作用与降低总外周阻力有关,降压同时减少心脏做功,为进一步阐明大钩降压胶囊降血压机制提供参考.

  12. The Anaesthete Complex in Peonies and Ponies by Sir Harlod Acton%《哈罗德·阿克顿牡丹与马驹》中的"爱美家"情结

    Institute of Scientific and Technical Information of China (English)

    陈夏临

    2015-01-01

    英国汉学家哈罗德·阿克顿爵士(Sir Harold Mario Mitchell Acton CBE)的《牡丹与马驹》(Peonies and Ponies)以跨文化的视角,将以西方文化为代表的异质文化为隐性标杆,名为仰慕中国,实以异质文化为他者之镜,探析两种文明邂逅下的文化碰撞与交融,以汲其成果为异质文化所用.这种拾取的目光,是既诞于自体文化模子,又衍生于相宜环境中的"爱美家"的文化追索.

  13. 两种麻醉方法在儿童牙科牙体预备过程中应用的比较%Comparision of two anaesthetic methods in cavity prepration of pediatric dentistry

    Institute of Scientific and Technical Information of China (English)

    李海鹰; 王怀洲; 施艳娟; 奚风华; 艾永华

    2005-01-01

    目的:观察比较传统的手动注射方法和The WandTM系统在龋病去腐质和洞型预备过程中的镇痛效果.方法:随机选取儿童牙科临床单颗活髓下颌第一乳磨牙深龋,需进行去腐质和洞型预备的患者128名(共128颗患牙),平均分成两组.实验组64名,接受The WandTM局部麻醉系统进行麻醉,对照组64名,接受传统的手动注射方法进行麻醉.比较两组的麻醉效果.结果:麻药注射过程中试验组疼痛程度明显轻于对照组(P<0.05);麻药起效时间试验组快于对照组(P<0.05);牙科恐惧及焦虑症试验组较对照组明显减轻(P<0.05).结论:The WandTM系统在牙体预备治疗中注射时疼痛,牙科恐惧及焦虑症,麻药生效时间优于传统的常规手动注射麻醉.

  14. [Mind the explosion? The evolution of safety at work in anaesthesiology].

    Science.gov (United States)

    Petermann, Heike

    2015-11-01

    The evolution of safety in anaesthesiology is characterized by 2 aspects: exposure of anaesthetic staff by volatile anaesthetics and fire as well as explosions in combination with those. In the 20th century, the exposure of staff in the operating room became more and more important. Trigger for the fatal complications were gas lights in combination with chloroform. Later oxygen and inhalation anaesthetics caused explosions and fires. Therefore safety rules were implemented in the 1980s in the Federal Republic of Germany. These were valid for application anaesthetics including apparatus and configuration of operating rooms. The only imponderability is still the human factor.

  15. Anaesthesia in the field. Spontaneous ventilation--a new technique.

    Science.gov (United States)

    Restall, J; Thompson, M C; Johnston, I G; Fenton, T C

    1990-11-01

    In recent years the British Army has used the Triservice Anaesthetic Apparatus in the field. Trichloroethylene is no longer manufactured in the United Kingdom and halothane is not recommended for closely repeated anaesthetics. A method based on existing equipment is described for patients breathing spontaneously. A background infusion of ketamine, midazolam and alfentanil supplements the inhalation of isoflurane in oxygen-enriched air.

  16. The peri-operative cytokine response in infants and young children following major surgery

    DEFF Research Database (Denmark)

    Hansen, Tom Giedsing; Tønnesen, Else Kirstine; Andersen, J B;

    1998-01-01

    The peri-operative cytokine response was studied in 13 infants and young children undergoing major surgery. All children were anaesthetized with a combined general and epidural anaesthetic technique, followed by post-operative epidural analgesia with bupivacaine and fentanyl. Blood samples were...

  17. Sectio og Brugadas syndrom

    DEFF Research Database (Denmark)

    Ammundsen, Henriette Berg; Ekelund, Kim; Afshari, Arash

    2016-01-01

    to induce fatal arrhythmias in patients with BS and in particular sodium channel blockers i.e. local anaesthetics such as bupivacaine. We report the anaesthetic management of two women with BS during caesarean section and provide a general discussion on the use of bupivacain for neuraxial blockade...

  18. Influence of intravenous clonidine pretreatment on anesthetic requirements during bispectral EEG-guided sevoflurane anesthesia

    NARCIS (Netherlands)

    De Deyne, C; Struys, M; Heylen, R; De Jongh, R; Vander Laenen, M; Buyse, L; Deghislage, J; Rolly, G

    2000-01-01

    Study Objective: To assess the anaesthetic effects of clonidine during sevoflurane anaesthesia guided by the bispectral index (BIS), which is a processed EEG variable correlated with anaesthetic-hypnotic depth. Design: Placebo-controlled, double-blind clinical trial Settings: Elective laparoscopic s

  19. Caudal bupivacaine supplemented with caudal or intravenous clonidine in children undergoing hypospadias repair

    DEFF Research Database (Denmark)

    Hansen, Tom Giedsing; Henneberg, Steen Winther; Walther-Larsen, Søren;

    2004-01-01

    Clonidine is used increasingly in paediatric anaesthetic practice to prolong the duration of action of caudal block with a local anaesthetic agent. Which route of administration of clonidine is the most beneficial remains unknown. We compared the effects of caudal and i.v. clonidine on postoperat...

  20. Anaesthesia in the cardiac catheterization laboratory

    NARCIS (Netherlands)

    Braithwaite, Sue; Kluin, Jolanda; Buhre, Wolfgang F.; de Waal, Eric E. C.

    2010-01-01

    Purpose of review Interventions in the cardiac catheterization laboratory (CCL) requiring anaesthetic expertise are becoming routine. These interventions involve a heterogeneous patient population and take place in an offsite location. This review aims to give an insight into anaesthetic issues surr

  1. INTERACTION OF ORG-9426 AND SOME OF THE CLINICALLY USED INTRAVENOUS ANESTHETIC AGENTS IN THE CAT

    NARCIS (Netherlands)

    KHUENLBRADY, KS; AGOSTON, S; MILLER, RD

    1992-01-01

    The interaction of ORG 9426, a new non-depolarizing neuromuscular blocking agent, with intravenous anaesthetic drugs (fentanyl, thiopental, midazolam, droperidol and etomidate) has been investigated in cats. During an infusion of one of the above anaesthetics, the ED95 dose was determined by titrati

  2. Discovery and development of veterinary pharmaceuticals in telemetered animals

    NARCIS (Netherlands)

    dr. Zwijnenberg, R.J.G.

    2010-01-01

    The NMDA antagonist Perzinfotel was tested for anaesthetic sparing properties in telemetered dogs and cats when used in a pre-anaesthetic protocol. In dogs, IV, SQ and IM administration of perzinfotel (10-30 mg/kg) decreased the mean isoflurane MAC values by 32 – 44%. The greatest MAC reduction (59%

  3. Cardiac Catheterization in Thoraco-Omphalocardiopagus Twins: A Case Report

    Directory of Open Access Journals (Sweden)

    Minati Choudhury

    2008-01-01

    literature on the anaesthetic management of these cases is sparse. The following case report details the expert and vigilant anaesthetic management leading to successful diagnostic cardiac catheterization. The report emphasizes the importance of synchronous ventilation, teamwork and communication required in cases such as this. This case report also details the difficulties encountered and how to overcome them during the prolonged procedure.

  4. Iatrogenic psoas abscess. Case report

    DEFF Research Database (Denmark)

    Bernstein, Inge Thomsen; Hansen, B J

    1991-01-01

    A case of iatrogenic pneumococcus psoas abscess is reported. The etiology was probably repeated local anaesthetic blockades in the lumbogluteal structures because of lumbago.......A case of iatrogenic pneumococcus psoas abscess is reported. The etiology was probably repeated local anaesthetic blockades in the lumbogluteal structures because of lumbago....

  5. Gabapentin for post-operative nausea and vomiting: a pilot study

    Directory of Open Access Journals (Sweden)

    Vikram Bhandari

    2014-08-01

    Conclusions: Gabapentin in the doses used was found to ineffective in post-operative nausea and vomiting in patients undergoing planned laparoscopic cholecystectomy with standardized pre-anaesthetic and anaesthetic medication. [Int J Basic Clin Pharmacol 2014; 3(4.000: 627-631

  6. 低剂量纳洛酮对氯胺酮抗局麻药致惊厥作用的影响%The effect of low-dose naloxone on the anticonvulsant action of ketamine on local anaesthetics-induced convulsion

    Institute of Scientific and Technical Information of China (English)

    徐小林; 周纯; 石春雷; 陈银宝; 戴体俊; 黄水平

    2009-01-01

    目的 观察氯胺酮(ketamine,KT)对罗哌卡因(ropivacaine,R)、布比卡因(bupivacaine,B)、利多卡因(lidocaine,L)致惊厥作用的影响,以及低剂量纳洛酮(naloxone, NL)对此效应的影响.方法 腹腔注射低剂量纳洛酮(10 ng/kg), 5 min后腹腔注射氯胺酮(10 mg/kg),再过5 min后腹腔注射致惊厥剂量的罗哌卡因、布比卡因、利多卡因(分别为89.5 mg/kg、100 mg/kg、60 mg/kg),观察小鼠惊厥的持续时间、惊厥次数和惊厥率.并用序贯法测定腹腔注射氯胺酮(20 mg/kg)5 min后,罗哌卡因、布比卡因、利多卡因致惊厥ED50.结果 氯胺酮(20 mg/kg)能增加罗哌卡因、布比卡因、利多卡因致惊厥的ED50(P0.05).结论 在本实验条件下,氯胺酮能够增强罗哌卡因、布比卡因、利多卡因致惊厥作用,低剂量纳洛酮能够增强氯胺酮抗利多卡因惊厥的作用.

