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Sample records for local anaesthetics procaine

  1. Periodic Classification of Local Anaesthetics (Procaine Analogues

    Directory of Open Access Journals (Sweden)

    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.

  2. Local anaesthetic toxicity

    African Journals Online (AJOL)

    Local anaesthetic toxicity has been known since the introduction of local anaesthetic drugs into anaesthetic practice more than a hundred ... was the first to think of cocaine as a narcotic. ..... anaesthetics act as Na+ channel-blocking agents, they slow down .... all neurons, leading to global CNS depression, slowing and.

  3. Extended release formulations for local anaesthetic agents.

    Science.gov (United States)

    Weiniger, C F; Golovanevski, L; Domb, A J; Ickowicz, D

    2012-08-01

    Systemic toxicity through overdose of local anaesthetic agents is a real concern. By encapsulating local anaesthetics in biodegradable carriers to produce a system for prolonged release, their duration of action can be extended. This encapsulation should also improve the safety profile of the local anaesthetic as it is released at a slower rate. Work with naturally occurring local anaestheticss has also shown promise in the area of reducing systemic and neurotoxicity. Extended duration local anaesthetic formulations in current development or clinical use include liposomes, hydrophobic based polymer particles such as Poly(lactic-co-glycolic acid) microspheres, pasty injectable and solid polymers like Poly(sebacic-co-ricinoleic acid) P(SA:RA) and their combination with synthetic and natural local anaesthetic. Their duration of action, rationale and limitations are reviewed. Direct comparison of the different agents is limited by their chemical properties, the drug doses encapsulated and the details of in vivo models described. Anaesthesia © 2012 The Association of Anaesthetists of Great Britain and Ireland.

  4. 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.

  5. Accidental deposition of local anaesthetic in the subdural space ...

    African Journals Online (AJOL)

    The incidence of accidental injection of local anaesthetic into the subdural space during neuraxial blockade is rare. The presentation of unexplainable clinical signs that do not match the clinical picture of subarachnoid or intravascular injection of the local anaesthetic agent should invoke high suspicion of unintentional ...

  6. 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...

  7. Local anaesthetics: Characteris tics, uses and toxicities

    African Journals Online (AJOL)

    LA in the body plasma, the more toxic it is. ... pain relief. As always, good judgement is necessary – an insulin- ... postgraduate anaesthetic specialisation training in Bloemfontein. ... at 3 - 5-minute intervals; then (or sooner ... Then, attach the fat.

  8. Local anaesthetics: Characteris tics, uses and toxicities | Du Plessis ...

    African Journals Online (AJOL)

    Surgeons currently perform more and larger procedures in an ambulatory setting. Local anaesthesia is an important aspect of office-based surgery. Local anaesthetics (LAs) vary in their pharmacological properties and are used in various techniques of local anaesthesia administration, i.e. topical, infiltrative, epidural, spinal, ...

  9. Local anaesthetic medication for the treatment of asthma

    Directory of Open Access Journals (Sweden)

    Rodrigo A Siqueira

    2005-03-01

    Full Text Available It is presumed that drugs able to prevent bronchial spasm and/or inflammation may have therapeutic potential to control asthma symptoms. The local anaesthetic lidocaine has recently received increased attention as an alternative form of treatment for asthmatic patients. This paper reviews the major findings on the topic and summarizes the putative mechanisms underlying the airway effects of local anaesthetic agents. We think that lidocaine extends the spectrum of options in asthma therapy, probably by counteracting both spasmogenic and inflammatory stimuli in the bronchial airways. The possibility of development of new anti-asthma compounds based on the synthesis of lidocaine derivatives is also on the horizon.

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Penicillin G Procaine Injection

    Science.gov (United States)

    Penicillin G procaine injection is used to treat certain infections caused by bacteria. Penicillin G procaine injection should not be used to ... early in the treatment of certain serious infections. Penicillin G procaine injection is in a class of ...

  12. IgE-mediated reaction to local anaesthetics

    International Nuclear Information System (INIS)

    Kartal, O.; Gulec, M.; Sener, O.; Caliskaner, A.Z.

    2013-01-01

    Local anaesthetics (LAs) are essential agents in daily practices of dentistry, minor surgery and dermatology. Although they have an impressive history of safety and efficacy, LAs also have the potential to produce adverse events, which are mainly of non-immune nature. The true IgE-mediated allergies are quite rare, but are more considerable in terms of ability to cause life-threatening outcomes. In this report, we present a case of IgE-mediated systemic reaction to LAs occurring during epidural anaesthesia for Cesarean section. (author)

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

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    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.

  14. 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

    significant reduction in post-operative, supplemental opioid consumption that was, however, of limited clinical relevance. CONCLUSION: Wound infiltration with local anaesthetics may have a modest analgesic effect in the first few hours after surgery. Pain after breast surgery is, however, generally mild......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...

  15. Evaluation of dressings used with local anaesthetic cream and for peripheral venous cannulation.

    Science.gov (United States)

    Needham, Rowan; Strehle, Eugen-Matthias

    2008-10-01

    To compare four polyurethane dressings manufactured by two different companies for use in children. Seventy-eight dressings were applied to secure either local anaesthetic creams (n = 62) or intravenous cannulae (n = 16). Each dressing was evaluated for ease of application, security and ease of removal, using a simple scoring system. 84 per cent of Opsite flexigrid and 90 per cent of Tegaderm local anaesthetic cream dressings were rated as easy or very easy to apply. Opsite flexigrid was felt to be more secure, whereas Tegaderm was easier to remove. The Tegaderm cannula dressing was easier to apply than the iv3000 dressing. There was little difference between the two brands, including costs.

  16. 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.

  17. Isolation of HIV-1 from experimentally contaminated multidose local anaesthetic vials.

    Science.gov (United States)

    Druce, J D; Locarnini, S A; Birch, C J

    1995-05-15

    To investigate the hypothesis that HIV can be transmitted via contamination of multidose vials of local anaesthetic solution through reuse of needles and syringes. Laboratory study. (1) By experiments with multidose vials and disposable needles and syringes, we identified a sequence of events in which HIV could contaminate the anaesthetic solution. (2) Three anaesthetic solutions were contaminated with a laboratory strain of HIV and tested by viral culture and p24 enzyme immunoassay one, two and four hours later to see how long the virus remained active. (1) Needles and syringes retained small volumes of fluid after use (mean, 25 microL; in syringe alone, mean 16 microL) which could be transferred to multidose vials of local anaesthetic. (2) 10 mL of anaesthetic solution contaminated with 8 microL of HIV-infected solution (equivalent to 1% infected lymphocytes in vivo) contained active virus one hour later. In some settings, HIV could be isolated four hours after exposure. When inadvertently contaminated with HIV, multidose solutions represent a potential source of transmissible virus.

  18. Differential effect of procaine on irradiated mammalian cells in culture

    International Nuclear Information System (INIS)

    Djordjevic, B.

    1979-01-01

    HeLa and V-79 Chinese hamster cells temporarily stored in ampoules were treated with the local anesthetic procaine. Postirradiation treatment increased lethality in HeLa cells depending on drug concentration, duration of treatment, and cell density, as measured by colony-forming ability upon plating. If present during irradiation only, procaine protected from irradiation. In V-79 cells, procaine potentiated radiation lethality only in freshly trypsinized cells. Procaine effect was thus cell type specific and most likely involved the cell membrane

  19. Impact of local anaesthetics and needle calibres used for painless PRP injections on platelet functionality.

    Science.gov (United States)

    Bausset, Olivier; Magalon, Jeremy; Giraudo, Laurent; Louis, Marie-Laure; Serratrice, Nicolas; Frere, Corrine; Magalon, Guy; Dignat-George, Françoise; Sabatier, Florence

    2014-01-01

    The platelet-rich plasma (PRP) is an autologous biotherapy commonly used for its healing properties. Once activated, platelets released a real "cocktail" of growth factor and cytokines implied in numerous regenerative processes. However the impact of medical practices associated to PRP therapeutic use on platelets functionality remains poorly known. we evaluated the in vitro effects of two commonly used local anesthetics (Xylocaine(*) and Naropin(*)) on PRP functionality. We also investigated the quantity and quality of PRP that passed through the smallest gauge needle commercialized. PRP from 9 healthy volunteers were prepared using our previously described home made purification protocol. Platelet aggregation capacity was evaluated by aggregometry assays and the growth factor release was determined by ELISA after platelet activation. We also evaluated the platelet activation status, reactivity and stability of platelets by flow cytometry using the P-selectin expression marker. the association of local anaesthetics with PRP injections resulted in a significant decrease of platelets functionality, assessed by their capacity of aggregating. Local anaesthetics did not interfere with the growth factor release. The different needle sizes and calibres tested for PRP injections did not influence the platelet functionality. the use of local anaesthetics to prevent pain during PRP injections could compromise the therapeutic potential of PRP. These results suggest using carefully local anaesthetics or limiting their use as often is possible. To minimize injection pain, we recommend using 30 G needles. These data will lead to clinical recommendations for painless and controlled PRP injections.

  20. Method development for the enantiomeric purity determination of low concentrations of adrenaline in local anaesthetic solutions by capillary electrophoresis

    NARCIS (Netherlands)

    Sänger-Van De Griend, Cari E.; Ek, Anders G.; Widahl-Näsman, Monica E.; Andersson, E. K Margareta

    2006-01-01

    L-Adrenaline is often included in local anaesthetic (LA) solutions for injection to improve the quality of the anaesthetic block. The concentration of the LA is between 2.5 and 20 mg/ml and the concentration of adrenaline is typically ≤0.1% of the LA concentration. In order to follow the

  1. A PROSPECTIVE STUDY ON LOCAL ANAESTHETIC INFILTRATION FOR POSTOPERATIVE PAIN RELIEF AFTER LAPAROSCOPY

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    Peter Manoharan Chellapa

    2017-05-01

    Full Text Available BACKGROUND Laparoscopic surgery is a modern surgical technique in which operations are performed through small incisions and with the aid of a camera. Pain is the most common complaint following any surgery, but as compared to open surgery, the severity of pain is much lower in patients undergoing surgery via laparoscopy. The pain following laparoscopic procedure can be divided into three components- parietal pain, visceral pain and shoulder pain. The use of local long-acting anaesthetics reduces postoperative parietal pain. In this study, we tested the hypothesis that local anaesthetics instilled at the end of laparoscopic procedure are able to prevent postoperative pain during the first 24 hours post-surgery. The outcome measures were pain scores, analgesic consumption and time to analgesic request. MATERIALS AND METHODS This was a prospective study conducted by the surgical department, Pondicherry Institute of Medical Sciences for a period of 13 months. The study comprised of 50 patients with an ASA I or II who underwent laparoscopic procedures between April 2016 to May 2017. Patients in this study were randomly categorised equally into two groups; in the study group (Group A patients received local anaesthetic infiltration with bupivacaine, while in the control group (Group B, patients did not receive local anaesthetic infiltration. Following history taking and physical examination, patients were subjected to routine laboratory investigations and ultrasonogram. Contrast-enhanced computerised tomography was done in patients when indicated and following which patients diagnosed with acute appendicitis or who had symptomatic cholelithiasis were taken up for laparoscopic surgery. In the study group, local anaesthetic was instilled at the end of surgery after port removal. The total volume of infiltrated solution in the study group was 10 mL divided proportionally according to the length of the skin incisions (3 mL for 10 mm incisions and 2 m

  2. 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

  3. 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

    was reduced in both groups with ropivacaine administration 24 h postoperatively (p time intervals. No reduction in pain scores was observed with ropivacaine injection 6 h postoperatively. The median (IQR [range]) dose of oxycodone administered......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...