  7. 初发性翼状胬肉术中单用利多卡因凝胶与丁卡因滴液表面麻醉效果对比分析%Comparation of the effectiveness of lidocaine gel versus tetracaine drops as the sole topical anaesthetic agent for primary pterygium surgery

    Institute of Scientific and Technical Information of China (English)

    邓莹莹; 邢怡桥; 许玲; 王玲丽

    2013-01-01

    Objective To compare the analgesic effect of lidocaine 2% gel vs. Tetracaine 1% drops in primary pterygium surgery. Methods This is a prospective, randomized controlled trial. One hundred and fifty patients who underwent surgical excision and mitomycin C for primary pterygium were recruited. Patients were randomly assigned into two groups. Croup 1 received tetracaine 1% drops and group 2 received xylocaine 2% gel with normal saline drops. All patients who experienced pain preoperatively were given tetracaine drops. The primary outcome was the pain experienced during and after surgery. Pain and discomfort was assessed using a 10-point linear analogue scale immediately after the surger-y. Surgical procedures included 4 steps: initial incision (step 1) , pterygium body excision (step 2) , conjunctival suturing (step 3), and patching (step 4). Results There was no significant difference in the mean pain scores experienced during pterygium excision (3.58 ±2.20 for the lidocaine group and 3.88 ±2.16 for the tetracaine group). However, there was a significant difference in mean pain scores experienced at third step of the surgery (I. E, conjunctival suturing; P =0.029) between lidocaine gel group (1.22 ± 0.65) and tetracaine group (2.66 ± 1.50) , with patients of group 2 experienced less pain. Additional eye drop administrations required in lidocaine gel group were also significantly less in lidocaine gel group (0.54 ± 0.10) than in tetracaine group (1.06 ± 0.19, P = 0.001). Conclusion Topical administration of lidocaine 2% gel or tetracaine 1 % drops are both effective anesthetic methods for primary pterygium surgery. However, lidocaine gel is superior to tetracaine eye drops. It is more convenient, requires less application, and imposes a longer duration of action.%目的 评价2%利多卡因凝胶与1%丁卡因滴液在初发性翼状胬肉手术中的有效性.方法 对手术切除的初发性翼状胬肉150例(150只眼)进行回顾性随机对照研究.翼状胬肉切除同时联合丝裂霉素C治疗.患者随机分成两组.第一组用1%丁卡因滴液.第二组用2%盐酸利多卡因凝胶和0.9%生理盐水滴液.术前疼痛患者均用丁卡因滴液.主要观察患者术中术后疼痛情况.患者和医生术后即分别用10分线型类比量表进行疼痛和不适评估.手术分4步:(1)切开;(2)翼状胬肉切除;(3)结膜缝合;(4)修补.结果 翼状胬肉切除过程中(第2步)患者平均疼痛评分差异无统计学意义(利多卡因组和丁卡因组分别为3.58 ±2.20和3.88±2.16).而在第3步,结膜缝合结膜期间平均疼痛评分差异有统计学意义(P=0.029,利多卡因组和丁卡因组分别为1.22±0.65和2.26±1.50),第二组患者疼痛轻.利多卡因凝胶组需额外滴液的平均次数(0.54 ±0.10)也显著低于丁卡因组(1.06±0.19,P=0.001).结论 2%利多卡因凝胶和1%丁卡因滴液都是初发性翼状胬肉手术中应用有效的表面麻醉药物,但利多卡因凝胶比丁卡因滴液应用更方便,不需频繁使用,作用时间长.

  8. MS-222、丁香油、苯唑卡因对养殖美洲鲥幼鱼的麻醉效果%Anaesthetic effects of MS -222, clove oil and benzocaine on cultured American shad Alosa sapidissima finglings

    Institute of Scientific and Technical Information of China (English)

    杜浩; 危起伟; 杨德国; 刘鉴毅; 甘芳; 陈细华; 沈丽

    2007-01-01

    研究了MS-222、丁香油、苯唑卡因3种麻醉剂对美洲鲥Alosa sapidissima幼鱼的麻醉效果,并运用该3种麻醉剂的适宜剂量对美洲鲥幼鱼进行了运输试验.麻醉试验结果表明:在较高麻醉浓度(MS-222为75 mg/L以上,丁香油为20 mg/L以上,苯唑卡因为40 mg/L以上)下,鱼很快(30 min内)停止鳃盖张合运动,且停止鳃盖运动的鱼在空气中暴露一定时间(10 min内)后也能够复苏;在适宜的麻醉浓度(MS-222为20~30 mg/L,丁香油为8~10 mg/L;苯唑卡因为20~30 mg/L)下,鱼能够进入麻醉状态,且能保持很长时间(12 h);麻醉效果随着水温的升高而增强;在20 mg/L MS-222麻醉剂下,小规格鱼较大规格鱼更容易进入麻醉状态,而在10 mg/L丁香油和20 mg/L苯唑卡因麻醉剂下,小规格鱼却难进入麻醉状态.运输试验结果表明:麻醉运输组和对照组(非麻醉运输组)鱼血清中皮质醇的含量均显著高于基础组(运输前)(P<0.05);麻醉运输后鱼血清中皮质醇的含量虽均有一定程度的升高,但明显低于对照组,其中仅苯唑卡因麻醉运输组鱼血清中皮质醇的含量显著低于对照组(P<0.05).试验结果表明,苯唑卡因更适合用于运输美洲鲥的麻醉.

  9. Clinical observation in two anaesthetic approaches applied video-assistant thorascope in diagnosis and treatment of membrana pleural and pulmonary disease%两种麻醉方法应用于电视辅助胸腔镜手术诊治胸膜、肺部疾病的临床观察

    Institute of Scientific and Technical Information of China (English)

    赵乃康; 覃兴龙; 唐华军

    2008-01-01

    目的 探讨电视辅助胸腔镜手术(VATS)诊治胸膜、肺部疾病的麻醉处理方法.方法 76例因胸膜、肺部疾病择期行VATS的患者,随机分为气管插管组(A组)和非气管插管组(B组),每组各38例.A组采用双腔气管插管、静脉复合全身麻醉.B组采用非气管插管、保留自主呼吸、麻醉机面罩紧闭式给氧、静脉复合全身麻醉辅以切口局部麻醉.采用多功能心电监护仪持续监测并记录收缩压(SBP)、舒张压(DBP)、HR、SpO2、呼气末二氧化碳分压(PETCO2)等生命体征,并观察两组患者的麻醉效果、丙泊酚用量和麻醉苏醒时间等情况.结果 两组麻醉效果均满意.A组术中HR明显低于B组(P<0.05),B组术中HR明显高于术前(P<0.05),A组丙泊酚用量[(282±49)mg]明显低于B组[(368±36)mg,P<0.05].B组术中发生SpO2下降8例,窦性心动过速9例,室性早搏5例,咳嗽8例,呃逆3例.结论 两种麻醉方法均能安全完成手术.采用非气管插管、保留自主呼吸、麻醉机面罩紧闭式给氧、静脉复合全身麻醉辅以切口局部麻醉的方法,具有操作简单、对麻醉操作技术要求较低、费用低廉的特点,但可控性不强,安全性不够,应用于病情较轻、胸腔内无广泛粘连、操作简单且时间较短的手术是安全可行的.

  10. Orexin A对麻醉大鼠前额叶皮层神经元电活动的影响及其机制研究%Effect of Orexin A on Unit Firing of Prefrontal Cortex Neurons in Anaesthetized Rats and Its Medchanism

    Institute of Scientific and Technical Information of China (English)

    陈伯成; 郑良成; 赵红梅; 谌小维; 薛丽; 杨天德; 胡志安

    2006-01-01

    目的 探明Orexin A对麻醉大鼠皮层调节作用的间接途径及可能机制.方法 将55只大鼠分为4组:①对照组;②Orexin A组;③Pyrilamine组;④Pyrilamine+Orexin A组.用玻璃微电极记录4组大鼠前额叶皮层脑区神经元细胞外电活动.结果 ①Orexin A溶液可明显增加额叶皮层神经元的发放频率(n=12),在6 min内达到高峰,与基础值比较,给药结束后前9 min各时间段明显增加(P<0.05).②经侧脑室给予150 μg Pyrilamine预处理后,给予4 nmol Orexin A溶液前后皮层神经元放电频率并无显著变化(n=15,P>0.05).结论 Orexin A对麻醉大鼠前额叶皮层神经元放电活动有明显的兴奋性,Pyrilamine对此兴奋性存在抑制效应.

  11. New Delivery Systems for Local Anaesthetics—Part 2

    Directory of Open Access Journals (Sweden)

    Edward A. Shipton

    2012-01-01

    Full Text Available Part 2 of this paper deals with the techniques for drug delivery of topical and injectable local anaesthetics. The various routes of local anaesthetic delivery (epidural, peripheral, wound catheters, intra-nasal, intra-vesical, intra-articular, intra-osseous are explored. To enhance transdermal local anaesthetic permeation, additional methods to the use of an eutectic mixture of local anaesthetics and the use of controlled heat can be used. These methods include iontophoresis, electroporation, sonophoresis, and magnetophoresis. The potential clinical uses of topical local anaesthetics are elucidated. Iontophoresis, the active transportation of a drug into the skin using a constant low-voltage direct current is discussed. It is desirable to prolong local anaesthetic blockade by extending its sensory component only. The optimal release and safety of the encapsulated local anaesthetic agents still need to be determined. The use of different delivery systems should provide the clinician with both an extended range and choice in the degree of prolongation of action of each agent.

  12. Asystole Following Profound Vagal Stimulation During Hepatectomy

    Directory of Open Access Journals (Sweden)

    Preeta John

    2008-01-01

    Full Text Available Asystole in a non laparoscopic upper abdominal surgery following intense vagal stimulation is a rare event. This case report highlights the need for awareness of such a complication when a thoracic epidural anaesthetic has been given in addition to a general anaesthetic for an upper abdominal procedure. A combined thoracic epidural and general anaesthetic was given. The anterior abdominal wall was retracted forty minutes after administration of the epidural bolus. This maneuver resulted in a profound vagal response with bradycardia and asystole. The patient was resuscitated successfully with a cardiac massage, atropine and adrenaline and the surgery was resumed. Surgery lasted eleven hours and was uneventful.

  13. Anaesthesia for minimally invasive gastric and bowel surgery

    DEFF Research Database (Denmark)

    Lund, Claus

    2002-01-01

    It is of great importance that anaesthetic regimens match surgical procedures in regard to surgical time, in reducing organ dysfunction elicited by the anaesthesia and surgical trauma and by providing optimal post-operative pain treatment, leaving the possibility of early mobilization. New, rapidly...... eliminated anaesthetic drugs are, by virtue of their pharmacodynamic and pharmacokinetic profiles, optimal for use; combined with continuous thoracic epidurals with local anaesthetics and low-dose opioids, these drugs may permit reduction of various post-operative complications. Minimally invasive surgical...

  14. Local anaesthesia outside the operating room.

    Science.gov (United States)

    Chan, S K; Karmakar, M K; Chui, P T

    2002-04-01

    An increasing number of minor surgical procedures are performed under local anaesthesia in clinical settings outside the operating room, where monitoring and resuscitation equipment--as well as personnel skilled in resuscitation--may not be readily available. Serious adverse effects and even fatalities may result from the use of local anaesthetic agents, arising from a variety of causes such as systemic toxicity, allergy, vasovagal syncope, and reaction to additives present in the local anaesthetic. This article briefly reviews the pharmacology of local anaesthetic agents, and describes various techniques commonly used for local anaesthesia, with special emphasis on safety. Clinical features of toxicity, and its differential diagnosis and management, are also discussed.

  15. Morbidity, mortality and local anaesthesia.

    Science.gov (United States)

    Malamed, S F

    1999-01-01

    Two cases of local anaesthetic overdose and death are described. The patients, a four-year-old child and a 68-year old female, received local anaesthetic doses greatly in excess of those recommended. Their overdose reactions are described as well as subsequent management. The paper reviews the causes of local anaesthetic overdose, its signs and symptoms, and the recommended management of these reactions. Specific discussion as to the cause of death of these two patients and of the means to prevent such occurrences in the future concludes the paper.

  16. Practical Management of Anaesthesia in the Elderly

    DEFF Research Database (Denmark)

    Strøm, Camilla; Rasmussen, Lars Simon; Steinmetz, Jacob

    2016-01-01

    The elderly population is rapidly growing and particularly diverse. Ageing leads to reduced organ function and a decline in physiologic reserve. Elderly patients are characterised by great inter-individual variability in physiological function with a high prevalence of chronic disease. In general......, older patients have a higher risk of postoperative adverse outcomes, and frailty is a very important risk factor. This review article aims to provide a practical guide to anaesthetic management of the elderly surgical patient. To optimise care, clinicians should be familiar with the typical physiologic...... changes related to ageing and the implications for anaesthetic management. All anaesthetic techniques, methods and agents can be applied, if tailored to the patient's physiologic and pathologic changes. The elderly are more sensitive to anaesthetics, meaning that desired sedative and analgesic effects...

  17. Plants and Medicinal Chemistry--2

    Science.gov (United States)

    Bailey, D.

    1977-01-01

    Second of a two part article on the influence of plants on medicinal chemistry. This part considers how drugs work, the attempts to develop anaesthetics safer than cocaine, and useful poisons. (Author/SL)

  18. NONTECHNICAL SKILLS IN ANAESTHESIOLOGY

    Directory of Open Access Journals (Sweden)

    D.S.DIVEKAR

    2009-06-01

    Full Text Available Crucial role of Non technical skills (NTS in the dynamic environment of day to day anaesthetic practice is emerging. Rather than mere acceptance, efforts are being made world over to identify & assess them to overcome their negative effects by structured taxonomy both in real time & simulated conditions. Reduction in anaesthetic accidental mishaps & near misses is the prime concern from the point of patient safety & towards that end training & education have a pivotal role.

  19. Anaesthesia for bronchoscopy: examination of a standard technique1

    Science.gov (United States)

    Newell, John P; Collis, John M

    1980-01-01

    An anaesthetic technique for bronchoscopy is described, based on increments of methohexitone given in strict relation to body weight and time, suxamethonium being used to produce relaxation. There was no awareness in the 75 patients studied, while the recovery was rapid and unrelated to the duration of bronchoscopy. The efficacy of small aliquots of lignocaine in reducing injection pain was the same whether given before, or mixed with, the initial methohexitone injection. Other sequelae relating to the anaesthetic technique were minimal. PMID:7241441

  20. Perioperative Management of Patients with Obstructive Sleep Apnoea - A Review

    Directory of Open Access Journals (Sweden)

    Fauzia A Khan

    2008-01-01

    The anaesthetic implications include the presence of comorbidities like cardiovascular, respiratory and cerebrovascular sequelae. Obesity is a commonly associated condition. Effects of sedatives, hypnotics and other anaesthetic drugs are of major concern and there are potential complications associated with the postoperative period. The purpose of this review is to update the readers on the recent literature available on the topic. The American Society of Anesthesiologists has recently suggested guidelines on the perioperative management of these patients.

  1. New antiplatelet drugs and new oral anticoagulants.

    Science.gov (United States)

    Koenig-Oberhuber, V; Filipovic, M

    2016-09-01

    In our daily anaesthetic practice, we are confronted with an increasing number of patients treated with either antiplatelet or anticoagulant agents. During the last decade, changes have occurred that make the handling of antithrombotic medication a challenging part of anaesthetic perioperative management. In this review, the authors discuss the most important antiplatelet and anticoagulant drugs, the perioperative management, the handling of bleeding complications, and the interpretation of some laboratory analyses related to these agents.

  2. Effects of topical ropivacaine on eicosanoids and neurotransmitters in the rectum of patients with distal ulcerative colitis

    DEFF Research Database (Denmark)

    Hillingsø, Jens; Kjeldsen, J; Schmidt, P T;

    2002-01-01

    BACKGROUND: Topical administration of lidocaine has been suggested to have beneficial clinical effects in patients with active ulcerative colitis, but the mechanism of action, if any, remains obscure. As local anaesthetics may exert anti-inflammatory actions through their inhibition of nervous......: These findings reveal no evidence of anti-inflammatory actions by ropivacaine in active ulcerative colitis and thus provide no rationale for topical treatment with local anaesthetics....

  3. Prevalence of benzocaine and lidocaine patch test sensitivity in Denmark: temporal trends and relevance

    DEFF Research Database (Denmark)

    Thyssen, Jacob P; Engkilde, Kåre; Menné, Torkil;

    2011-01-01

    BACKGROUND. Allergens included in the European baseline series should result in positive patch test reactions in at least 1% of a patch test population. Inclusion of local anaesthetics other than benzocaine in the baseline series has previously been debated.......BACKGROUND. Allergens included in the European baseline series should result in positive patch test reactions in at least 1% of a patch test population. Inclusion of local anaesthetics other than benzocaine in the baseline series has previously been debated....

  4. Epidural anaesthesia and analgesia - effects on surgical stress responses and implications for postoperative nutrition

    DEFF Research Database (Denmark)

    Holte, Kathrine; Kehlet, H

    2002-01-01

    for improved mobilization and oral nutrition, and preservation of body composition and muscle function. Studies integrating continuous epidural local anaesthetics with enforced early nutrition and mobilization uniformly suggest an improved recovery, decreased hospital stay and convalescence. CONCLUSIONS......: Epidural local anaesthetics should be included in a multi-modal rehabilitation programme after major surgical procedures in order to facilitate oral nutrition, improve recovery and reduce morbidity....

  5. Pain and efficacy rating of a microprocessor-controlled metered injection system for local anaesthesia in minor hand surgery.

    Science.gov (United States)

    Nimigan, André S; Gan, Bing Siang

    2011-01-01

    Purpose. Little attention has been given to syringe design and local anaesthetic administration methods. A microprocessor-controlled anaesthetic delivery device has become available that may minimize discomfort during injection. The purpose of this study was to document the pain experience associated with the use of this system and to compare it with use of a conventional syringe. Methods. A prospective, randomized clinical trial was designed. 40 patients undergoing carpal tunnel release were block randomized according to sex into a two groups: a traditional syringe group and a microprocessor-controlled device group. The primary outcome measure was surgical pain and local anaesthetic administration pain. Secondary outcomes included volume of anaesthetic used and injection time. Results. Analysis showed that equivalent anaesthesia was achieved in the microprocessor-controlled group despite using a significantly lower volume of local anaesthetic (P = .0002). This same group, however, has significantly longer injection times (P microprocessor controlled methods of administering local anaesthetic showed similar levels of discomfort in both groups. While the microprocessor-controlled group used less volume, the total time for the administration was significantly greater.

  6. Comparison of methods for the reduction of acute pain produced by rubber ring castration or tail docking of week-old lambs.

    Science.gov (United States)

    Kent, J E; Molony, V; Graham, M J

    1998-01-01

    Behavioural and plasma cortisol changes were recorded for groups of eight Suffolk x Greyface lambs subjected to castration or tail docking using rubber rings with and without local anaesthetic treatment. Immediately after application of the rubber ring, local anaesthetic (2 x 0.2 ml 2% lignocaine) was administered either by needle and syringe or by high-pressure needleless injection into each side of the neck of the scrotum or tail at the site of the ring, or by high pressure needleless injection into the testes before ring application. In other groups, the innervation to the scrotum or tail was disabled by crushing with a powered bloodless castrator just proximal to the ring. Measurements were recorded in groups of control (handled) lambs, with and without local anaesthetic treatment. Application of local anaesthetic by high pressure needleless injection had little effect on either plasma cortisol values or behaviour of control lambs. For castration, application of the bloodless castrator and/or local anaesthetic at the ring site reduced the peak plasma cortisol concentration by 50% (P 0.05)]. Injection of local anaesthetic into the testes was less effective than injection into the neck of the scrotum at the site of the ring [reduction in abnormal lying postures (P < or = 0.05), 45 vs 71%, respectively]. The rapid action, effectiveness, and ease of application of these experimental methods may provide the basis for commercially viable methods for reducing the acute pain produced by rubber ring castration and tail docking of lambs.

  7. Anaesthesia practice and reproductive outcomes: Facts unveiled

    Directory of Open Access Journals (Sweden)

    Amrutha Bindu Nagella

    2015-01-01

    Full Text Available Background and Aims: Anaesthetic practice is associated with a risk of chronic exposure to anaesthetic agents. With the advent of newer inhalational agents and changing anaesthetic practices, the risks for anaesthesiologists with regard to adverse reproductive outcomes is unknown. Hence, a nationwide online survey was conducted to study the anaesthetic practices prevalent in India and their association, if any, with poor reproductive outcomes. Methods: The online survey involved 9974 anaesthesiologists. A questionnaire soliciting information regarding anaesthetic practice techniques, reproductive outcomes and perinatal outcomes was designed. All the anaesthesiologists in the ISA National database were mailed a link to the above questionnaire. Results: Female anaesthesiologists and spouses of male anaesthesiologists had a higher incidence of first trimester spontaneous abortions than the general population. Female anaesthesiologists when compared with spouses of male anaesthesiologists faced more difficulty with conception (P = 0.015. Female anaesthesiologists who worked in the operating room (OR in their first trimester of gestation had a higher incidence of spontaneous abortions than those who did not work in the OR (P = 0.05. Longer hours of general anaesthesia conducted in the first trimester of pregnancy was associated with a higher risk of birth defects in their progeny (P = 0.05. Conclusion: Spontaneous abortions and birth defects were higher in female anaesthesiologists who worked in the OR in the first trimester of gestation. Both female anaesthesiologists and spouses of male anaesthesiologists had a greater risk for a first trimester miscarriage than the general population.

  8. Dispersal of radioisotope labelled solution following deep dermal injection in Ehlers-Danlos syndrome.

    Science.gov (United States)

    Oliver, D W; Balan, K K; Burrows, N P; Hall, P N

    2000-06-01

    Ehlers-Danlos syndrome (EDS) is the commonest inherited disorder of connective tissue, affecting around 10 000 patients in the UK. Patients with EDS have reported that local anaesthetic is often ineffective. Patients with less severe skin laxity often have the most problems. We have postulated that this resistance to local anaesthetics is not due to the lax connective tissues as is often assumed. This study used radioactively labelled solution ((99m)Tc-pertechnetate) administered as a deep dermal injection in the forearm. The rate of dispersal of isotope was measured over 60 min and found to be identical between six patients with EDS and three controls. The effects of local anaesthetics are complex and depend on the individual chemical properties of the agent and a number of tissue factors. This study would suggest that the lack of effectiveness of local anaesthetic solutions is not due to rapid dispersal of solution. It is unlikely therefore that its lack of effect can be compensated for by simply increasing the amount used. The diagnosis of EDS should be considered in any patient who complains unexpectedly of pain during their procedure, particularly when the surgeon knows that an adequate volume of local anaesthetic has been used.