  4. Evaluation of local anaesthetic efficacy of the crude extract of ...

    African Journals Online (AJOL)

    ADEYEYE

    Assessment of pain induced by castration in piglets: behavioural and physiologic responses over the subsequent five days. Applied Animal Behaviour Science, 82: 201-. 218. Horn T, Marx G & Borell E (1999). Behaviours of piglets during castration with and without local anaesthesia. Deutsche Tierarztliche. Wochenschrift ...

  5. Local anaesthetic refinement of pentobarbital euthanasia reduces abdominal writhing without affecting immunohistochemical endpoints in rats.

    Science.gov (United States)

    Khoo, Shaun Y-S; Lay, Belinda P P; Joya, Josephine; McNally, Gavan P

    2018-04-01

    Sodium pentobarbital is a commonly used agent for euthanizing laboratory rats, however its high pH can cause abdominal discomfort after intraperitoneal injection. Previous studies suggest that the addition of a local anaesthetic may alleviate this discomfort, but the practice has not been widely adopted. We examined the effect of combining lidocaine with pentobarbital on abdominal writhing, defecation, ultrasonic vocalizations, the rat grimace scale and immunohistochemical staining for c-Fos in the nucleus accumbens and basolateral amygdala of the brain. We also compared the amount of abdominal writhing following intraperitoneal administration of pentobarbital-lidocaine with that of pentobarbital-bupivacaine. Our results show that lidocaine reduces abdominal writhing and defecation without affecting immunohistochemistry for c-Fos or latency to loss of posture. However, scores on the rat grimace scale were low in both situations and almost no ultrasonic vocalizations were recorded. Additionally, we found that the amount of abdominal writhing was not significantly different when bupivacaine was used rather than lidocaine. Our results suggest that pentobarbital-induced euthanasia can be refined with the addition of lidocaine or other local anaesthetics.

  6. 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.

  7. Optimal Solubility of Diclofenac β-Cyclodextrin in Combination with Local Anaesthetics for Mesotherapy Applications.

    Science.gov (United States)

    Tringali, Giuseppe; Navarra, Pierluigi

    2017-01-01

    Because of low injection volume, the recently marketed injectable solution of diclofenac in complex with β -cyclodextrin (Akis®, IBSA Farmaceutici Italia) is an ideal candidate for mesotherapy applications. In this study, we investigated the solubility of Akis, 25 and 50 mg/kg, in combination with various local anaesthetics (lidocaine, mepivacaine, bupivacaine, levobupivacaine, and ropivacaine) at different concentrations in aqueous vehicles (normal saline, sterile water, or bicarbonate). Final injection mixtures were classified as limpid, turbid, or milky at visual analysis under standardized conditions. We found that (i) the use of sterile water for injections or normal saline as vehicles to dilute Akis in combination with whatever local anaesthetic normally results in milky solutions and therefore is not recommended; (ii) using bicarbonate, optimal solubility was obtained combining Akis with lidocaine, both 1 and 2%, or mepivacaine, both 1 and 2%, whereas solutions were turbid in combination with bupivacaine, levobupivacaine, or ropivacaine. Thus, we recommend that Akis is used in combination with lidocaine or mepivacaine in a bicarbonate vehicle.

  8. Optimal Solubility of Diclofenac β-Cyclodextrin in Combination with Local Anaesthetics for Mesotherapy Applications

    Directory of Open Access Journals (Sweden)

    Giuseppe Tringali

    2017-01-01

    Full Text Available Because of low injection volume, the recently marketed injectable solution of diclofenac in complex with β-cyclodextrin (Akis®, IBSA Farmaceutici Italia is an ideal candidate for mesotherapy applications. In this study, we investigated the solubility of Akis, 25 and 50 mg/kg, in combination with various local anaesthetics (lidocaine, mepivacaine, bupivacaine, levobupivacaine, and ropivacaine at different concentrations in aqueous vehicles (normal saline, sterile water, or bicarbonate. Final injection mixtures were classified as limpid, turbid, or milky at visual analysis under standardized conditions. We found that (i the use of sterile water for injections or normal saline as vehicles to dilute Akis in combination with whatever local anaesthetic normally results in milky solutions and therefore is not recommended; (ii using bicarbonate, optimal solubility was obtained combining Akis with lidocaine, both 1 and 2%, or mepivacaine, both 1 and 2%, whereas solutions were turbid in combination with bupivacaine, levobupivacaine, or ropivacaine. Thus, we recommend that Akis is used in combination with lidocaine or mepivacaine in a bicarbonate vehicle.

  9. 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

    (bupivacaine, prilocaine, procaine, levobupivacaine, ropivacaine, and 2-chloroprocaine) was 7.31 (95% confidence interval (CI) 4.16 to 12.86). Mepivacaine was found to give similar results as lidocaine and was therefor omitted from the overall comparison to diminish the heterogeneity. AUTHORS' CONCLUSIONS...

  10. Radiation killing of E. coli K1060: role of membrane fluidity, hypothermia and local anaesthetics

    International Nuclear Information System (INIS)

    Yatvin, M.B.; Schmitz, B.J.; Dennis, W.H.

    1980-01-01

    The enhancement of killing by γ irradiation, which is seen when E. coliK1060 are cooled below the transition temperature of their membrane lipids, is blocked by procaine-HCl. These data are consistent with the hypothesis that increased killing associated with irradiation at 0 0 C is the result of membrane microviscosity increases, since procaine is known to fluidize membranes. A cooling enhancement ratio (c.e.r.) is defined as the ratio of radiation D 0 at 22 0 C to its value at 0 0 C. The c.e.r. for oxygen-bubbled cells is 1.5 and for nitrogen-bubbled cells is 2.1. In the presence of 25mM procaine the respective c.e.r. values are 1.08 and 1.29. The oxygen enhancement ratio (o.e.r.) at 22 0 C is 3.43 and at 0 0 C is 2.45. The addition of procaine does not change the o.e.r. Thus, the temperature effect on o.e.r. does not appear to be related to membrane fluidity. (author)

  11. No cases of perioperative allergy to local anaesthetics in the Danish Anaesthesia Allergy Centre

    DEFF Research Database (Denmark)

    Kvisselgaard, A D; Krøigaard, M; Mosbech, H F

    2017-01-01

    BACKGROUND: Local anaesthetics (LA) are often suspected as possible causes of allergic reactions. The Danish Anaesthesia Allergy Centre (DAAC) is the national reference centre for investigation of perioperative allergic reactions. The purpose of this study was to investigate the incidence of Ig......E-mediated immediate type perioperative allergic reactions to LA. METHODS: In the period 2004-2013, a total of 409 patients (244 women/165 men; median age 49 years, range 1-86 years) were investigated in DAAC on suspicion of allergy associated with anaesthesia and surgery. A total of 162 (40%) patients were exposed...... were carried out on 162 patients (89 women/73 men; mean age 49 years, range 2-85 years) with the following drugs: Lidocaine n = 80 (49%), bupivacaine n = 82 (51%), ropivacaine n = 31 (19%) and mepivacaine n = 10 (6%). All 162 patients had negative subcutaneous provocation for all tested LA (95% CI: 0...

  12. Molecular and kinetic determinants of local anaesthetic action on sodium channels.

    Science.gov (United States)

    French, R J; Zamponi, G W; Sierralta, I E

    1998-11-23

    (1) Local anaesthetics (LA) rely for their clinical actions on state-dependent inhibition of voltage-dependent sodium channels. (2) Single, batrachoxin-modified sodium channels in planar lipid bilayers allow direct observation of drug-channel interactions. Two modes of inhibition of single-channel current are observed: fast block of the open channels and prolongation of a long-lived closed state, some of whose properties resemble those of the inactivated state of unmodified channels. (3) Analogues of different parts of the LA molecule separately mimic each blocking mode: amines--fast block, and water-soluble aromatics--closed state prolongation. (4) Interaction between a mu-conotoxin derivative and diethylammonium indicate an intrapore site of fast, open-state block. (5) Site-directed mutagenesis studies suggest that hydrophobic residues in transmembrane segment 6 of repeat domain 4 of sodium channels are critical for both LA binding and stabilization of the inactivated state.

  13. Validation of a capillary electrophoresis method for the enantiomeric purity testing of ropivacaine, a new local anaesthetic compound

    NARCIS (Netherlands)

    Sänger-Van De Griend, C. E.; Gröningsson, K.

    A capillary electrophoresis method for the determination of the enantiomeric purity of ropivacaine, a new local anaesthetic compound developed by Astra Pain Control AB, has been validated. The method showed the required limit of quantitation of 0.1%, enantiomeric impurity and proved to be robust.

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

    Science.gov (United States)

    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 delayed-rectifier K+ current by shifting its steady-state activation characteristic and the voltage-dependence of the activation time constant to more negative potentials by 10–20 mV.Detailed analysis has revealed that bupivacaine also increased the maximum delayed-rectifier K+ conductance by changing the open probability, rather than the unitary conductance, of the channel.It is concluded that local anaesthetics show a dual effect on delayed-rectifier K+ currents by potentiating them at low concentrations and partially suppressing at high concentrations. The phenomenon observed demonstrated the complex action of local anaesthetics during spinal and epidural anaesthesia, which is not restricted to a suppression of Na+ conductance only. PMID:12055132

  15. 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.

  16. Anaesthesia in Dental Medicine with Local Infiltrative Anaesthetic Technique Versus Diploe Anaesthesia Delivery Systems: Efficacy and Behaviour, an Experimental Study

    OpenAIRE

    Manuel Marques-Ferreira; Eunice Carrilho; Siri Paulo; Teresa Carrilho; José Pedro Figueiredo; Ricardo Macedo

    2017-01-01

    Introduction: This study aimed to compare the analgesic efficacy and the influence of local infiltrative anesthesia techniques, with diploe anesthesia, on the cardiac rhythm Material and Methods: We selected 32 healthy volunteers who were given both anaesthetic techniques on tooth 1.4 (0.45 mL of lidocaine with adrenaline, 1:80 000). In the first phase, the volunteers underwent periapical infiltrative anaesthesia. In the second phase, diploe anaesthesia was performed with a QuickSleeper® d...

  17. Use of Pre-Injection Diffusion of Local Anaesthetic as a Means of Reducing Needle Penetration Discomfort

    Directory of Open Access Journals (Sweden)

    Nuket Sandalli

    2014-01-01

    Full Text Available Aim: To determine if pre-injection diffusion of local anaesthetic solution influences the discomfort of needle penetration in the palate. Methods: A placebo-controlled, randomised, doubleblind split-mouth investigation was conducted. 25 healthy adult volunteers were recruited and each received two needle penetrations in a random order during one visit. The penetration sites were 1 cm from the gingival margin of the first maxillary premolars on each side of the mouth. 30 gauge-13 mm needles which were attached to syringes that contained either 2% lidocaine with 0.125mg/ml epinephrine or physiological saline were used. For each penetration an operator encouraged a drop of solution to appear at the end of the needle and placed this drop with the bevel of the needle flat on the palate for 20 seconds. The discomfort was noted on a 100 mm visual analogue scale with end points marked “No pain” and “Unbearable pain”. Results: There was no significant difference in penetration discomfort between solutions, (mean VAS = 26.80±19.36mm for lidocaine and 26.20±18.39mm for saline however the 2nd penetration was significantly more uncomfortable than the first (mean VAS = 31.00±19.84 mm and 22.00±16.65 mm respectively. Conclusion: Pre-injection diffusion of local anaesthetic solution did not influence the discomfort of needle penetration in the palate.

  18. 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

    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...... that effects of this management routine are more persistent than earlier suggested, and suggesting that docking length may influence the post-surgical behaviour of piglets. By use of the present sites of injection and dosages, neither local anaesthetic nor NSAID had marked effects on post-surgical behavioural......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...