  9. Determination of the minimum alveolar concentration for halothane, isoflurane and sevoflurane in the gerbil.

    Science.gov (United States)

    de Segura, I A Gómez; de la Víbora, J Benito; Criado, A

    2009-07-01

    The present work determined the minimum alveolar concentrations (MAC) of halothane, isoflurane and sevoflurane in adult female gerbils (n=24). Animals were placed in a chamber for anaesthetic induction before performing tracheal intubation. The tracheal tube was connected to a non-rebreathing circuit with minimal dead space. Body temperature, blood pressure, heart and respiratory rates and end-tidal volatile anaesthetic levels were measured continuously. MAC was determined using a standard noxious stimulus (tail-clamp). All experiments were performed at the same time of the day, body temperature was maintained constant and blood-gas analysis was performed to confirm that values were within normal limits. The mean+/-SD MAC values were 1.06+/-0.11% halothane (n=8), 1.55+/-0.08% isoflurane (n=8) and 2.90+/-0.12% sevoflurane (n=7). Cardiovascular parameters at 1xMAC did not differ significantly among anaesthetics but the respiratory rate was significantly higher in the halothane group than in the isoflurane and sevoflurane groups. The SpO2 values recorded throughout anaesthesia and the pH and partial oxygen pressure values determined at the end of the study did not differ among the studied anaesthetics at 1xMAC. These data suggest that the MAC for halogenated inhalant anaesthetics in gerbils is lower than the average MAC values obtained in rats and mice.

  10. The effects of ropivacaine hydrochloride on coagulation and fibrinolysis. An assessment using thromboelastography.

    LENUS (Irish Health Repository)

    Porter, J M

    2012-02-03

    Amide local anaesthetics impair coagulation by inhibition of platelet function and enhanced fibrinolysis. The potential therefore exists that the presence of amide local anaesthetics in the epidural space could contribute to the therapeutic failure of an epidural autologous blood patch. Ropivacaine is an aminoamide local anaesthetic increasingly used for epidural analgesia and anaesthesia, particularly in obstetric practice. This study was undertaken to investigate whether concentrations of ropivacaine in blood, which could occur clinically in the epidural space, alter coagulation or fibrinolysis. Thromboelastography was used to assess clotting and fibrinolysis of blood to which ropivacaine had been added. Although modest alterations in maximum amplitude, coagulation time and alpha angle were observed, the effect of ropivacaine on clotting and fibrinolysis was not clinically significant. We conclude that it is unlikely that the presence of ropivacaine in the epidural space would reduce the efficacy of an early or prophylactic epidural blood patch.

  11. Evidence that the positive inotropic effects of the alkylxanthines are not due to adenosine receptor blockade.

    Science.gov (United States)

    Collis, M. G.; Keddie, J. R.; Torr, S. R.

    1984-01-01

    We investigated the possibility that the positive inotropic effects of the alkylxanthines are due to adenosine receptor blockade. The potency of 8-phenyltheophylline, theophylline and enprofylline as adenosine antagonists was assessed in vitro, using the guinea-pig isolated atrium, and in vivo, using the anaesthetized dog. The order of potency of the alkylxanthines as antagonists of the negative inotropic response to 2-chloroadenosine in vitro, and of the hypotensive response to adenosine in vivo was 8-phenyltheophylline greater than theophylline greater than enprofylline. The order of potency of the alkylxanthines as positive inotropic and chronotropic agents in the anaesthetized dog was enprofylline greater than theophylline greater than 8-phenyltheophylline. The results of this study indicate that the inotropic effects of the alkylxanthines in the anaesthetized dog are not due to adenosine receptor blockade. PMID:6322898

  12. Fatal subacute liver failure after repeated administration of sevoflurane anaesthesia.

    Science.gov (United States)

    Zizek, David; Ribnikar, Marija; Zizek, Bogomir; Ferlan-Marolt, Vera

    2010-01-01

    Sevoflurane is a widely used halogenated inhalation anaesthetic. In comparison with other similar anaesthetics, it is not metabolized to potentially hepatotoxic trifluoroacetylated proteins. In this case report, we present a 66-year-old woman with breast carcinoma, who underwent sevoflurane general anaesthesia twice in 25 days. Soon after the second elective surgical procedure, jaundice and marked elevations in serum transaminases developed. The patient died 66 days thereafter. Autopsy results denied evidence of major cardiovascular abnormality, and histological examination confirmed massive liver cell necrosis with no feature of chronic liver injury. Sevoflurane anaesthesia was imputed as the cause after exclusion of other possible aetiological agents. Besides, coexistent malignant tumours found in the patient could have modulated the immunological response to the applied anaesthetic followed by fatal consequences.

  13. Hypnosis as sole anaesthesia for skin tumour removal in a patient with multiple chemical sensitivity.

    Science.gov (United States)

    Facco, E; Pasquali, S; Zanette, G; Casiglia, E

    2013-09-01

    A female patient with multiple chemical sensitivity and previous anaphylactoid reactions to local anaesthetics was admitted for removal of a thigh skin tumour under hypnosis as sole anaesthesia. The hypnotic protocol included hypnotic focused analgesia and a pre-operative pain threshold test. After inducing hypnosis, a wide excision was performed, preserving the deep fascia, and the tumour was removed; the patient's heart rate and blood pressure did not increase during the procedure. When the patient was de-hypnotised, she reported no pain and was discharged immediately. Our case confirms the efficacy of hypnosis and demonstrates that it may be valuable as a sole anaesthetic method in selected cases. Hypnosis can prevent pain perception and surgical stress as a whole, comparing well with anaesthetic drugs.

  14. Hargreaves does not evaluate nociception following a surgical laparotomy in Xenopus leavis frogs.

    Science.gov (United States)

    Vachon, P

    2014-10-01

    The present study was performed to determine the effectiveness of the Hargreaves test for the evaluation of nociception in frogs, more precisely to determine if cutaneous thresholds to a radiant heat stimulus would increase with analgesics following an abdominal laparotomy performed under general anaesthesia. Non breeding female Xenopus leavis frogs (3 groups (non-anaesthetized, anaesthetized with tricaine methanesulfonate (MS222), with or without an abdominal laparotomy) were used to evaluate the effectiveness of the Hargreaves test. Cutaneous thresholds were evaluated at baseline and following anaesthetic recovery (over 8 h) at six different body locations. Increased reaction times were observed in the gular area only at 1 h post-recovery following a MS222 bath immersion in frogs with (p leavis frogs.

  15. Fascia iliaca block, for fractured femur, in Emergency Departments

    Directory of Open Access Journals (Sweden)

    M.A. Majeed*

    2013-12-01

    Discussion: We have traditionally been using opiates for severe pain but they don’t come without side effects, especially the elderly group takes most of the blow. As discussed above, NOF fracture makes a significant number of patients presenting to ED. Therefore having a non-opiates based pain relief like FIB, makes it very useful. The above papers suggest a beneficial role of ultrasound guided FIB in femoral fractures either as an alternative or adjunct to the routinely used analgesia. Evidence suggests that the placement of local anaesthetic in the wrong plane will reduce the success of any regional anaesthetic technique. The use of ultrasound guidance will permit the identification of the fascia iliaca and neurovascular bundle. It will also provide help in the needle guidance and direct observation of local anaesthetic spread in real time. Therefore the chances of effective block are extremely high when done under ultrasound guidance.

  16. Evidence-based management of postoperative pain in adults undergoing open inguinal hernia surgery

    DEFF Research Database (Denmark)

    Joshi, G P; Rawal, N; Kehlet, H

    2012-01-01

    and increased time to home-readiness compared with regional anaesthesia. CONCLUSION: Field block with, or without wound infiltration, either as a sole anaesthetic/analgesic technique or as an adjunct to general anaesthesia, is recommended to reduce postoperative pain. Continuous local anaesthetic infusion......, in English, published between January 1966 and March 2009, assessing analgesic and anaesthetic interventions in adult open hernia surgery, and reporting pain scores, were retrieved from the Embase and MEDLINE databases. In addition to published evidence, clinical practice was taken into account to ensure...... that the recommendations had clinical validity. RESULTS: Of the 334 randomized studies identified, 79 were included. Quantitative analysis suggested that regional anaesthesia was superior to general anaesthesia for reducing postoperative pain. Spinal anaesthesia was associated with a higher incidence of urinary retention...

  17. Low susceptibility to inert gases and pressure symptoms in TREK-1-deficient mice.

    Science.gov (United States)

    Vallée, Nicolas; Rostain, Jean-Claude; Risso, Jean-Jacques

    2009-02-18

    Nervous disorders may occur after an organism is saturated with inert gases, which may alter the lipid bilayer structure, according to their liposolubility coefficient. Increase in the nitrogen partial pressure induces a neurological syndrome called 'nitrogen narcosis'. By contrast, high pressures of helium induce epilepsy, an high-pressure nervous syndrome symptom. On the basis of an analogy with anaesthetic mechanisms, we used TREK-1 knockout mice, earlier described to volatile the anaesthetics resistance. These mice had a higher threshold of resistance to the narcotic effects of nitrogen and to the death after recurrent epileptic seizure induced by high pressure. TREK-1 channels seem to play a key role in modulating the anaesthetic potential of inert gases and in neuroprotection.

  18. Electrical nerve stimulation as an aid to the placement of a brachial plexus block : clinical communication

    Directory of Open Access Journals (Sweden)

    K.E. Joubert

    2002-07-01

    Full Text Available Most local anaesthetic blocks are placed blindly, based on a sound knowledge of anatomy. Very often the relationship between the site of deposition of local anaesthetic and the nerve to be blocked is unknown. Large motor neurons may be stimulated with the aid of an electrical current. By observing for muscle twitches, through electrical stimulation of the nerve, a needle can be positioned extremely close to the nerve. The accuracy of local anaesthetic blocks can be improved by this technique. By using the lowest possible current a needle could be positioned within 2-5mm of a nerve. The correct duration of stimulation ensures that stimulation of sensory nerves does not occur. The use of electrical nerve stimulation in veterinary medicine is a novel technique that requires further evaluation.

  19. Seizure activity occurring in two dogs after S-ketamine-induction.

    Science.gov (United States)

    Adami, C; Spadavecchia, C; Casoni, D

    2013-10-01

    Two healthy dogs were anaesthetized to undergo elective orthopaedic procedures. After premedication with methadone and acepromazine, general anaesthesia was induced with midazolam and S-ketamine. Immediately after anaesthetic induction, seizures occurred in both dogs. In the first dog the syndrome was characterized by tonic and clonic motor activity, muscular hypertone, hypersalivation, urination, defecation and hyperthermia. In the second dog muscular twitches of the temporal and masseter regions were observed, followed by increased skeletal muscles tone, hypersalivation, spontaneous urination and increase in body temperature. Recoveries from anaesthesia were uneventful and no seizures were observed. Considering the temporal association between anaesthetic induction and occurrence of seizures, and the fact that other causative factors could not be identified, it is hypothesized that S-ketamine played a role in determining the convulsive phenomena observed in these patients. S-ketamine might carry the potential for inducing seizures in otherwise healthy dogs, despite the concomitant use of GABA-ergic drugs.

  20. The development of postgraduate anaesthesia and intensive care training at the University of the West Indies.

    Science.gov (United States)

    Scarlett, M D; Crawford-Sykes, A; Harding, H E; Chen, D R

    2012-07-01

    The one-year Diploma in Anaesthetics (DA) was the first postgraduate programme offered by the then Faculty of Medicine of The University of the West Indies (UWI). It was instituted in 1966, when the need for trained physician anaesthetists became paramount. Over 200 physicians have been awarded the DA which was discontinued in 1994. The four-year Doctor of Medicine in Anaesthetics [DM (Anaesthetics)] was commenced in 1974 and continues to train most of the region's physician anaesthetists. The majority of the 119 graduates (as of December 2011) are providing invaluable services to the people of the Caribbean. The time has come for the establishment of a regional certifying body, the Caribbean College of Anaesthetists. This college would determine the standards for the training and clinical practice of anaesthetists as perioperative physicians including: the conduct of anaesthesia, critical care, acute and chronic pain management. It would also facilitate continuing medical education and recertification of all practising anaesthetists within the region.

  1. Anaesthesia for procedures in the intensive care unit.

    Science.gov (United States)

    Chollet-Rivier, M; Chioléro, R L

    2001-08-01

    Taking in charge severely ill patients in the intensive care environment to manage complex procedures is a performance requiring highly specific knowledge. Close collaboration between anaesthetists and intensive care specialists is likely to improve the safety and quality of medical care. Three forms of anaesthetic care should be considered in clinical practice: sedation and analgesia; monitored anaesthetic care; and general anaesthesia or conduction block anaesthesia. Even in the field of sedation and analgesia, the anaesthesiologist can offer expertise on new anaesthetic techniques like: the most recent concepts of balanced anaesthesia in terms of pharmacokinetics and dynamics, favouring the use of short-acting agents and of sedative-opioid combinations. New modes of administration and monitoring intravenous anaesthesia have been developed, with potential application in the intensive care unit. These include the use of target-controlled administration of intravenous drugs, and of electroencephalographic signals to monitor the level of sedation.

  2. Mucosal/submucosal blood flow in the small intestine in pigs determined by local washout of 133Xe and microsphere techniques

    DEFF Research Database (Denmark)

    Mortensen, Peter; Olsen, J; Sejrsen, P

    1990-01-01

    In 11 anaesthetized pigs a laparotomy was performed and the mucosal and submucosal blood flow rate in the small intestine of the pig was determined by a local application of 133Xe and by 6.5-microns radioactive microspheres. The 133Xe washout plotted in a semilogarithmic diagram showed a multiexp......In 11 anaesthetized pigs a laparotomy was performed and the mucosal and submucosal blood flow rate in the small intestine of the pig was determined by a local application of 133Xe and by 6.5-microns radioactive microspheres. The 133Xe washout plotted in a semilogarithmic diagram showed...

  3. God behandlingseffekt af botulinum toxin A hos systemisk sklerodermi patienter med digitale sår

    DEFF Research Database (Denmark)

    Nielsen, Jane Baumgartner; Hvid, Lone; Olesen, Anne Braae

    2014-01-01

    In this case we describe a successful combined treatment with local anaesthetics and botulinum toxin A. A 61-year-old man with systemic sclerosis of limited type presented treatment refractory digital ulcers on his toes with a poor response to conventional treatment. A combined treatment as above......-mentioned prevented a threatening amputation and improved quality of life, reduction of pain and healing of wounds. Using botulinum toxin A combined with local anaesthetics to severe toe digital ulcers in patients with systemic sclerosis may be a solution, when other treatments have been ineffective and amputation...

  4. ANESTHESIA FOR CHARCOT-MARIE-TOOTH DISEASE: CASE REPORT.

    Science.gov (United States)

    Alzaben, Khalid R; Samarah, Omar Q; Obeidat, Salameh S; Halhouli, Oday; Al Kharabsheh, Murad

    2016-06-01

    Charcot-Marie-Tooth disease comprises a group of disorders characterized by progressive muscle weakness and wasting. Reviewing the anaesthetic literature produced conflicting reports about the best anaesthetic options for patients with CMTD; as they are at increased risk of prolonged response to muscle relaxants, malignant hyperthermia and risks of regional anaesthesia. We present a case of the successful use of total intravenous anaesthesia with dexmedetomidine and propofol combined with caudal block using bupivacaine mixed with dexmedetomidine without any complications, for a 17 year old male patient with Charcot Marie-Tooth disease who underwent a lower limb orthopedic surgery.

  5. Pain and convalescence after laparoscopic cholecystectomy

    DEFF Research Database (Denmark)

    Bisgaard, T; Kehlet, H; Rosenberg, J

    2001-01-01

    rather than other pain components. Early pain after cholecystectomy is reduced by minimising residual pneumoperitoneum and by giving incisional local anaesthetics, epidural analgesia, and non-steroidal anti-inflammatory drugs. There are inconclusive data about type and pressure of pneumoperitoneum......, the use of intraperitoneal local anaesthetics, and the type of general anaesthesia. Pain and medico-cultural traditions are the main factors responsible for prolonged convalescence after laparoscopic cholecystectomy. To minimise pain and the duration of convalescence, we recommend multi-modal analgesic...

  6. The effect of 0.5% ropivacaine on epidural blood flow

    DEFF Research Database (Denmark)

    Dahl, J B; Simonsen, L; Mogensen, T;

    1990-01-01

    Twenty patients scheduled for elective abdominal surgery received epidural analgesia with 20 ml 0.5% ropivacaine or 0.5% bupivacaine. Epidural blood flow was measured by an epidural 133Xe clearance technique on the day before surgery (no local anaesthetic) and again 1 h before surgery, 30 min after...... injection of the local anaesthetic during continuous infusion (8 ml/h). Median initial blood flow was 5.0 ml/min and 6.0 ml/min per 100 g tissue in patients receiving ropivacaine and bupivacaine, respectively. After epidural bupivacaine, blood flow increased in 8 of 10 patients to 6.9 ml/min per 100 g...

  7. [Anaesthesia in connection with liver transplantation

    DEFF Research Database (Denmark)

    Secher, N.H.; Nissen, P.; Swiatek, F.A.;

    2008-01-01

    The anaesthetic plan for liver transplantation focuses on maintaining central blood volume and thereby cerebral oxygenation. Normovolaemia represents a central blood volume that establishes a maximal venous oxygen saturation, and a value of 85% (78-90%) is maintained during the operation by admin......The anaesthetic plan for liver transplantation focuses on maintaining central blood volume and thereby cerebral oxygenation. Normovolaemia represents a central blood volume that establishes a maximal venous oxygen saturation, and a value of 85% (78-90%) is maintained during the operation...

  8. Anaesthesia in operations of congenital craniofacial abnormalities

    Directory of Open Access Journals (Sweden)

    Jahangirie B

    1996-07-01

    Full Text Available Some syndromes that are characterized by abnormalities of the skull, facial bones, and mandibule, most of these patients are from the pediatric population. For the anaesthetic management of patients with various craniofacial dysostosis are as follows: 1 The necessary for careful evaluation of the airway by simply observing the patient. 2 Evaluation of the patient for abnormalities of the heart and lungs. 3 Patients may also have increased intracranial pressure. 4 Anaesthetic drugs and techniques: no particular drugs is recommended. Techniques controlled ventilation. 5 All patients should be cared in the intensive care unit after operation between 24-48 hours

  9. Peak and averaged bicoherence for different EEG patterns during general anaesthesia

    Directory of Open Access Journals (Sweden)

    Myles Paul

    2010-11-01

    Full Text Available Abstract Background Changes in nonlinear neuronal mechanisms of EEG generation in the course of general anaesthesia have been extensively investigated in research literature. A number of EEG signal properties capable of tracking these changes have been reported and employed in anaesthetic depth monitors. The degree of phase coupling between different spectral components is a marker of nonlinear EEG generators and is claimed to be an important aspect of BIS. While bicoherence is the most direct measure of phase coupling, according to published research it is not directly used in the calculation of BIS, and only limited studies of its association with anaesthetic depth and level of consciousness have been published. This paper investigates bicoherence parameters across equal band and unequal band bifrequency regions, during different states of anaesthetic depth relating to routine clinical anaesthesia, as determined by visual inspection of EEG. Methods 41 subjects scheduled for day surgery under general anaesthesia were recruited into this study. EEG bicoherence was analysed using average and smoothed-peak estimates calculated over different regions on the bifrequency plane. Statistical analysis of associations between anaesthetic depth/state of consciousness and bicoherence estimates included linear regression using generalised linear mixed effects models (GLMs, ROC curves and prediction probability (Pk. Results Bicoherence estimates for the δ_θ region on the bifrequency plane were more sensitive to anaesthetic depth changes compared to other bifrequency regions. Smoothed-peak bicoherence displayed stronger associations than average bicoherence. Excluding burst suppression and large transients, the δ_θ peak bicoherence was significantly associated with level of anaesthetic depth (z = 25.74, p 2 = 0.191. Estimates of Pk for this parameter were 0.889(0.867-0.911 and 0.709(0.689-0.729 respectively for conscious states and anaesthetic depth

  10. Hallermann-Streiff syndrome: airway problems during anaesthesia.

    Directory of Open Access Journals (Sweden)

    Malde A

    1994-10-01

    Full Text Available In the patients with Hallermann-Streiff Syndrome, presence of mandibular hypoplasia and microstomia results in difficult intubation. The anaesthetic management of a three month old child with this syndrome for lensectomy is presented in this report. There was difficulty in maintaining the airway patency during induction which was solved with the help of a modified, improvised airway. Intubation was done after induction with a combination of inhalational and intravenous anaesthetic agents and muscle relaxant. Recognition of this syndrome should alert the physician to the possibility of difficulty in airway maintenance.

  11. [Use of clonidine for perioperative therapy].