  19. Local anaesthetic infiltration for peri-operative pain control in total hip and knee replacement: systematic review and meta-analyses of short- and long-term effectiveness.

    Science.gov (United States)

    Marques, Elsa M R; Jones, Hayley E; Elvers, Karen T; Pyke, Mark; Blom, Ashley W; Beswick, Andrew D

    2014-07-05

    Surgical pain is managed with multi-modal anaesthesia in total hip replacement (THR) and total knee replacement (TKR). It is unclear whether including local anaesthetic infiltration before wound closure provides additional pain control. We performed a systematic review of randomised controlled trials of local anaesthetic infiltration in patients receiving THR or TKR. We searched MEDLINE, Embase and Cochrane CENTRAL to December 2012. Two reviewers screened abstracts, extracted data, and contacted authors for unpublished outcomes and data. Outcomes collected were post-operative pain at rest and during activity after 24 and 48 hours, opioid requirement, mobilisation, hospital stay and complications. When feasible, we estimated pooled treatment effects using random effects meta-analyses. In 13 studies including 909 patients undergoing THR, patients receiving local anaesthetic infiltration experienced a greater reduction in pain at 24 hours at rest by standardised mean difference (SMD) -0.61 (95% CI -1.05, -0.16; p = 0.008) and by SMD -0.43 (95% CI -0.78 -0.09; p = 0.014) at 48 hours during activity.In TKR, diverse multi-modal regimens were reported. In 23 studies including 1439 patients undergoing TKR, local anaesthetic infiltration reduced pain on average by SMD -0.40 (95% CI -0.58, -0.22; p SMD -0.27 (95% CI -0.50, -0.05; p = 0.018) at 48 hours during activity, compared with patients receiving no infiltration or placebo. There was evidence of a larger reduction in studies delivering additional local anaesthetic after wound closure. There was no evidence of pain control additional to that provided by femoral nerve block.Patients receiving local anaesthetic infiltration spent on average an estimated 0.83 (95% CI 1.54, 0.12; p = 0.022) and 0.87 (95% CI 1.62, 0.11; p = 0.025) fewer days in hospital after THR and TKR respectively, had reduced opioid consumption, earlier mobilisation, and lower incidence of vomiting.Few studies reported long-term outcomes. Local

  20. Subcutaneous versus subcutaneous and intraperitoneal local anaesthetic in the management of post appendicectomy pain

    International Nuclear Information System (INIS)

    Qureshi, K.Z.; Gondal, Z.I.; Raza, A.

    2014-01-01

    To compare the efficacy of subcutaneous only and combined subcutaneous and peritoneal infiltration of 0.5% bupivacaine during appendicectomy for the management of early post operative pain. Study Design: Randomized controlled study. Place and Duration of Study: Department of Surgery, CMH Kohat from 13th December 2007 to 20th December 2008. Patients and Methods: Sixty patients of a cute appendicitis, divided into two groups of 30 each, were included in the study. Group A was given 0.5% bupivacaine subcutaneously, whereas group B was given the anaesthetic subcutaneously as well as intraperitoneally during appendectomy. Results: In group A, 24 (80%) were VAS (visual analoguescoring) 3 (uncomfortable) and 6 (20%) were VAS 2 (mild pain) whereas in study group B, 11 (36.6%) were VAS 3, 19 (63.3%) were VAS 2 and 19 (63.3%) were VAS 2 during 1st 12 hrs postoperatively (p=0.001). In 12-24 hrs post operatively, 15 (50%) patients were VAS 3 in group A and same number was VAS 2 and in group B, only 3 (10%) were in VAS 3 and 27 (90%) were VAS 2 (p=0.001). Conclusion: A combination of subcutaneous and peritoneal infiltration with bupivacaine is superior in relieving post appendectomy pain so patients require less dosage of analgesics in early post operative period along with early mobilization. (author)

  1. More about … Anaesthetics

    African Journals Online (AJOL)

    (intercostal or phrenic nerve paralysis) effect. Although not a direct toxic effect, one must note that ester derivatives and the methylparaben preservative of the amide derivatives may cause allergic reactions, even though this is quite rare. Peak plasma levels of injected local anaesthetics depend on the site of injection.

  2. 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

    benefit (NNTB) 4). When pain was defined as an increase in PIPP > 4 there was a statistically significant reduction in the absolute number of patients who experienced pain at one minute (typical RR 0.70, 95% CI 0.52 to 0.94; typical RD -0.19, 95% CI -0.34 to -0.04; NNTB 5.3). AUTHORS\\' CONCLUSIONS: The administration of topical proparacaine 30 seconds prior to the ophthalmological evaluation was associated with a reduction in pain scores especially at the time of speculum insertion. However, despite treatment, screening remains a painful procedure and the role of nonpharmacological and pharmacological intervention including different local anaesthetic agents should be ascertained in future randomised trials.

  3. Anaesthesia in Dental Medicine with Local Infiltrative Anaesthetic Technique Versus Diploe Anaesthesia Delivery Systems: Efficacy and Behaviour, an Experimental Study.

    Science.gov (United States)

    Marques-Ferreira, Manuel; Carrilho, Eunice; Paulo, Siri; Carrilho, Teresa; Pedro Figueiredo, José; Macedo, Ricardo

    2017-12-29

    This study aimed to compare the analgesic efficacy and the influence of local infiltrative anesthesia techniques, with diploe anesthesia, on the cardiac rhythmMaterial and Methods: We selected 32 healthy volunteers who were given both anaesthetic techniques on tooth 1.4 (0.45 mL of lidocaine with adrenaline, 1:80 000). In the first phase, the volunteers underwent periapical infiltrative anaesthesia. In the second phase, diploe anaesthesia was performed with a QuickSleeper® device. The parameters analysed were pulp response to the electrical test and heart rate of the participants. These parameters were evaluated on five different occasions: before anaesthesia (t0), immediately after anaesthesia (t1), 15 minutes later (t15), 30 minutes later (t30) and 60 minutes later (t60). Statistical analysis of the data was performed using SPSS 2.0 software, with α = 0.05. With the diploe anaesthesia, a level of analgesia was obtained faster. There was a slight increase in heart rate soon after administration of diploe anaesthesia, which stabilized after t15 of the procedure. This technique still proved to be painless. Diploe anaesthesia demonstrated better results in terms of analgesia than the infiltrative anaesthesia. It has been reported to be easy, safe and an effective procedure that allows anaesthesia in almost all clinical situations. This approach may offer particular advantages for endodontic therapy, providing greater comfort for the patient.

  4. Music Listening Intervention vs Local Anaesthetic Cream for Pain Management in Infants Undergoing Venepuncture: A Collaborative Trans-Disciplinary Research

    Directory of Open Access Journals (Sweden)

    Wen Fen Beh

    2018-03-01

    Full Text Available Aim: Local anaesthetic cream (EMLA is often used for paediatric procedural pain management. However, there are concerns about dependency on pain medication. A healthier alternative would be to use music listening intervention instead. This study aimed to test the effectiveness of music listening intervention in managing pain for infants undergoing venepuncture procedures in comparison to using EMLA. Materials and Methods: The research was conducted in two phases-in the first phase, surveys were conducted to determine the spectrum of popular Malaysian folk songs for children in nursery schools, and the selection of songs was then rearranged in an instrumental form to be played in the experimental phase. The experimental phase is the second part which involved the focus and control groups of infants that required venepuncture procedures. The focus group was given music listening intervention during the procedure while the control group was given EMLA. Results: The results revealed that there was no statistical difference between the two groups in pain management. Conclusion: This study shows that music listening intervention is comparable to EMLA cream in the management of venepuncture pain based on physiological response and pain behavioural score.

  5. The safety of peri-articular local anaesthetic injection for patients undergoing total knee replacement with autologous blood transfusion: a randomised trial.

    Science.gov (United States)

    Wallace, D F; Emmett, S R; Kang, K K; Chahal, G S; Hiskens, R; Balasubramanian, S; McGuinness, K; Parsons, H; Achten, J; Costa, M L

    2012-12-01

    Intra-operative, peri-articular injection of local anaesthesia is an increasingly popular way of controlling pain following total knee replacement. At the same time, the problems associated with allogenic blood transfusion have led to interest in alternative methods for managing blood loss after total knee replacement, including the use of auto-transfusion of fluid from the patient's surgical drain. It is safe to combine peri-articular infiltration with auto-transfusion from the drain. We performed a randomised clinical trial to compare the concentration of local anaesthetic in the blood and in the fluid collected in the knee drain in patients having either a peri-articular injection or a femoral nerve block. Clinically relevant concentrations of local anaesthetic were found in the fluid from the drains of patients having peri-articular injections (4.92 μg/ml (sd 3.151)). However, none of the patients having femoral nerve blockade had detectable levels. None of the patients in either group had clinically relevant concentrations of local anaesthetic in their blood after re-transfusion. The evidence from this study suggests that it is safe to use peri-articular injection in combination with auto-transfusion of blood from peri-articular drains during knee replacement surgery.

  6. 21 CFR 558.145 - Chlortetracycline, procaine penicillin, and sulfamethazine.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Chlortetracycline, procaine penicillin, and... FEEDS Specific New Animal Drugs for Use in Animal Feeds § 558.145 Chlortetracycline, procaine penicillin... pound, 4.4 percent (20 grams) of sulfamethazine, and procaine penicillin equivalent in activity to 10...

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

    Directory of Open Access Journals (Sweden)

    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.

  8. Comparison of efficacy of spinal anaesthesia and sub-fascial local anaesthetic inguinal field block for open inguinal hernia repair-a single institutional experience

    International Nuclear Information System (INIS)

    Shafique, N.; Rashid, H.U.; Raja, M.I.; Saeed, M.

    2015-01-01

    The use of local anaesthetic for open inguinal hernia surgery has long been restricted to specialist centres. This study aimed to compare the efficacy of spinal anaesthesia and sub-fascial local anaesthetic (LA) for performing open hernia repair and at the same time provide better post op pain relief and early mobilization. Methods: In this randomized clinical trial, 62 male patients aged 16-72 were randomly allocated to two groups. Group A received mixture of 20ml 0.5% bupivacain, 20ml 2% lignocaine with adrenaline, 20ml normal saline (N/S), 3 ml NaHCO/sub 3/ sub-fascially for Local anaesthetic (LA) inguinal field block, while Group B received Spinal Anaesthesia (SA) with 0.5% Bupivacaine. Comparison was made in terms of Visual Analogue Score (VAS) recorded intra-operatively at 0 and 30 minutes and post operatively at 2, 4 and 12 hours at rest and on movement. Need for rescue analgesia and total analgesic consumption in both groups were calculated. Interval to pain free ambulation as well as procedural and anaesthesia related complications were compared. Results: Mean VAS in the intraoperative period were significantly high in Group A (p-value 0.011) at the start of operation and at 30 minutes (p-value <0.001). However, it did not correlate with patient satisfaction as 90% of patients in Group A successfully underwent the procedure without need for supplemental analgesia. VAS scores at rest and on movement/cough were comparable in the post op period at 2, 4 and 12 hours in both groups. Interval to pain free ambulation was significantly low in Group A (p-value 0.0012). Conclusion: Sub facial LA inguinal field block provides effective anaesthesia with optimum post op analgesia, prompt recovery and fewer systemic side effects compared to SA and can safely be used for routine open inguinal hernia surgery. (author)

  9. Development of thermotolerance in CHO cells: modification by procaine.

    Science.gov (United States)

    Rastogi, D; Henle, K J; Nagle, W A; Moss, A J; Neilan, B A; Rastogi, S P

    1987-01-01

    We have tested the reported ability of procaine to inhibit the induction and the development of thermotolerance in Chinese hamster ovary cells. Thermotolerance was induced either by hyperthermia alone (10 min, 45 degrees C) or by combining hyperthermia and procaine (5 min, 45 degrees C + 10 mM procaine) with heating times adjusted to yield similar cell survival after the conditioning treatments. Both the kinetics of thermotolerance development in fresh medium without procaine and the magnitude of thermotolerance 6 h after heat conditioning were similar for the two treatment groups. Development of thermotolerance in the presence of procaine was tested by adding the drug at 5 or 10 mM to culture medium between, but not during two fractionated heat treatments. Thermotolerance development was observed even in the presence of 10 mM procaine, but only if cell survival was corrected for the 37 degrees C-procaine toxicity. Complete survival curves of cells incubated for 6 h at 37 degrees C in 7.5 mM procaine between heat conditioning and test heating showed a D0 that was only 35 per cent lower than that of thermotolerant controls. The data are consistent with the reported sensitization to heat killing by procaine, but show that thermotolerance induction and development were only minimally perturbed by procaine.