    Science.gov (United States)

    Fidziańska-Długosz, E

    1998-01-01

    Clonidine is a selective alpha 2 adrenergic receptors agonist with a wide spectrum of activity. Except well known hypotensive effect, clonidine stabilizes circulatory system and has sedative, anxiolytic, analgesic, diuretic etc. activities. Clonidine has some appliance during perioperative period. When used in premedication it has a lot of advantages: causes sedation, has anxiolytic properties, reduces secretion of saliva, stabilizes circulatory system, diminishes stress reaction, augments action of anaesthetic and analgesic drugs. When used during the operation, regulates circulatory system, prolongs and amplifies central and peripheral blocks. Clonidine diminishes patients requirement for opioids and local anaesthetics during postoperative and long-term pain therapy.

  12. Endoscopic ultrasound duplex scanning for measurement of portal venous flow. Validation against transit time ultrasound flowmetry in pigs

    DEFF Research Database (Denmark)

    Hansen, E F; Strandberg, C; Bendtsen, F;

    1999-01-01

    with that of transit time ultrasound (TTU) in healthy pigs. The ability of EUS to detect changes in the portal venous flow after pharmacologic intervention was also investigated. METHODS: Six anaesthetized pigs were studied. Portal venous flow was measured simultaneously by EUS duplex scanning, using a Pentax FG-32UA...

  13. Breath gas concentrations mirror exposure to sevoflurane and isopropyl alcohol in hospital environments in non-occupational conditions.

    Science.gov (United States)

    Castellanos, Mar; Xifra, Gemma; Fernández-Real, José Manuel; Sánchez, Juan M

    2016-01-29

    Anaesthetic gases and disinfectants are a primary source of air contamination in hospitals. A highly sensitive sorbent-trap methodology has been used to analyse exhaled breath samples with detection limits in the pptv range, which allows volatile organic compounds (VOCs) to be detected at significantly lower levels (5-6 orders of magnitude below) than the recommended exposure limits by different organizations. Two common VOCs used in hospital environments, isopropyl alcohol (IPA) and sevoflurane, have been evaluated. Forced-expiratory breath samples were obtained from 100 volunteers (24 hospital staff, 45 hospital visitors and 31 external controls). Significant differences for IPA were found between samples from volunteers who had not been in contact with hospital environments (mean value of 8.032 ppbv) and people staying (20.981 ppbv, p  =  0.0002) or working (19.457 ppbv, p  =  0.000 09) in such an environment. Sevoflurane, an anaesthetic gas routinely used as an inhaled anaesthetic, was detected in all samples from volunteers in the hospital environment but not in volunteers who had not been in recent contact with a hospital environment. The levels of sevoflurane were significantly higher (p  =  0.000 24) among staff members (0.522 ppbv) than among visitors to the hospital (0.196 ppbv). We conclude that highly sensitive methods are required to detect anaesthetic gas contamination in hospital environments.

  14. Professional risk in anesthesiology.

    Directory of Open Access Journals (Sweden)

    Marlene Alejo Aris

    2006-04-01

    Full Text Available Working with the profession is an exercise that implies a risk that is related to the characteristics of the job, that is why anaesthesiology can cause diseases due to the exposition to the stress of surgical and urgency environment, inhalation and contact with anaesthetic teratogenic and carciogenic agents and to the eventual exposition to iozining radiation among other dangers.

  15. Comparison of lidocaine/tetracaine cream and lidocaine/prilocaine cream for local anaesthesia during laser treatment of acne keloidalis nuchae and tattoo removal: Results of two randomized controlled trials

    NARCIS (Netherlands)

    K. Greveling (Karin); E.P. Prens (Errol); ten Bosch, N.; M.B.A. van Doorn (Martijn)

    2017-01-01

    textabstractBackground: Pain is a common adverse effect of dermatological laser procedures. Currently, no standard topical anaesthetic cream exists for deeper dermal laser procedures. Objectives: To compare the efficacy of lidocaine/tetracaine cream and lidocaine/prilocaine cream in reducing self-re

  16. Occupational exposure to sevoflurane during cardiopulmonary bypass

    NARCIS (Netherlands)

    M.J. Blokker-Veldhuis; P.M.M.J. Rutten; S.G. de Hert

    2011-01-01

    Volatile anaesthetic agents are widely used for maintenance of anaesthesia in all kinds of surgical procedures. Despite the implementation of measures such as adequate ventilation of the operating room and the use of efficient scavenging systems, concern remains about the risks for occupational expo

  17. Postoperative ileus: progress towards effective management

    DEFF Research Database (Denmark)

    Holte, Kathrine; Kehlet, Henrik

    2002-01-01

    of adverse effects. The development of new peripheral selective opioid antagonists is promising and has been demonstrated to shorten PI significantly. A multi-modal rehabilitation programme including continuous epidural analgesia with local anaesthetics, enforced nutrition and mobilisation may reduce PI to 1...

  18. A new device for the inflation of the antigravity suit.

    Science.gov (United States)

    Brodrick, P M

    1986-02-01

    The 'Schuco' orthopaedic tourniquet inflator can be simply converted into a suitable device for inflating an antigravity suit (G-suit). The antigravity suit may be used on neurosurgical patients undergoing procedures in the sitting position to help prevent hypotension and air embolism. The availability of this device may encourage the more widespread use of an antigravity suit in neuro-anaesthetic practice.

  19. Anxiolytics, sedatives and hypnotics

    NARCIS (Netherlands)

    Absalom, Anthony; Adapa, R. M.

    2007-01-01

    Anxiolytics and sedatives are used in current anaesthetic practice for anxiolysis before surgery and as adjuvants during anaesthesia. The safety profile of these agents depends on their pharmacokinetic and pharmacodynamic profiles, patient comorbidity and the experience of the clinician. Sedative dr

  20. Optimizing intravenous drug administration by applying pharmacokinetic/pharmacodynamic concepts

    NARCIS (Netherlands)

    Struys, M. M. R. F.; Sahinovic, M.; Lichtenbelt, B. J.; Vereecke, H. E. M.; Absalom, A. R.

    2011-01-01

    This review discusses the ways in which anaesthetists can optimize anaesthetic-analgesic drug administration by utilizing pharmacokinetic and pharmacodynamic information. We therefore focus on the dose-response relationship and the interactions between i.v. hypnotics and opioids. For i.v. hypnotics

  1. Pharmacological interactions of vasoconstrictors.

    Science.gov (United States)

    Gómez-Moreno, Gerardo; Guardia, Javier; Cutando, Antonio; Calvo-Guirado, José Luis

    2009-01-01

    This article is the first of a series on pharmacological interactions involving medicaments commonly prescribed and/or used in odontology: vasoconstrictors in local anaesthetics and anti-inflammatory and anti-microbial analgesics. The necessity for the odontologist to be aware of adverse reactions as a result of the pharmacological interactions is due to the increase in medicament consumption by the general population. There is a demographic change with greater life expectancy and patients have increased chronic health problems and therefore have increased medicament intake. The presence of adrenaline (epinephrine) and other vasoconstrictors in local odontological anaesthetics is beneficial in relation to the duration and depth of anaesthesia and reduces bleeding and systemic toxicity of the local anaesthetic. However, it might produce pharmacological interactions between the injected vasoconstrictors and the local anaesthetic and adrenergic medicament administered exogenically which the odontologist should be aware of, especially because of the risk of consequent adverse reactions. Therefore the importance of conducting a detailed clinical history of the general state of health and include all medicaments, legal as well as illegal, taken by the patient.

  2. Treacher-Collins Syndrome-A Challenge For Aaesthesiologists

    Directory of Open Access Journals (Sweden)

    Leena Goel

    2009-01-01

    Full Text Available Treacher-Collins syndrome is a rare congenital disease known to be associated with a difficult airway and presents some of the most hazardous and difficult challenges that anaesthetists may encounter within the entire practice of paediatric anesthesia. Successful anaesthetic management in a case of Treacher-Collins syndrome posted for cleft palate repair is presented in this report.

  3. Treacher-Collins Syndrome–A Challenge For Anaesthesiologists

    OpenAIRE

    2009-01-01

    Summary Treacher-Collins syndrome is a rare congenital disease known to be associated with a difficult airway and presents some of the most hazardous and difficult challenges that anaesthetists may encounter within the entire practice of paediatric anesthesia. Successful anaesthetic management in a case of Treacher-Collins syndrome posted for cleft palate repair is presented in this report.

  4. PHARMACODYNAMICS AND PHARMACOKINETICS OF AN INFUSION OF ORG-9487, A NEW SHORT-ACTING STEROIDAL NEUROMUSCULAR BLOCKING-AGENT

    NARCIS (Netherlands)

    VANDENBROEK, L; WIERDA, JMKH; SMEULERS, NJ; PROOST, JH

    1994-01-01

    We have evaluated in 10 anaesthetized patients the time course of action, infusion requirements, reversibility and pharmacokinetics of Org 9487. Org 9487 was administered as a bolus dose of 1.5 mg kg(-1), followed by an infusion to maintain a block of 75-85 % for 60 min. After recovery from the bolu

  5. Urinary, biliary and faecal excretion of rocuronium in humans

    NARCIS (Netherlands)

    Proost, JH; Eriksson, LI; Mirakhur, RK; Wierda, JMKH

    2000-01-01

    The excretion of rocuronium and its potential metabolites was studied in 38 anaesthetized patients, ASA I-III and 21-69 yr old. Rocuronium bromide was administered as an i.v. bolus dose of 0.3 or 0.9 mg kg(-1). in Part A of the study, the excretion into urine and bile, and the liver content were stu

  6. Quality assessment of 26,304 herniorrhaphies in Denmark: a prospective nationwide study

    DEFF Research Database (Denmark)

    Bay-Nielsen, M; Kehlet, H; Strand, L;

    2001-01-01

    BACKGROUND: Groin hernia repair is one of the most frequent operations, but there is no consensus about surgical or anaesthetic technique. Furthermore, no nationwide studies have been done. Our aim was to investigate outcome results of groin hernia surgery to improve quality of treatment. METHODS...

  7. Inhaled analgesia for pain management in labour (Review)

    NARCIS (Netherlands)

    Klomp, T.; Poppel, M. van; Jones, L.; Lazet, J.; Nisio, M. Di; Lagro-Janssen, A.L.M.

    2012-01-01

    BACKGROUND: Many women would like to have a choice in pain relief during labour and also would like to avoid invasive methods of pain management in labour. Inhaled analgesia during labour involves the self-administered inhalation of sub-anaesthetic concentrations of agents while the mother remains a

  8. Presence and function of the calcitonin gene-related peptide receptor on rat pial arteries investigated in vitro and in vivo

    DEFF Research Database (Denmark)

    Petersen, K A; Nilsson, E; Olesen, J;

    2005-01-01

    diameter. Only abluminally applied CGRP induced dilation of the cerebral arteries; E(max) for alphaCGRP and betaCGRP were 35 +/- 0.5% and 10.8 +/- 0.2%. These responses were blocked by CGRP(8-37). The gCCW model allowed videomicroscopic visualization of the pial vessels in anaesthetized rats. Changes...