  10. A randomised controlled trial of the effect of a head-elevation pillow on intrathecal local anaesthetic spread in caesarean section.

    Science.gov (United States)

    Elfil, H; Crowley, L; Segurado, R; Spring, A

    2015-11-01

    A head-elevation pillow places a patient in a ramped posture, which maximises the view of the larynx during laryngoscopy, particularly in obese parturients. In our institution an elevation pillow is used pre-emptively for neuraxial anaesthesia. We hypothesised that head-elevation may impair cephalad spread of local anaesthetic before caesarean section resulting in a lower block or longer time to achieve a T6 level. We aimed to investigate the effect of head-elevation on spread of intrathecal local anaesthetics during anaesthesia for caesarean section. One-hundred parturients presenting for caesarean section under combined spinal-epidural anaesthesia were randomised to either the standard supine position with lateral displacement or in the supine position with lateral displacement on an head-elevation pillow. Each patient received intrathecal hyperbaric bupivacaine 11 mg, morphine 100 μg and fentanyl 15 μg. Patients were assessed for adequacy of sensory block (T6 or higher) at 10 min. Sensory block to T6 was achieved within 10 min in 65.9% of parturients in the Elevation Pillow Group compared to 95.7% in the Control Group (P<0.05). Compared to the Control Group, patients in the Elevation Pillow Group had greater requirements for epidural supplementation (43.5% vs 2.1%, P<0.001) or conversion to general anaesthesia (9.3% vs 0%, P<0.04). Use of a ramped position with an head-elevation pillow following injection of the intrathecal component of a combined spinal-epidural anaesthetic for scheduled caesarean section was associated with a significantly lower block height at 10min. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Preparation and immunological properties of procaine-protein conjugates

    International Nuclear Information System (INIS)

    Liakopoulou, A.

    1981-01-01

    Procaine was conjugated to BSA and rat and rabbit Gf using the carbodiimide method and 14 C-procaine as tracer. The composition of the conjugates could be varied depending on the time of incubation and the concentration of procaine in the reaction mixtures. Procaine-BSA conjugates were soluble in water or saline. However, procaine conjugates to rat or rabbit Gf were not readily soluble in saline. These conjugates were good for immunization purposes, but it was cumbersome to work with them when clear solutions were needed, as in the immunochemical procedures used in this study. The immunological properties of the conjugates were studied in rats and rabbits. Rats responded with production of IgGa and precipitating antibodies to the procaine group, but IgE antibodies to the immunogen could not be detected. Furthermore, precipitating antibodies towards the procaine group were raised in rabbits. When BSA was the protein carrier, antibodies to the carrier molecule were also detected in both rats and rabbits. The conjugates of procaine to rat or rabbit Gf did not elicit antibody response to the carrier molecule when used in the homologous species. Hapten inhibition studies suggested that, in the rabbit, antibodies were also produced with specificity directed towards the molecular configuration of the hapten-carrier bond. (author)

  12. High-dose versus low-dose local anaesthetic for transversus abdominis plane block post-Caesarean delivery analgesia: a meta-analysis.

    Science.gov (United States)

    Ng, S C; Habib, A S; Sodha, S; Carvalho, B; Sultan, P

    2018-02-01

    The optimal local-anaesthetic (LA) dose for transversus-abdominis-plane (TAP) block is unclear. In this meta-analysis, we aimed to determine whether TAP blocks for Caesarean delivery (CD) with low-dose (LD) LA demonstrated non-inferiority in terms of analgesic efficacy, compared with high-dose (HD) LA. A literature search was performed for randomised controlled trials examining the analgesic efficacy of TAP blocks vs control after CD. The different dosing used in these studies was classified as HD or LD (bupivacaine equivalents >50 or ≤50 mg per block side, respectively). The pooled results of each dose group vs control were indirectly compared using the Q test. The primary outcome was 24 h opioid consumption. Secondary outcomes included 6 and 24 h postoperative pain scores, time to first analgesia, 6 h opioid consumption, opioid-related side-effects, and maternal satisfaction. Fourteen studies consisting of 770 women (389 TAP and 381 control) were included. Compared with controls, the 24 h opioid consumption (milligram morphine equivalents) was lower in HD [mean difference (MD) 95% confidence interval (CI) -22.41 (-38.56, -6.26); P=0.007; I 2 =93%] and LD [MD 95% CI -16.29 (-29.74, -2.84); P=0.02; I 2 =98%] TAP groups. However, no differences were demonstrated between the HD and LD groups (P=0.57). There were also no differences between the HD and LD groups for the 6 h opioid consumption, time to first analgesia, 6 and 24 h pain scores, postoperative nausea and vomiting, pruritus, and maternal satisfaction. Low-dose TAP blocks for Caesarean delivery provide analgesia and opioid-sparing effects comparable with the high-dose blocks. This suggests that lower doses can be used to reduce local anaesthetic toxicity risk without compromising the analgesic efficacy. Copyright © 2017 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

  13. Post-operative bilateral continuous ultrasound-guided transversus abdominis plane block versus continuous local anaesthetic wound infusion in patients undergoing abdominoplasty

    Directory of Open Access Journals (Sweden)

    Eman Ramadan Salama

    2018-01-01

    Full Text Available Background and Aims: Transversus abdominis plane (TAP block and continuous local anaesthetic wound infusion are used as part of multimodal analgesia to treat postoperative pain after lower abdominal surgeries. The aim of this randomised controlled study was to assess the efficacy of the two techniques and compare the two in patients undergoing abdominoplasty. Methods: Ninety female patients undergoing abdominoplasty were allocated to receive continuous wound infusion with saline (control group, GC, n = 30, continuous bilateral TAP block with 0.25% levobupivacaine (group GT, n = 30, or continuous wound infusion with 0.25% levobupivacaine (group GW, n = 30. The primary end-point was morphine requirement in the first 48 h. Numerical rating scale (NRS at rest and during movement, time to first morphine dose and time to first ambulation were recorded. Results: Morphine requirement in the first 48 h was significantly higher in GC than GW and GT (61.9 ± 12.8, 21.5 ± 9.5, and 18.9 ± 8.1 mg, respectively; P = 0.001, but GW and GT were comparable (P = 0.259. NRS was significantly higher in GC during movement in the first 24 h. GW and GT showed significantly longer time to first morphine dose (6.5 ± 1.7 and 8.9 ± 1.4 h, respectively, vs. 1.2 ± 0.3 h in GC and significantly shorter time to first ambulation (7.8 ± 3.1 and 6.9 ± 3.4 h, respectively, vs. 13.2 ± 4.9 h in GC (P = 0.001. Conclusion: Continuous bilateral ultrasound-guided TAP block and continuous local anaesthetic wound infusion significantly decreased total morphine consumption in the first 48 h compared to placebo; however, both treatment techniques were comparable.

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

    International Nuclear Information System (INIS)

    Humeau, Anne; Koitka, Audrey; Abraham, Pierre; Saumet, Jean-Louis; L'Huillier, Jean-Pierre

    2004-01-01

    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

  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. 21 CFR 522.1696c - Penicillin G procaine in oil.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Penicillin G procaine in oil. 522.1696c Section... § 522.1696c Penicillin G procaine in oil. (a) Specifications. Each milliliter contains penicillin G procaine equivalent to 300,000 units of penicillin G. (b) Sponsor. See No. 053501 in § 510.600(c) of this...

  17. 21 CFR 522.1696b - Penicillin G procaine aqueous suspension.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Penicillin G procaine aqueous suspension. 522... ANIMAL DRUGS § 522.1696b Penicillin G procaine aqueous suspension. (a) Specifications. Each milliliter contains penicillin G procaine equivalent to 300,000 units of penicillin G. (b) Sponsors. See sponsor...

  18. 21 CFR 522.1696a - Penicillin G benzathine and penicillin G procaine suspension.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Penicillin G benzathine and penicillin G procaine... FORM NEW ANIMAL DRUGS § 522.1696a Penicillin G benzathine and penicillin G procaine suspension. (a) Specifications. Each milliliter of aqueous suspension contains penicillin G benzathine and penicillin G procaine...

  19. Monitoring volatile anaesthetic agents

    International Nuclear Information System (INIS)

    Russell, W.J.

    2000-01-01

    Full text: The methods that have been used for monitoring volatile anaesthetic agents depend on some physical property such as Density, Refractometry, Mass, Solubility, Raman scattering, or Infra-red absorption. Today, refractometry and infra-red techniques are the most common. Refractometry is used for the calibration of vaporizers. All anaesthetic agents increase the refractive index of the carrier gas. Provided the mixture is known then the refractive change measures the concentration of the volatile anaesthetic agent. Raman Scattering is when energy hits a molecule a very small fraction of the energy is absorbed and re-emitted at one or more lower frequencies. The shift in frequency is a function of the chemical bonds and is a fingerprint of the substance irradiated. Electromagnetic (Infra-red) has been the commonest method of detection of volatile agents. Most systems use a subtractive system, i.e. the agent in the sampling cell absorbed some of the infrared energy and the photo-detector therefore received less energy. A different approach is where the absorbed energy is converted into a pressure change and detected as sound (Acoustic monitor). This gives a more stable zero reference. More recently, the detector systems have used multiple narrow-band wavelengths in the infrared bands and by shape matching or matrix computing specific agent identification is achieved and the concentration calculated. In the early Datex AS3 monitors, a spectral sweep across the 3 micron infrared band was used to create spectral fingerprints. The recently released AS3 monitors use a different system with five very narrow band filters in the 8-10 micron region. The transmission through each of these filters is a value in a matrix which is solved by a micro computer to identify the agent and its concentration. These monitors can assist in improving the safety and efficiency of our anaesthetics but do not ensure that the patient is completely anaesthetized. Copyright (2000

  20. Monitoring volatile anaesthetic agents

    Energy Technology Data Exchange (ETDEWEB)

    Russell, W J [Royal Adelaide Hospital, SA (Australia). Department of Anaesthesia and Intensive Care

    2000-12-01

    Full text: The methods that have been used for monitoring volatile anaesthetic agents depend on some physical property such as Density, Refractometry, Mass, Solubility, Raman scattering, or Infra-red absorption. Today, refractometry and infra-red techniques are the most common. Refractometry is used for the calibration of vaporizers. All anaesthetic agents increase the refractive index of the carrier gas. Provided the mixture is known then the refractive change measures the concentration of the volatile anaesthetic agent. Raman Scattering is when energy hits a molecule a very small fraction of the energy is absorbed and re-emitted at one or more lower frequencies. The shift in frequency is a function of the chemical bonds and is a fingerprint of the substance irradiated. Electromagnetic (Infra-red) has been the commonest method of detection of volatile agents. Most systems use a subtractive system, i.e. the agent in the sampling cell absorbed some of the infrared energy and the photo-detector therefore received less energy. A different approach is where the absorbed energy is converted into a pressure change and detected as sound (Acoustic monitor). This gives a more stable zero reference. More recently, the detector systems have used multiple narrow-band wavelengths in the infrared bands and by shape matching or matrix computing specific agent identification is achieved and the concentration calculated. In the early Datex AS3 monitors, a spectral sweep across the 3 micron infrared band was used to create spectral fingerprints. The recently released AS3 monitors use a different system with five very narrow band filters in the 8-10 micron region. The transmission through each of these filters is a value in a matrix which is solved by a micro computer to identify the agent and its concentration. These monitors can assist in improving the safety and efficiency of our anaesthetics but do not ensure that the patient is completely anaesthetized. Copyright (2000

  1. [The influence of procaine electrophoresis and mesotherapy on the characteristics of biological age].