  9. Patient state index vs bispectral index as measures of the electroencephalographic effects of propofol.

    NARCIS (Netherlands)

    Soehle, M.; Kuech, M.; Grube, M.; Wirz, S.; Kreuer, S.; Hoeft, A.; Bruhn, J.; Ellerkmann, R.K.

    2010-01-01

    BACKGROUND: The patient state index (PSI) and the bispectral index (BIS) quantify anaesthetic depth based on the EEG using different algorithms. We compared both indices with regard to the prediction of the depth of propofol anaesthesia. METHODS: In 17 patients, propofol was infused until burst supp

  10. EFFECTS OF LOCAL NERVE COOLING ON CONDUCTION IN VAGAL FIBERS SHED LIGHT UPON RESPIRATORY REFLEXES IN THE RABBIT

    NARCIS (Netherlands)

    PATBERG, WR; NIJMEIJER, A; VERSPRILLE, A; ZOCK, JP; ZIJLSTRA, WG; Schut, J.K.

    1992-01-01

    In ten vagus nerves the effect of local cooling on the compound action potential was studied in the temperature range of 34 to 0-degrees-C in spontaneously breathing, anaesthetized rabbits. The mean temperature at which the myelinated (A) fibres were completely blocked, was 10.2 +/- 2.4-degrees-C (m

  11. Effects of local nerve cooling on conduction in vagal fibres shed light upon respiratory reflexes in the rabbit

    NARCIS (Netherlands)

    W.R. Patberg (Wiebe); A. Nijmeijer (Arie); J.K. Schut (Jan); A. Versprille (Adrian); J.P. Zock; W.G. Zijlstra

    1992-01-01

    textabstractIn ten vagus nerves the effect of local cooling on the compound action potential was studied in the temperature range of 34 to 0 °C in spontaneously breathing, anaesthetized rabbits. The mean temperature at which the myelinated (A) fibres were completely blocked, was 10.2±2.4 °C (mean ±

  12. Agonist effects at putative central 5-HT4receptors in rat hippocampus by R(+)- and S(-)-zacopride; no evidence for stereo-selectivity

    NARCIS (Netherlands)

    Boddeke, H.W.G.M.; Kalkman, H.O.

    1992-01-01

    The EEG of halothane anaesthetized rats was recorded from an electrode implanted into the hippocampus. In the present study the effect of R(+)- and S(-)-zacopride, administered intra-cerebroventricularly, on different frequency bands of the EEG was investigated. Both enantiomers induced similar dose

  13. Inhibition of centrally-evoked pressor responses by neurohypophyseal peptides and their fragments

    NARCIS (Netherlands)

    Versteeg, C.A.M.; Bohus, B.; Jong, Wybren de

    1982-01-01

    Intracerebroventricular administration of fragments of [arginine8]-vasopressin (AVP) such as AVP1–6 and AVP7–9 attenuated the pressor response evoked by electrical stimulation of the mesencephalic reticular formation in urethane-anaesthetized rats. Oxytocin (OXT) and the fragment OXT7–9 were also ac

  14. Pre-operative testing for pregnancy in Dublin day surgery units.

    LENUS (Irish Health Repository)

    Wong, L F A

    2013-06-01

    The safety of anaesthetic agents in early pregnancy cannot be guaranteed. Certain types of surgery, particularly gynaecological, may also be dangerous. It is therefore important to ensure that, female patients are not inadvertently pregnant when undergoing elective surgery. Different hospitals have different policies and guidelines in place to determine female patients\\' pregnancy status prior to elective surgery.

  15. Tumescent anaesthesia.

    LENUS (Irish Health Repository)

    Conroy, Patrick H

    2013-01-31

    Tumescent anaesthesia describes the practice of injecting a very dilute solution of local anaesthetic combined with epinephrine and sodium bicarbonate into tissue until it becomes firm and tense (tumescent). It was initially described in the field of liposuction but now surgical applications for the technique are widely varied ranging across vascular surgery, breast surgery, plastic surgery and ENT procedures. It is widely used in both hospital- and office-based environments and may form the sole method of anaesthesia for surgery. Advantages include a reduction in blood loss through both epinephrine-induced vasoconstriction as well as hydrostatic compression from the tumescent effect. Sodium bicarbonate reduces pain associated with the injection of an acidic local anaesthetic solution. Due to the unique pharmacokinetic profile of this technique lidocaine doses of 35 mg\\/kg bodyweight have been shown to be safe for liposuction procedures. Tumescent lidocaine is absorbed very slowly from subcutaneous tissues producing lower, and more delayed, peak blood levels compared to other routes, as well as extended postoperative analgesia. Slow systemic absorption allows the rapid hepatic plasma clearance of lidocaine to maintain safe local anaesthetic blood levels. This slow absorption from subcutaneous tissue has been likened to a depot injection. Careful attention must be given to appropriate local anaesthetic dosage alterations in cases of co-administration with agents affecting hepatic drug clearance or conditions reducing liver blood supply. Adherence to these pharmacological principles has produced an exemplary safety record for this technique to date.

  16. Non-diabetic atypical necrobiosis lipoidica

    Directory of Open Access Journals (Sweden)

    Mittal R

    1994-01-01

    Full Text Available One 8 year female child had asymptomatic, anaesthetic, hypohidrotic, atrophic, yellowish, waxy plaque on the front of left thigh since 2 months. No nerve thickening was observed clinically or histopathologically. Hyperkeratosis, follicular keratosis, epidermal atrophy, degeneration of collagen, mononuclear granulomas and perivascular mononuclear infiltrate confirmed the clinical diagnosis of atypical necrobiosis lipoidica.

  17. ROCURONIUM-INDUCED AND MIVACURIUM-INDUCED NEUROMUSCULAR BLOCK AND INTUBATING CONDITIONS - A COMPARISON WITH VECURONIUM

    NARCIS (Netherlands)

    VANDENBROEK, L; HOMMES, FDM; NAP, HJA; WIERDA, JMKH

    1995-01-01

    The time-course of action after an initial 2 x ED(90) dose and after maintenance doses of 0.5 x ED(90), and intubating conditions at 90 s after a 2 x ED(90) dose following rocuronium, vecuronium and mivacurium were evaluated in anaesthetized adult patients. Neuromuscular measurements were performed

  18. Stabilization and stability of twitch force during mechanomyography of the adductor pollicis muscle

    NARCIS (Netherlands)

    van Santen, G; Fidler, [No Value; Wierda, JMKH

    1998-01-01

    Objective. In order to study the stabilization time, the increase in twitch force during stabilization and the maintenance of stability during mechanomyography of the adductor pollicis muscle, neuromuscular function was monitored in 20 patients anaesthetized without the use of a neuromuscular blocki

  19. Cranial circulatory effects of antimigraine drugs: an experimental study in the pig

    NARCIS (Netherlands)

    M.O. den Boer (Marinus)

    1993-01-01

    textabstractThis thesis is main! y concerned with an investigation in anaesthetized pigs of the vascular effects of sumatriptan, ergotamine and dihydroergotamine, drugs used in the treatment of the acute migraine attack. There are several reasons for performing this investigation. Firstly, a disturb

  20. Takotsubo cardiomyopathy with severe bradyarrhythmia following epidural insertion

    Science.gov (United States)

    Gamble, David T; Shuttleworth, Kara J; Scally, Caroline; Leslie, Stephen J

    2016-01-01

    We present a case of takotsubo cardiomyopathy (TTC) with ventricular stand still and atrioventricular block. TTC can mimic ST elevation myocardial infarction and heart failure, but in this case resulted in a severe cardiac conduction disorder and ventricular standstill. This is a recognised but unusual presentation and serves as a lesson to those undertaking anaesthetics to be vigilant for TTC. PMID:27797840

  1. Lejringsskader hos rygopererede patienter

    DEFF Research Database (Denmark)

    Sestoft, Bodil; Larsen, Birgit; Erlandsen, Mogens;

    2009-01-01

    INTRODUCTION: The aim of this study was to answer the questions: Which kind of positioning injuries occurred in anaesthetized orthopaedic patients undergoing spine surgery who were prone-positioned for more than two hours? What was the incidence of positioning injuries? Which patients were at par...

  2. Neurodevelopmental outcome at 2 years of age after general anaesthesia and awake-regional anaesthesia in infancy (GAS): an international multicentre, randomised controlled trial

    NARCIS (Netherlands)

    Davidson, Andrew J; Disma, Nicola; De Graaff, Jurgen C; Withington, Davinia E; Dorris, Liam; Bell, Graham; Stargatt, Robyn; Bellinger, David C; Schuster, Tibor; Arnup, Sarah J; Hardy, Pollyanna; Hunt, Rodney W; Takagi, Michael J; Giribaldi, Gaia; Hartmann, Penelope L; Salvo, Ida; Morton, Neil S; Von Ungern Sternberg, Britta S; Locatelli, Bruno Guido; Wilton, Niall; Lynn, Anne; Thomas, Joss J; Polaner, David; Bagshaw, Oliver; Szmuk, Peter; Absalom, Anthony R; Frawley, Geoff; Berde, Charles; Ormond, Gillian D; Marmor, Jacki; Mccann, Mary Ellen

    2016-01-01

    Background Preclinical data suggest that general anaesthetics affect brain development. There is mixed evidence from cohort studies that young children exposed to anaesthesia can have an increased risk of poor neurodevelopmental outcome. We aimed to establish whether general anaesthesia in infancy h

  3. Neurodevelopmental outcome at 2 years of age after general anaesthesia and awake-regional anaesthesia in infancy (GAS) : an international multicentre, randomised controlled trial

    NARCIS (Netherlands)

    Davidson, Andrew J; Disma, Nicola; de Graaff, Jurgen C; Withington, Davinia E; Dorris, Liam; Bell, Graham; Stargatt, Robyn; Bellinger, David C; Schuster, Tibor; Arnup, Sarah J; Hardy, Pollyanna; Hunt, Rodney W; Takagi, Michael J; Giribaldi, Gaia; Hartmann, Penelope L; Salvo, Ida; Morton, Neil S; von Ungern Sternberg, Britta S; Locatelli, Bruno Guido; Wilton, Niall; Lynn, Anne; Thomas, Joss J; Polaner, David; Bagshaw, Oliver; Szmuk, Peter; Absalom, Anthony R; Frawley, Geoff; Berde, Charles; Ormond, Gillian D; Marmor, Jacki; McCann, Mary Ellen

    2016-01-01

    BACKGROUND: Preclinical data suggest that general anaesthetics affect brain development. There is mixed evidence from cohort studies that young children exposed to anaesthesia can have an increased risk of poor neurodevelopmental outcome. We aimed to establish whether general anaesthesia in infancy

  4. Bilateral brachial plexus blocks in a patient of hypertrophic obstructive cardiomyopathy with hypertensive crisis

    Directory of Open Access Journals (Sweden)

    Rohini V Bhat Pai

    2013-01-01

    Full Text Available Hypertrophic obstructive cardiomyopathy (HOCM is a challenge to anesthesiologists due to the complex pathophysiology involved and various perioperative complications associated with it. We present a 50-year-old man, a known case of HOCM, who successfully underwent emergency haemostasis, and debridement of the traumatically amputated right upper limb and the contused lacerated wound on the left forearm under bilateral brachial plexus blocks. His co-morbidities included hypertension (in hypertensive crisis and diabetes mellitus. He was full stomach and also had an anticipated difficult airway. The management included invasive pressure monitoring and labetalol infusion for emergent control of blood pressure. The regional anaesthesia technique required careful consideration to the dosage of local anaesthetics and staggered performance of brachial plexus blocks on each of the upper limbs to avoid local anaesthetic toxicity. Even though bilateral brachial plexus blocks are rarely indicated, it seemed to be the most appropriate anaesthetic technique in our patient. With careful consideration of the local anaesthetic toxicity and meticulous technique, bilateral brachial plexus blocks can be successfully performed in those patients where general anaesthesia is deemed to be associated with higher risk.