    Science.gov (United States)

    Turova, E A; Konchugova, T V; Balaban, E I; Fadeeva, N I; Golovach, A V; Teniaeva, E A

    2012-01-01

    The assessment of the biological age is needed to estimate the level of health and the efficacy of measures being undertaken to slow down the ageing processes and prolong the active life of the patients. Earlier studies have demonstrated the improvement of both physical health and psychic status of the elderly patients following intravenous administration of procaine. The objective of the present work was to evaluate effect of various methods of administration of a 2% procaine solution on the biological age. A total of 95 subjects at the age between 30 and 75 years were enrolled in the study. The procaine solutions were applied to the collar region. The patients of group 1 were treated with 2% procaine electrophoresis, those in group 2 with procaine galvanization with the same parameters. Mesotherapy using the 2% procaine solution was given to the patients of group 3. It was substituted by placebo (0.9% physiological solution) in the patients of group 4 (controls). The study revealed the most significant decrease of the biological age (calculated as described by L. M. Belozerova) in the patients treated with procaine electrophoresis (91% improvement). The mesotherapeutic administration of procaine also produced the beneficial effect (59% improvement). Neither procaine galvanization nor placebo mesotherapy caused any significant change of the variables characterizing the biological age.

  2. Spinal anesthesia: a comparison of procaine and lidocaine.

    Science.gov (United States)

    Le Truong, H H; Girard, M; Drolet, P; Grenier, Y; Boucher, C; Bergeron, L

    2001-05-01

    To compare spinal procaine to spinal lidocaine with regard to their main clinical characteristics and incidence of transient radicular irritation (TRI). In this randomized, double-blind, prospective study, patients (two groups, n=30 each) received either 100 mg of lidocaine 5% in 7.5% glucose (Group L) or 100 mg of procaine 10% diluted with 1 ml cerebrospinal fluid (Group P). After spinal anesthesia, segmental level of sensory block was assessed by pinprick. Blood pressure and the height of the block were noted each minute for the first ten minutes, then every three minutes for the next 35 min and finally every five minutes until regression of the block to L4. Motor blockade was evaluated using the Bromage scale. To evaluate the presence of TRI, each patient was questioned 48 hr after surgery. Time to highest sensory level and to maximum number of segments blocked showed no difference between groups. Mean time for sensory regression to T10 and for regression of the motor block were shorter in Group P. Eighty minutes following injection, sensory levels were lower in Group P. Five patients had inadequate surgical anesthesia in Group P and only one in Group L. No patient in Group P had TRI (95% CI 10-12%) while eight (27%) in Group L did (95% CI 12-46%). Procaine 10% was associated with a clinical failure rate of 14.2%. This characteristic must be balanced against an absence of TRI, which occurs more frequently with the use of lidocaine 5%.

  3. 75 FR 35044 - Notice of Approval of a Supplemental New Animal Drug Application; Penicillin G Procaine Suspension

    Science.gov (United States)

    2010-06-21

    ...] Notice of Approval of a Supplemental New Animal Drug Application; Penicillin G Procaine Suspension AGENCY... Laboratories, Ltd. The supplemental NADA provides for a revised formulation of penicillin G procaine injectable... of NOROCILLIN (penicillin G procaine) Injectable Suspension by intramuscular injection in cattle...

  4. 21 CFR 526.1696c - Penicillin G procaine-dihydrostreptomycin sulfate for intramammary infusion (dry cows).

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Penicillin G procaine-dihydrostreptomycin sulfate... INTRAMAMMARY DOSAGE FORMS § 526.1696c Penicillin G procaine-dihydrostreptomycin sulfate for intramammary infusion (dry cows). (a) Specifications. Each 10 milliliters of suspension contains penicillin G procaine...

  5. Procaine rapidly inactivates acetylcholine receptors from Torpedo and competes with agonist for inhibition sites

    International Nuclear Information System (INIS)

    Forman, S.A.; Miller, K.W.

    1989-01-01

    The relationship between the high-affinity procaine channel inhibition site and the agonist self-inhibition site on acetylcholine receptors (AChRs) from Torpedo electroplaque was investigated by using rapid 86 Rb + quenched-flux assays at 4 degree C in native AChR-rich vesicles on which 50-60% of ACh activation sites were blocked with α-bungarotoxin (α-BTX). In the presence of channel-activating acetylcholine (ACh) concentrations alone, AChR undergoes one phase of inactivation in under a second. Addition of procaine produces two-phase inactivation similar to that seen with self-inhibiting ACh concentrations rapid inactivation complete in 30-75 ms is followed by fast desensitization at the same k d observed without procaine. The dependence of k r on [procaine] is consistent with a bimolecular association between procaine and its AChR site. Inhibition of AChR function by mixtures of procaine plus self-inhibiting concentrations of ACh or suberyldicholine was studied by reducing the level of α-BTX block in vesicles. The data support a mechanism where procaine binds preferentially to the open-channel AChR state, since no procaine-induced inactivation is observed without agonist and k r 's dependence on [ACh] in channel-activating range closely parallels that of 86 Rb + flux response to ACh

  6. 21 CFR 522.1696 - Penicillin G procaine implantation and injectable dosage forms.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Penicillin G procaine implantation and injectable dosage forms. 522.1696 Section 522.1696 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH... DOSAGE FORM NEW ANIMAL DRUGS § 522.1696 Penicillin G procaine implantation and injectable dosage forms. ...

  7. Effects of procaine on a central neuron of the snail, Achatina fulica Ferussac.

    Science.gov (United States)

    Lin, Chia-Hsien; Tsai, Ming-Cheng

    2005-02-18

    Effects of procaine on a central neuron (RP1) of the giant African snail (Achatina fulica Ferussac) were studied pharmacologically. The RP1 neuron showed spontaneous firing of action potential. Extra-cellular application of procaine (10 mM) reversibly elicited bursts of potential. The bursts of potential elicited by procaine were not blocked after administration of (1) prazosin, propranolol, atropine, d-tubocurarine, (2) calcium-free solution, (3) ryanodine (4) pretreatment with KT-5720 or chelerythrine. The bursts of potential elicited by procaine were blocked by adding U73122 (10 microM) and the bursts of potential were decreased if physiological sodium ion was replaced with lithium ion or incubated with either neomycin (3.5 mM) or high magnesium solution (30 mM). Preatment with U73122 (10 microM) blocked the initiation of bursts of potential. Ruthenium red (100 microM) or caffeine (10 mM) facilitated the procaine-elicited bursts of potential. It is concluded that procaine reversibly elicits bursts of potential in the central snail neuron. This effect was not directly related to (1) the extra-cellular calcium ion fluxes, (2) the ryanodine sensitive calcium channels in the neuron, or (3) the PKC or PKA related messenger systems. The procaine-elicited bursts of potential were associated with the phospholipase activity and the calcium mobilization in the neuron.

  8. Effect of 60Co-irradiation on penicillin G procaine in veterinary mastitis products

    International Nuclear Information System (INIS)

    Tsuji, K.; Goetz, J.F.; Vanmeter, W.

    1979-01-01

    The effect of 60 Co-irradation on penicillin G procaine in a peanut oil-based veterinary mastitis product was examined by reversed-phase high-performance liquid chromatography (HPLC). The HPLC method is capable of separating and quantifiying procaine, penicillin G, and various degradation compounds. Values obtained by the HPLC method on the product irradiated and stored at various temperatures correlated well with those of the microbiological assay. No significant decrease in the procaine was detected even after 4.0-Mrad irradiation. The HPLC method is applicable for analysis of other beta-lactam antibiotics

  9. Anaesthetic gases: environmental impact and alternatives

    African Journals Online (AJOL)

    Little consideration has been given to the environmental impact of anaesthetic gas .... our practice to select gases with a lower environmental impact is also ... is used as raw material for new anaesthetics. ... none in the pipeline.1. Conclusion.

  10. Effect of halogenated benzenes on acetanilide esterase, acetanilide hydroxylase and procaine esterase in rats.

    Science.gov (United States)

    Carlson, G P; Dziezak, J D; Johnson, K M

    1979-07-01

    1,2,4-Trichlorobenzene, 1,3,5-trichlorobenzene, hexachlorobenzene, 1,2,4-tribromobenzene, 1,3,5-tribromobenzene and hexabromobenzene were compared for their abilities to induce acetanilide esterase, acentailide hydroxylase and procaine esterase. Except for hexabromobenzene all induced acetanilide esterase whereas the hydroxylation of acetanilide was seen only with the fully halogenated benzenes and with 1,3,5-tribromobenzene. Hepatic procaine esterase activity was increased by the three chlorinated benzenes and 1,2,4-tribromobenzene.

  11. Cardiovascular drugs in anaesthetic practice

    NARCIS (Netherlands)

    Schwarte, Lothar A.; Loer, S.A.; Wietasch, Johann; Scheeren, TWL

    This two-volume work of 91 chapters covers all aspects of practice in anaesthesia. Volume 1 addresses the underpinning sciences of anaesthesia including physiology, pharmacology, physics, anaesthetic equipment, statistics, and evidence-based anaesthesia. Volume 1 also outlines the fundamental

  12. Procaine-mediated modification of membranes and of the response to x irradiation and hyperthermia in mammalian cells

    International Nuclear Information System (INIS)

    Yau, T.M.

    1979-01-01

    Procaine, a membrane-specific agent, was found to protect the response of oxygenated mammalian cells toward x irradiation in vitro. In addition, the drug also potentiates hyperthermic killing of cells. In an effort to gain further insights into the mechanisms underlying the action of procaine as a modifier of cell injury in x-irradiated and heated cells, the effects of procaine on cellular morphology, membrane fluidity, and cellular electrokinetic properties were studied. It was found that procaine can reversibly influence the cellular morphology. Using scanning electron microscopy, we were able to demonstrate the presence of numerous smooth blebs on the cell surface of either normal or SV40-transformed 3T3 mouse fibroblasts treated with procaine. When 1,6-diphenyl-1,3,5-hexatriene was used as a membrane probe, the overall fluidity of cell membranes from 3T3 cells grown as monolayers or L5178Y lymphoma cells grown in suspensions was not significantly changed by procaine; however, when perylene was used as a probe, the overall fluidity of cell membranes of procaine-treated cells was found to increase significantly. Lastly, procaine was found to alter the electrophoretic mobility of cells. These results indicate that procaine may exert its modification of radiation- and heat-induced effects via a still elusive membrane-mediated mechanism(s). It is anticipated that membrane-active agents with different specificities may be employed as tools to probe the role of membranes in the radiation or heat response of cells

  13. Anaesthetic safety of the Macintosh® oral laryngeal spray device

    African Journals Online (AJOL)

    2013-01-14

    Jan 14, 2013 ... is there a difference in the amount of local anaesthetic delivered when two ... pairwise comparisons were made among the factors using Student's t-test with Tukey's ... a dangerous outlier (Figure 1). This amount, inadvertently.

  14. Single-shot pectoral plane (PECs I and PECs II) blocks versus continuous local anaesthetic infusion analgesia or both after non-ambulatory breast-cancer surgery: a prospective, randomised, double-blind trial.

    Science.gov (United States)

    O'Scanaill, P; Keane, S; Wall, V; Flood, G; Buggy, D J

    2018-04-01

    Pectoral plane blocks (PECs) are increasingly used in analgesia for patients undergoing breast surgery, and were recently found to be at least equivalent to single-shot paravertebral anaesthesia. However, there are no data comparing PECs with the popular practice of continuous local anaesthetic wound infusion (LA infusion) analgesia for breast surgery. Therefore, we compared the efficacy and safety of PECs blocks with LA infusion, or a combination of both in patients undergoing non-ambulatory breast-cancer surgery. This single-centre, prospective, randomised, double-blind trial analysed 45 women to receive either PECs blocks [levobupivacaine 0.25%, 10 ml PECs I and levobupivacaine 0.25%, 20 ml PECs II (PECs group); LA infusion catheter (levobupivacaine 0.1% at 10 ml h -1 for 24 h (LA infusion group); or both (PECs and LA infusion)]. The primary outcome measure was area under the curve of the pain verbal rating score whilst moving vs time (AUC) over 24 h. Secondary outcomes included total opioid consumption at 24 h. AUC moving was mean (SD) 71 (34) mm h -1 vs 58 (41) vs 23 (20) in PECs, LA infusion, and both, respectively; P=0.002. AUC at rest was also significantly lower in patients receiving both. The total 24 h opioid consumption [median (25-75%)] was 14 mg (9-26) vs 11 (8-24) vs 9 (5-11); P=0.4. No adverse events were observed. The combination of both pre-incisional PECs blocks and postoperative LA infusion provides better analgesia over 24 h than either technique alone after non-ambulatory breast-cancer surgery. NCT 03024697. Copyright © 2018 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

  15. Procaine Induces Epigenetic Changes in HCT116 Colon Cancer Cells

    Directory of Open Access Journals (Sweden)

    Hussein Sabit

    2016-01-01

    Full Text Available Colon cancer is the third most commonly diagnosed cancer in the world, and it is the major cause of morbidity and mortality throughout the world. The present study aimed at treating colon cancer cell line (HCT116 with different chemotherapeutic drug/drug combinations (procaine, vorinostat “SAHA,” sodium phenylbutyrate, erlotinib, and carboplatin. Two different final concentrations were applied: 3 μM and 5 μM. Trypan blue test was performed to assess the viability of the cell before and after being treated with the drugs. The data obtained showed that there was a significant decrease in the viability of cells after applying the chemotherapeutic drugs/drug combinations. Also, DNA fragmentation assay was carried out to study the effect of these drugs on the activation of apoptosis-mediated DNA degradation process. The results indicated that all the drugs/drug combinations had a severe effect on inducing DNA fragmentation. Global DNA methylation quantification was performed to identify the role of these drugs individually or in combination in hypo- or hypermethylating the CpG dinucleotide all over the genome of the HCT116 colon cancer cell line. Data obtained indicated that different combinations had different effects in reducing or increasing the level of methylation, which might indicate the effectiveness of combining drugs in treating colon cancer cells.

  16. Teamwork, communication, and anaesthetic assistance in Scotland.

    Science.gov (United States)

    Rutherford, J S; Flin, R; Mitchell, L

    2012-07-01

    Teamwork involves supporting others, solving conflicts, exchanging information, and co-ordinating activities. This article describes the results of interviews with anaesthetic assistants (n=22) and consultant anaesthetists (n=11), investigating the non-technical skills involved in the effective teamwork of the anaesthetic assistants in the operating theatre. Anaesthetic assistants most commonly saw themselves as either being part of a theatre team or an anaesthetic subgroup and most commonly described the senior theatre nurse as their team leader. Examples of supporting others included the following: checking equipment, providing equipment, being a second pair of eyes, providing emotional and decision support, and supporting trainee anaesthetists. Of the 19 anaesthetic assistants who were asked if they would speak up if they disagreed with a decision in theatre, only 14 said that they would voice their concerns, and the most common approach was to ask for the logic behind the decision. The WHO checklist was described as prompting some anaesthetists to describe their anaesthetic plan to the anaesthetic assistant, when previously the anaesthetist would have failed to communicate their intentions in time for equipment to be prepared. The prioritization of activities to achieve co-ordination and the anaesthetic assistants becoming familiar with the idiosyncrasies of their regular anaesthetists were also described by anaesthetic assistants.

  17. Anaesthetic considerations for paediatric laparoscopy | Lasersohn ...

    African Journals Online (AJOL)

    Children, infants and neonates represent an anaesthetic challenge because of age-specific anatomical and physiological issues. Apart from paediatric-specific anaesthetic considerations, the paediatric anaesthetist must understand the implications of laparoscopic surgery, and prevent and react appropriately to changes ...

  18. Effects of penicillin on procaine-elicited bursts of potential in central neuron of snail, Achatina fulica.

    Science.gov (United States)

    Chen, Yi-Hung; Lu, Kuan-Ling; Hsiao, Ru-Wan; Lee, Ya-Ling; Tsai, Hong-Chieh; Lin, Chia Hsien; Tsai, Ming-Cheng

    2008-08-01

    Effects of penicillin on changes in procaine-elicited bursts of potential (BoP) were studied in a central neuron (RP4) of snail, Achatina fulica Ferussac. Procaine elicited BoP in the RP4 neuron while penicillin elicited depolarization of the neuron. Penicillin decreased the BoP elicited by procaine in a concentration-dependent manner. The effect of penicillin on the procaine-elicited BoP was not altered in the preparations treated with ascorbate or L-NAME (N-nitro-L-arginine methyl ester). However, the inhibitory effect of penicillin on the procaine-elicited BoP was enhanced with a decrease in extracellular sodium ion. Sodium ion was one of the important ions contributing to the action potential of the neuron. Two-electrode voltage-clamp studies revealed that penicillin decreased the fast sodium inward current of the neuron. It is concluded that penicillin inhibited the BoP elicited by procaine and sodium ion altered the effect of penicillin on procaine-elicited BoP.

  19. 21 CFR 526.1696d - Penicillin G procaine-novobiocin for intramammary infusion.

    Science.gov (United States)

    2010-04-01

    ... of use—(1) Lactating cows—(i) Amount. 10 milliliters in each infected quarter after milking. Repeat once after 24 hours. (ii) Indications for use. Treating lactating cows for mastitis caused by... novobiocin as novobiocin sodium. For dry cows: 200,000 units of penicillin G procaine and 400 milligrams of...

  20. Rural anaesthetic audit 2006 to 2010.

    Science.gov (United States)

    Mills, P D; Newbury, J

    2012-03-01

    In order to review anaesthetic morbidity in our remote rural hospital, a retrospective audit of all anaesthetic records was undertaken for a five-year period between 2006 and 2010. Eight hundred and eighty-nine anaesthetic records were reviewed. The patients were all American Society of Anaesthesiologists physical status I to III. Ninety-eight percent of the anaesthetics were performed by general practitioner (non-specialist) anaesthetists. There were no anaesthetic deaths or serious adverse outcomes reported over this period. Sixteen intraoperative and seven postoperative problems were documented, but all were resolved uneventfully. The most common problems documented were difficult intubation (n=9) and respiratory depression (n=3). Within the limitations of this retrospective audit, these findings indicate that general practitioner anaesthetists provided safe anaesthesia in a remote rural hospital. It is our opinion that the case selection, prior experience of anaesthetic and theatre staff, stable nursing workforce and the use of protocols were important factors in determining the low rate of adverse events. However, we caution against over-interpretation of the data, given its retrospective nature, relatively small sample size, reliance on case records and the absence of agreed definitions for adverse events. We would also like to encourage all anaesthetic services, however remote, to audit their results as part of ongoing quality assurance.

  1. Time-dependent Influence of Procaine Hydrochloride on Cisplatin Antitumor Activity in P388 Tumor Bearing Mice

    Czech Academy of Sciences Publication Activity Database

    Viale, M.; Vánnozzi, M. O.; Mandys, Václav; Esposito, M.

    2001-01-01

    Roč. 21, - (2001), s. 485-488 ISSN 0250-7005 Institutional research plan: CEZ:AV0Z5039906 Keywords : cisplatin * procaine * antitumor activity Subject RIV: EA - Cell Biology Impact factor: 1.416, year: 2001

  2. Anaesthetic management of intussusception in pregnancy | Nwasor ...

    African Journals Online (AJOL)

    Teamwork will win and effective communication between obstetrician, surgeon, anesthesiologist and neonatologist is obligatory. Good knowledge of the simplest and fastest anaesthetic techniques available will ensure a fruitful outcome. Keywords: anaesthesia, intussusception, obstetric patients. Annals of African Medicine ...

  3. An audit of anaesthetic record keeping

    African Journals Online (AJOL)

    QuickSilver

    tive assessment and the intra-operative data is usually con- ... An audit of anaesthetic records was performed to determine the rate of completion and adequacy of such records. ... medicolegal practice, where the risks of legal action being.

  4. Haemodynamic and anaesthetic advantages of dexmedetomidine

    African Journals Online (AJOL)

    2012-01-27

    Jan 27, 2012 ... anaesthetic requirements, the pressor response to intuba- tion and ... maintain HR and mean arterial pressure (MAP) within 20% .... opioids or other analgesics in any of the patients during the ..... surgery in prone position.

  5. The modulation effects of d-amphetamine and procaine on the spontaneously generated action potentials in the central neuron of snail, Achatina fulica Ferussac.

    Science.gov (United States)

    Lin, Chia-Hsien; Tsai, Ming-Cheng

    2005-05-01

    The modulation effects of d-amphetamine and procaine on the spontaneously generated action potentials were studied on the RP1 central neuron of giant African snails (Achatina fulica Ferussac). Extra-cellular application of d-amphetamine or procaine reversibly elicited bursts of potential (BoP). Prazosin, propranolol, atropine or d-tubocurarine did not alter the BoP elicited by either d-amphetamine or procaine. KT-5720 or H89 (protein kinase A inhibitors) blocked d-amphetamine-elicited BoP, whereas they did not block the procaine-elicited BoP. U73122, neomycin (phospholipase C inhibitors) blocked the procaine-elicited BoP, whereas they did not block the d-amphetamine-elicited BoP in the same neuron. These results suggest that BoP elicited by d-amphetamine or procaine were associated with protein kinase A and phospholipase C activity in the neuron.

  6. Anaemia and pregnancy: Anaesthetic implications

    Directory of Open Access Journals (Sweden)

    Anju Grewal

    2010-01-01

    Full Text Available Anaemia in pregnancy defined as haemoglobin (Hb level of < 10 gm/dL, is a qualitative or quantitative deficiency of Hb or red blood cells in circulation resulting in reduced oxygen (O 2 -carrying capacity of the blood. Compensatory mechanisms in the form of increase in cardiac output (CO, PaO 2 , 2,3 diphosphoglycerate levels, rightward shift in the oxygen dissociation curve (ODC, decrease in blood viscosity and release of renal erythropoietin, get activated to variable degrees to maintain tissue oxygenation and offset the decreases in arterial O 2 content. Parturients with concomitant medical diseases or those with acute ongoing blood losses may get decompensated, leading to serious consequences like right heart failure, angina or tissue hypoxemia in severe anaemia. Preoperative evaluation is aimed at assessing the severity and cause of anaemia. The concept of an acceptable Hb level varies with the underlying medical condition, extent of physiological compensation, the threat of bleeding and ongoing blood losses. The main anaesthetic considerations are to minimize factors interfering with O 2 delivery, prevent any increase in oxygen consumption and to optimize the partial pressure of O 2 in the arterial blood. Both general anaesthesia and regional anaesthesia can be employed judiciously. Monitoring should focus mainly on the adequacy of perfusion and oxygenation of vital organs. Hypoxia, hyperventilation, hypothermia, acidosis and other conditions that shift the ODC to left should be avoided. Any decrease in CO should be averted and aggressively treated.