  5. The Human Performance Evaluation Process: A Resource for Reviewing the Identification and Resolution of Human Performance Problems

    Science.gov (United States)

    2002-03-01

    steadiness and manual dexterity, and reduces eye-hand coordination. 8.1.1.2 Stimulants Drugs that are stimulants include caffeine, cocaine and...decline. At higher doses of indoles, the user may experience euphoria , fear, hostility and confusion. Anaesthetics cause confusion, distorted spatial... Mechanical maintenance personnel 7. Radiological protection technician 8. Chemistry technician 9. Engineering support personnel These training

  6. Haemophilus influenzae induces a potentiated increase in guinea-pig pulmonary resistance to histamine

    NARCIS (Netherlands)

    Folkerts, G.; Nijkamp, F.P.

    1985-01-01

    The human respiratory pathogen Haemophilus influenzae (H.i.) induced bronchial hyperreactivity to histamine (1.0–8.0 μg/100 g b.w. i.v.) in vivo in anaesthetized spontaneously breathing guinea-pigs. This hyperreactivity was caused by a potentiated increase in pulmonary resistance. Decreases in dynam

  7. Analgesic efficacy of intracapsular and intra-articular local anaesthesia for knee arthroplasty

    DEFF Research Database (Denmark)

    Andersen, L Ø; Husted, H; Kristensen, B B;

    2010-01-01

    The optimal site for wound delivery of local anaesthetic after total knee arthroplasty is undetermined. Sixty patients having total knee arthroplasty received intra-operative infiltration analgesia with ropivacaine 0.2% and were then were randomly assigned to receive either intracapsular or intra...

  8. Anaesthesia For Caesarean Section of Single Umbilical Artery and Herpes Simplex Virus Type 1 Ig M Positive Obstetric Patient

    OpenAIRE

    Gülhaş, Nurçin; Toğal, Türkan; Demirbilek, Semra; Köroğlu, Ahmet; YÜCEL, Aytaç; Ersoy, M. Özcan

    2003-01-01

    Single umbilical artery is associated with multiple organ malformations, fetoplacental insufficiency and intrauterine fetal growth retardation. During anaesthesia severe hypotension can cause decrease of uteroplacental blood flow and fetal distress. Herpes Simplex (HSV) infection is activated by exogeneous factors such as sunlight, wind, trauma and fever or endogenous physcological factors such as stress especially in immune deficiency. The choice of anaesthetic technique for ...

  9. An unusual delayed complication of inferior alveolar nerve block.

    Science.gov (United States)

    Smyth, Joanna; Marley, John

    2010-01-01

    Systemic and localised complications after administration of local anaesthetic for dental procedures are well recognised. We present two cases of patients with trismus and sensory deficit that arose during resolution of trismus as a delayed complication of inferior alveolar nerve block.

  10. Renal cortical and medullary blood flow during modest saline loading in humans

    DEFF Research Database (Denmark)

    Damkjær, M; Vafaee, M; Braad, P E;

    2012-01-01

    Renal medullary blood flow (RMBF) is considered an important element of sodium homeostasis, but the experimental evidence is incongruent. Studies in anaesthetized animals generally support the concept in contrast to measurements in conscious animals. We hypothesized that saline-induced natriuresis...

  11. Pain perception and anaesthesia in research frogs.

    Science.gov (United States)

    Guénette, Sarah Annie; Giroux, Marie-Chantal; Vachon, Pascal

    2013-01-01

    Frogs possess pain receptors and pathways that support processing and perception of noxious stimuli however the level of organization is less well structured compared to mammals. It was long believed that the experience of pain was limited to 'higher' phylums of the animal kingdom. However, it is now commonly accepted that amphibians possess neuro-anatomical pathways conductive of a complete nociceptive experience. Xenopus laevis frogs have been one of the most popular aquatic research models for developmental studies and genetic research. These frogs have been extensively use in research for their eggs, that can be collected following hormonal stimulation either naturally or by surgical intervention. Many anaesthetics have been used in amphibians such as bath solutions of MS-222, benzocaine and eugenol as well as systemic injections of ketamine or tiletamine, barbiturates, propofol and gas administrations of methoxyflurane, halothane and isoflurane. Most of these anaesthetic drugs produce variability in depth and duration of anaesthesia. MS-222 appears to be one of the most reliable anaesthetics. This review will focus on the evidence of pain perception in frogs and will compare the effectiveness and limitations of different anaesthetics used in Xenopus leavis frogs.

  12. Intravenous lidocaine infusion reduces bispectral index-guided requirements of propofol only during surgical stimulation(dagger)

    NARCIS (Netherlands)

    Hans, G. A.; Lauwick, S. M.; Kaba, A.; Bonhomme, V.; Struys, M. M. R. F.; Hans, P. C.; Lamy, M. L.; Joris, J. L.

    2010-01-01

    I.V. lidocaine reduces volatile anaesthetics requirements during surgery. We hypothesized that lidocaine would also reduce propofol requirements during i.v. anaesthesia. A randomized controlled study of 40 patients tested the effect of i.v. lidocaine (1.5 mg kg(-1) then 2 mg kg(-1) h(-1)) on propofo

  13. FUSIMOTOR EFFECTS OF MIDBRAIN STIMULATION ON JAW MUSCLE-SPINDLES OF THE ANESTHETIZED CAT

    NARCIS (Netherlands)

    TAYLOR, A; JUCH, PJW

    1993-01-01

    The effects of electrical stimulation within the midbrain on fusimotor output to the jaw elevator muscles were studied in anaesthetized cats. Muscle spindle afferents recorded in the mesencephalic trigeminal nucleus were categorised as primary or secondary by their responses to succinylcholine durin

  14. Generelle anæstetikas potentielle neurotoksicitet for den immature hjerne

    DEFF Research Database (Denmark)

    Clausen, Nicola G; Venø, Søren; Astvad, Mads;

    2014-01-01

    Animal studies (including non-human primates) have shown that most general anaesthetics cause enhanced neuroapoptosis with subsequent long-term neurocognitive deficits later in life. Some human cohort studies have indicated an association between anaesthesia/surgery and adverse neurocognitive...

  15. Prevention of postoperative pain by balanced analgesia

    DEFF Research Database (Denmark)

    Dahl, J B; Rosenberg, J; Dirkes, W E;

    1990-01-01

    Fourteen patients undergoing colorectal surgery received an intraoperative afferent neural block with combined intrathecal and extradural local anaesthetics plus a balanced postoperative low-dose regimen of extradural bupivacaine 10 mg h-1-morphine 0.2 mg h-1 and systemic piroxicam 20 mg/24 h...

  16. Epidural anaesthesia with levobupivacaine and ropivacaine : effects of age on the pharmacokinetics, neural blockade and haemodynamics

    NARCIS (Netherlands)

    Simon, Mischa J.G.

    2006-01-01

    Epidural neural blockade results from processes after the administration of a local anaesthetic in the epidural space until the uptake in neural tissue. The pharmacokinetics, neural blockade and haemodynamics after epidural anaesthesia may be influenced by several factors, with age as the most impor

  17. Pharmacokinetics and clinical efficacy of long-term epidural ropivacaine infusion in children

    DEFF Research Database (Denmark)

    Hansen, Tom Giedsing; Ilett, K F; Lim, S I;

    2000-01-01

    The clinical efficacy and pharmacokinetics of long-term epidural ropivacaine infusion were investigated in 18 postoperative children aged between 0.3 and 7.3 yr. A lumbar or thoracic epidural catheter was inserted after the anaesthetic induction. Sixty minutes following a bolus dose of ropivacaine...

  18. Depth of the thoracic epidural space in children.

    NARCIS (Netherlands)

    Masir, F.; Driessen, J.J.; Thies, K.C.; Wijnen, M.H.W.A.; Egmond, J. van

    2006-01-01

    Thoracic epidural anaesthesia in anaesthetized children requires a meticulous technique and may have an increased success rate when the distance between skin and epidural space is known. The objective of this observational study was to measure the skin to epidural distance (SED) during thoracic epid

  19. Intravenous lipid emulsion as antidote: a summary of published human experience.

    Science.gov (United States)

    Cave, Grant; Harvey, Martyn; Graudins, Andis

    2011-04-01

    Intravenous lipid emulsion (ILE) has been demonstrated to be effective in amelioration of cardiovascular and central nervous system sequelae of local-anaesthetic and non-local-anaesthetic drug toxicity in animal models. Sequestration of lipophilic toxins to an expanded plasma lipid phase is credited as the predominant beneficial mechanism of action of ILE. Systematic review of published human experience is however lacking. We determined to report a comprehensive literature search of all human reports of ILE application in drug poisoning. Forty-two cases of ILE use (19 local-anaesthetic, 23 non-local-anaesthetic) were identified, with anecdotal reports of successful resuscitation from cardiovascular collapse and central nervous system depression associated with ILE administration in lipophilic toxin overdose. Although significant heterogeneity was observed in both agents of intoxication, and reported outcomes; case report data suggest a possible benefit of ILE in potentially life-threatening cardio-toxicity from bupivacaine, mepivacaine, ropivacaine, haloperidol, tricyclic antidepressants, lipophilic beta blockers and calcium channel blockers. Further controlled study and systematic evaluation of human cases is required to define the clinical role of ILE in acute poisonings.

  20. Transversus Abdominis Plane Block for Surgical Anaesthesia at Multiple Sites-Not Ideal

    Directory of Open Access Journals (Sweden)

    Vasanth RaoKadam

    2015-06-01

    Full Text Available Ultrasound (US guided Transversus abdominis plane (TAP block is commonly used for postoperative analgesia and there are case reports of its use for providing surgical anaesthesia in emergency procedures. We report its use as a regional anaesthetic technique in inguinal hernia and epigastric hernia repair in an elective setting and discuss issues during the intra and postoperative period.