  7. Thermodynamics of mixing of sodium naproxen and procaine hydrochloride in ethanol + water cosolvent mixtures

    OpenAIRE

    Mora Guerrero, Carolina Del Pilar

    2010-01-01

    Thermodynamic functions Gibbs energy, enthalpy, and entropy of mixing of sodium naproxen and procaine hydrochloride were evaluated. Mixing quantities were calculated based on fusion calorimetric values obtained from differential scanning calorimetry measurements and equilibrium solubility values reported in the literature for both drugs in ethanol + water mixtures. By means of enthalpy-entropy compensation analysis, non-linear ΔH°mix vs. ΔG°mix plots were obtained which indicates different me...

  8. Intramuscular administration of sodium benzylpenicillin in horses as an alternative to procaine benzylpenicillin.

    Science.gov (United States)

    Olsén, Lena; Bremer, Hanna; Olofsson, Karin; Bröjer, Johan; Bondesson, Ulf; Bergh, Anna; Nostell, Katarina; Broström, Hans; Bengtsson, Björn; Ingvast-Larsson, Carina

    2013-08-01

    The aim was to supply information about the possibility of replacing the procaine salt with the sodium salt for benzylpenicillin IM treatment in horse in order to diminish the risk for procaine adverse effects. In a crossover study eight horses were given 15 mg/kg sodium benzylpenicillin (Na-pc) twice daily or procaine benzylpenicillin (control) once daily IM for four days. The half-life of Na-pc was 1.9h, peak concentration was 14,600 ng/mL reached after about 23 min. Trough plasma concentration was 281 ng/mL and protein binding 62.8%. The fT>MIC for Staphylococcus aureus was 63% and 100% for Streptococcus equi subsp. equi and Streptococcus zooepidemicus, indicating an adequate antimicrobial therapy. However, Na-pc cannot be recommended from a welfare point of view since the horses showed more pain related behaviour and more pain and swelling compared to the control treatment. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. Pre-anaesthetic screening of geriatric dogs

    Directory of Open Access Journals (Sweden)

    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

  10. Anaesthetic Management of Conjoined Twins′ Separation Surgery

    Directory of Open Access Journals (Sweden)

    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. [Anaesthetic-induced myocardial preconditioning: fundamental basis and clinical implications].

    Science.gov (United States)

    Chiari, P; Bouvet, F; Piriou, V

    2005-04-01

    Volatile halogenated anaesthetics offer a myocardial protection when they are administrated before a myocardial ischaemia. Cellular mechanisms involved in anaesthetic preconditioning are now better understood. The objectives of this review are to understand the anaesthetic-induced preconditioning underlying mechanisms and to know the clinical implications. References were obtained from PubMed data bank (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi) using the following keywords: volatile anaesthetic, isoflurane, halothane, sevoflurane, desflurane, preconditioning, protection, myocardium. Ischaemic preconditioning (PC) is a myocardial endogenous protection against ischaemia. It has been described as one or several short ischaemia before a sustained ischemia. These short ischaemia trigger a protective signal against this longer ischaemia. An ischemic organ is able to precondition a remote organ. It is possible to replace the short ischaemia by a preadministration of halogenated volatile anaesthetic with the same protective effect, this is called anaesthetic PC (APC). APC and ischaemic PC share similar underlying biochemical mechanisms including protein kinase C, tyrosine kinase activation and mitochondrial and sarcolemnal K(ATP) channels opening. All halogenated anaesthetics can produce an anaesthetic PC effect. Myocardial protection during reperfusion, after the long ischaemia, has been shown by successive short ischaemia or volatile anaesthetic administration, this is called postconditioning. Ischaemic PC has been described in humans in 1993. Clinical studies in human cardiac surgery have shown the possibility of anaesthetic PC with volatile anaesthetics. These studies have shown a decrease of postoperative troponin in patient receiving halogenated anaesthetics.

  12. Anaesthetic management of ostrich. Initial experiences

    International Nuclear Information System (INIS)

    Vaccarino, M.; Mauthe Degerfeld, M. von

    1997-01-01

    Different anaesthetic induction and maintenance protocols were used in 2 adult ostriches and 3 juvenile ostriches. After the intramuscolar (im) administration of an induction agent, like ketamine or tiletamine/zolazepam, general anaesthesia in 4 cases was maintained with isoflurane or halothane. General anaesthesia for radiological examinations was also performed with metedomidine/ketamine im [it

  13. anaesthetic registrars' experiences of perioperative death

    African Journals Online (AJOL)

    Death on the table: anaesthetic registrars' experiences of perioperative ... aDepartment of Anaesthesiology and Critical Care, University of KwaZulu-Natal, Durban, South Africa ... Results: Themes expressed by participants fell into three broad categories: ... number (up to 70%) of anaesthetists report experiencing adverse.

  14. Anaesthetic management of tracheobronchial disruption during ...

    African Journals Online (AJOL)

    2011-01-29

    Jan 29, 2011 ... despite advances in surgical technique and intensive care management. ... female was investigated for dysphagia and diagnosed with a middle-third ... was inserted without any difficulty and correct placement confirmed by ... the patient was placed in the lateral thoracotomy position. Anaesthetic ...

  15. Anaesthetic gases: environmental impact and alternatives ...

    African Journals Online (AJOL)

    Anaesthetic gases: environmental impact and alternatives. ... PROMOTING ACCESS TO AFRICAN RESEARCH ... to be small when compared to gaseous emissions from industrial and agricultural sources, the actual percentage contribution to climate change is small. ... EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT

  16. Anaesthetic management of endoscopic resection of juvenile ...

    African Journals Online (AJOL)

    P Khanna, BR Ray, R Sinha, R Kumar, K Sikka, AC Singh ... We present the anaesthetic management of endoscopic resection of 14 JNAs, together with a review. ... Mean duration of surgery was 197.14 ± 77 minutes, and median blood loss ...

  17. Non-gaseous radiolysis products of procaine benzylpenicillin and Na salt 3-ortho-chloro-5-methyl-4-isoxasolyl penicillin

    International Nuclear Information System (INIS)

    Dziegielewski, J.; Jezowska-Trzebiatowska, B.

    1974-01-01

    Radiolysis products of procaine benzylpenicillin and Na salt 3-ortho-chlorophenyl-5-methyl-4-isoxasolyl penicillin were isolated and spectroscopic studies were made over the NMR, IR, UV and mass spectrometric ranges. On the basis of the results obtained, the bond breakage sites resulting from irradiation were determined and the modes of radiolysis decomposition were suggested. Irradiation of penicillins has been found to result in decomposition of the β-lactam and thiazolidine rings. Besides, decarboxylation of penicillins and bond cleavages within the amide group were observed as well as dehydrogenation and abstraction of simple hydrocarbons. The role of procaine and crystallization water in the radiolysis of penicillins was determined. (author)

  18. Chloroquine, quinine, procaine, quinidine, tricyclic antidepressants, and methylxanthines as prostaglandin agonists and antagonists.

    Science.gov (United States)

    Manku, M S; Horrobin, D F

    1976-11-20

    Chloroquine, quanine, procaine, quinidine, clomipramine, theophylline, and caffeine have been shown to be strong prostaglandin antagonists and weak agonists. The antagonist effect is clearly demonstrable at concentrations reached in human plasma when the drugs are used therapeutically. This suggests that prostaglandins are important in several situations in which their role has hitherto been unsuspected. New approaches to the development of prostaglandin antagonists and new uses for established drugs are indicated. In a preliminary study chloroquine has been successfully used to close patent ductus arteriosus in three infants.

  19. Managing anaesthetic provision for global disasters.

    Science.gov (United States)

    Craven, R M

    2017-12-01

    The numbers of people affected by large-scale disasters has increased in recent decades. Disasters produce a huge burden of surgical morbidity at a time when the affected country is least able to respond. For this reason an international disaster response is often required. For many years this disaster response was not coordinated. The response consisted of what was available not what was needed and standards of care varied widely producing a healthcare lottery for the affected population. In recent years the World Health organisation has initiated the Emergency Medical Team programme to coordinate the response to disasters and set minimum standards for responding teams. Anaesthetists have a key role to play in Level 2 Surgical Field Hospitals. The disaster context produces a number of logistical challenges that directly impact on the anaesthetist requiring adaptation of anaesthetic techniques from their everyday practice. The context in which they will be working and the wider scope of practice that will be expected from them in the field mandates that deploying anaesthetists should be trained for disaster response. There have been significant improvements in recent years in the speed of response, equipment availability, coordination and training for disasters. Future challenges include increasing local disaster response capacity, agreeing international standards for training and improving data collection to allow for future research and improvement in disaster response. The goal of this review article is to provide an understanding of the disaster context and what logistical challenges it provides. There has been a move during the last decade from a globally uncoordinated, unregulated response, with no consensus on standards, to a globally coordinated response through the World Health Organisation (WHO). A classification system for responding Emergency Medical Teams (EMTs) and a set of agreed minimum standards has been defined. This review outlines the scope of

  20. Achondroplasia: anaesthetic challenges for caesarean section.

    Science.gov (United States)

    Dubiel, L; Scott, G A; Agaram, R; McGrady, E; Duncan, A; Litchfield, K N

    2014-08-01

    Pregnancy in women with achondroplasia presents major challenges for anaesthetists and obstetricians. We report the case of a woman with achondroplasia who underwent general anaesthesia for an elective caesarean section. She was 99cm in height and her condition was further complicated by severe kyphoscoliosis and previous back surgery. She was reviewed in the first trimester at the anaesthetic high-risk clinic. A multidisciplinary team was convened to plan her peripartum care. Because of increasing dyspnoea caesarean section was performed at 32weeks of gestation. She received a general anaesthetic using a modified rapid-sequence technique with remifentanil and rocuronium. The intraoperative period was complicated by desaturation and high airway pressures. The woman's postoperative care was complicated by respiratory compromise requiring high dependency care. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Congenital lobar emphysema in neonates: Anaesthetic challenges

    Directory of Open Access Journals (Sweden)

    Mridu Paban Nath

    2011-01-01

    Full Text Available Congenital lobar emphysema (CLE is a potentially reversible, though possibly life-threatening, cause of respiratory distress in the neonate. It poses dilemma in diagnosis and management. We are presenting a 6-week-old baby who presented with a sudden onset of respiratory distress related to CLE affecting the left upper lobe. Lobectomy was performed under general anaesthesia with one lung ventilation. The details of anaesthetic challenges and management are described here.

  2. Differential effects of procaine and phenethyl alcohol on excision repair of DNA in u.v.-irradiated Escherichia coli

    International Nuclear Information System (INIS)

    Tomiyama, H.; Tachibana, A.; Yonei, S.

    1986-01-01

    Experiments were performed to investigate the involvement of the cell membrane in the excision DNA repair process in Escherichia coli. Two membrane-binding drugs, procaine and phenethyl alcohol (PEA), inhibited liquid-holding recovery (LBR) in u.v.-irradiated E. coli wild-type and recA strains. In uvrB and polA strains where, after u.v.-irradiation, LHR was absent the two drugs had no effect. Both drugs markedly reduced the removal of u.v.-induced thymine dimers in the DNA of wild-type cells (H/r30). Analysis by alkaline sucrose gradients revealed that PEA inhibited the incision step in excision repair. In contrast, procaine had no effect on incision but apparently inhibited the late steps in excision repair. PEA dissociated DNA from the cell membrane, whereas procaine did not. The results suggest that the two drugs PEA and procaine inhibit LHR and the excision repair process operating on u.v.-induced damage in E. coli by at least two different mechanisms each of which may involve the cell membrane. (author)

  3. Withdrawal of amoxicillin and penicillin G procaine from milk after intramammary administration in dairy cows with mastitis

    Directory of Open Access Journals (Sweden)

    Burmańczuk Artur

    2017-03-01

    Full Text Available Introduction: There are many veterinary products containing β-lactam antibiotics which are used for mastitis treatment in cows. The aim of the study was to determine whether mastitis could have any effect on amoxicillin (AMX or penicillin G procaine (PEN withdrawal period from milk, in the context of current maximum residue limits established by the European Commission.

  4. 21 CFR 526.1696b - Penicillin G procaine-dihydrostreptomycin in soybean oil for intramammary infusion (dry cows).

    Science.gov (United States)

    2010-04-01

    ... subclinical mastitis in dairy cows at the time of drying off, specifically against infections caused by... soybean oil for intramammary infusion (dry cows). 526.1696b Section 526.1696b Food and Drugs FOOD AND DRUG... infusion (dry cows). (a) Specifications. Each 10 milliliters of suspension contains penicillin G procaine...

  5. Investigation of Electrochemical Behaviour of Quercetin on the Modified Electrode Surfaces with Procaine and Aminophenyl in Non-Aquous Medium

    Directory of Open Access Journals (Sweden)

    Ibrahim Ender Mulazimoglu

    2008-01-01

    Full Text Available In this study, cyclic voltammetry and electrochemical ımpedance spectroscopy have been used to investigate the electrochemical behaviour of quercetin (3,3′,4′,5,7-pentahydroxyflavone on the procaine and aminophenyl modified electrode. The modification of procaine and aminophenyl binded electrode surface with quercetin was performed in +0,3/+2,8 V (for procaine and +0,4/+1,5 V (for aminophenyl potential range using 100 mV s-1 scanning rate having 10 cycle. A solution of 0.1 M tetrabutylammonium tetrafluoroborate in acetonitrile was used as a non-aquous solvent. For the modification process a solution of 1 mM quercetin in 0.1 M tetrabutylammonium tetrafluoroborate was used. In order to obtain these two surface, a solution of 1 mM procaine and 1 mM nitrophenyl diazonium salt in 0.1 M tetrabutylammonium tetrafluoroborate was used. By using these solutions bare glassy carbon electrode surface was modified. Nitrophenyl was reduced to amine group in 0.1 M HCl medium on the nitrophenyl modified glassy carbon elelctrode surface. Procaine modified glassy carbon electrode surface was quite electroactive. Although nitrophenyl modified glassy carbon elelctrode surface was electroinactive, it was activated by reducing nitro group into amine group. For the characterization of the modified surface 1 mM ferrocene in 0.1 M tetrabutylammonium tetrafluoroborate for cyclic voltammetry and 1 mM ferricyanide/ferrocyanide (1:1 mixture in 0,1 M KCl for electrochemical impedance spectroscopy were used.

  6. Anaesthetic Management of Caesarean Section in an Achondroplastic Dwarf

    Directory of Open Access Journals (Sweden)

    Kirti N Saxena

    2008-01-01

    A twenty year old parturient with short stature presented to the hospital in early labour. An elective lower segment caesarean section(LSCS was planned in view of cephalopelvic disproportion. She had papers which suggested that she had been diagnosed as a case of achondroplasia though details were not available. Combined spinal epidural(CSE anaesthesia was planned in the patient in view of the death of her first baby following caesarean section under general anaesthesia. Repeatedly dry taps were achieved on attempting dural puncture. Dural puncture was abandoned and an 18 G epidural catheter was threaded via the Tuohy needle. Sensory block till T 6 was achieved with 6ml of local anaesthetic solution. The patient was stable during the intraoperative and postoperative period.

  7. Chloroquine, quinine, procaine, quinidine and clomipramine are prostaglandin agonists and antagonists.

    Science.gov (United States)

    Manku, M S; Horrobin, D F

    1976-11-01

    Chloroquine, quinine, procaine, quinidine and clomipramine behave as prostaglandin (PG) antagonists in a rat mesenteric vascular bed preparation. The ID50 concentrations were within the range of therapeutically effective human plasma levels in each case. Antagonism to PGE2 was studied in detail and seemed to be at least in part competitive. The drugs also antagonized the effects of PGs A1, A2, F2alpha and E1. Each drug also had weak prostaglandin agonist activity but only over a very narrow range of concentrations. It is possible that some of the clinical actions of these drugs may depend on blockade or imitation of natural PG effects. The findings suggest new approaches to the search for PG antagonists, a new screening technique for anti-inflammatory drugs and possible new uses for these established drugs. A preliminary study suggests that chloroquine may be successful in closing a patent ductus arteriosus in infants.

  8. Peri-anaesthetic complications in an equine referral hospital: Risk factors for post anaesthetic colic.

    Science.gov (United States)

    Jago, R C; Corletto, F; Wright, I M

    2015-11-01

    Peri-anaesthetic complications are relatively common in equine patients and further investigations are warranted to identify manageable risk factors. To report morbidity and mortality rates and identify associated risk factors for horses undergoing general anaesthesia, within a predominantly racing Thoroughbred (TB) population. Single centre retrospective observational study. Anaesthetic and case records of all horses ≥12 months old undergoing general anaesthesia at Newmarket Equine Hospital between August 2010 and April 2012 were analysed, excluding emergency abdominal/dystocia procedures or traumatology cases with cardiovascular compromise. Mortality and morbidity rates were calculated and described. Uni- and multivariable analyses were used to investigate the relationship between the principal complication, post anaesthetic colic (PAC) and risk factors. A total of 1067 anaesthetic records of 1021 horses were included in the study; of these, 702 horses (65.8%) were TB, 169 (15.8%) developed a complication within 7 days of general anaesthesia and 10 (0.94%) died as a result. The most prevalent morbidity was PAC, 111 horses (10.5%) developed colic within 7 days of general anaesthesia. Thoroughbred horses (odds ratio [OR] 2.93, 95% confidence interval [CI] 1.73-4.96) and horses receiving sodium benzylpenicillin (NaBP) (OR 2.77, 95% CI 1.69-4.50) were at increased risk of PAC. Thoroughbred racehorses were identified as at increased risk of PAC in this study and might benefit from more critical evaluation of post anaesthetic gastrointestinal function. An alternative to the administration of NaBP for prophylactic antimicrobial therapy needs to be further investigated if its role in PAC is confirmed by other studies. © 2015 EVJ Ltd.

  9. What is anaesthetic death? | Tudjegbe | Annals of Biomedical ...

    African Journals Online (AJOL)

    Anaesthetic death” is often defined as the death of a patient who has had an anaesthetic, within 24 hours of the procedure. This is irrespective of the contribution of anaesthesia to the cause of death. Many people disagree with this definition. We illustrate this point by presenting the case of a 5-year old boy who had ...

  10. The long-term consequences of anaesthetic management | Sessler ...

    African Journals Online (AJOL)

    Thus, it is reasonable to ask to what extent anaesthetic management might influence long-term outcomes. The distinction being made here is between the classical definition of anaesthetic complications, which is restricted to the immediate perioperative period, perhaps extending to a few days after surgery, and the ...

  11. Anaesthetic indices and vital parameters of PPR-infected West ...

    African Journals Online (AJOL)

    The aim of this study, was to assess and compare the anaesthetic indices and vital parameters of West African Dwarf (WAD) goats naturally infected with PPR before and after epidural anaesthesia with plain lignocaine and also to compare the measured anaesthetic indices with those of healthy goats. Ten goats were used ...

  12. Anaesthetic management of appendectomy in a patient with ...

    African Journals Online (AJOL)

    Background: The aim of anaesthetic management for appendectomy in a patient with cerebral arteriovenous malformation (AVM) is to maintain a stable cardiovascular system. As this condition is rare, there are no definitive guidelines regarding the anaesthetic management of such patients. Case report: We report a case of ...

  13. Influence of pre-anaesthetic thoracic radiographs on ASA physical status classification and anaesthetic protocols in traumatized dogs and cats

    International Nuclear Information System (INIS)

    Sigrist, N.; Mosing, M.; Iff, I.; Larenza, M.P.; Lang, J.; Spreng, D.

    2008-01-01

    The purpose of this study was to evaluate if pre-anaesthetic thoracic radiographs contribute to the anaesthetic management of trauma patients by comparing American Society of Anesthesiologists Physical Status Classification (ASA grade) with and without information from thoracic radiography findings. Case records of 157 dogs and cats being anaesthetized with or without post-traumatic, pre-anaesthetic chest radiographs were retrospectively evaluated for clinical parameters, radiographic abnormalities and anaesthetic protocol. Animals were retrospectively assigned an ASA grade. ASA grades, clinical signs of respiratory abnormalities and anaesthesia protocols were compared between animals with and without chest radiographs. The group of animals without pre-anaesthetic radiographs was anaesthetized earlier after trauma and showed less respiratory abnormalities at presentation. The retrospectively evaluated ASA grade significantly increased with the information from thoracic radiography. Animals with a higher ASA grade were less frequently mechanically ventilated. Pre-anaesthetic radiographs may provide important information to assess the ASA grade in traumatized patients and may therefore influence the anesthesia protocol

  14. Alteraciones biofarmacológicas de la procaína empleada por vía intradérmica Biopharmacological alterations of procaine used by via intradermal

    Directory of Open Access Journals (Sweden)

    LC López Agüero

    2010-12-01

    Full Text Available Se ha demostrado que los anestésicos locales tienen muchos efectos en diferentes células. Actúan directamente a nivel de la membrana plasmática e interactúan con lípidos y proteína de membrana produciendo desorden molecular, inhibición de la actividad de los fibroblastos, induce vacuolización de varios tipos celulares y entre otras acciones, disminuye la síntesis de colágeno. La procaína inhibe selectivamente el ATP calcio dependiente, bloqueando el ingreso celular del calcio extracelular, altera la función de los microtúbulos y microfilamentos, modifica la forma celular y la distribución de los receptores de membrana, inhibe diversas enzimas como la fosfolipasa A2 implicada en la lipólisis, altera el ADN y el ciclo celular. A pesar del hecho que los anestésicos locales (Ej: procaína han sido empleados en fórmulas de mesoterapia, como un "vector indispensable" por más de 55 años, debemos ser cuidadosos en su utilización como un diluyente de fórmulas. En base a estas modificaciones tisulares, consideramos que es importante conocer las acciones específicas de la procaína en las diferentes estructuras celulares.It has been shown that local anesthetics have many effects on different cells. They act directly at the plasma membrane and interact with membrane lipid and protein producing molecular disorder, inhibition of fibroblast activity, induces vacuolization of many cell types and, among other actions, decreases the synthesis of collagen. Procaine selectively inhibits ATP-calcium dependent, blocking the entry of extracellular calcium to the cell, alters the function of microtubules and microfilaments, changes cell shape and the distribution of membrane receptors, inhibits various enzymes like phospolipase A2 involved in lipolysis, alter the DNA and cell cycle. Despite the fact that local anesthetics (e.g. procaine have been used in mesotherapy formulas as an "indispensable vector" for over 55 years, we must be careful in

  15. 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.

  16. Attitudes and intentions of current anaesthetic trainees.

    Science.gov (United States)

    Fröhlich, S; Moriarty, J

    2013-03-01

    We report the results of a survey of Irish anaesthetic specialist trainees to establish their future training intentions, their interest in seeking a Consultant position in Ireland and identification of factors that may reduce the attractiveness of future employment in the HSE. 149 responses were received (71% of trainees). 137 (92%) are likely to complete further training abroad, but only 24 (16.1%) are definitely planning to return to work in Ireland. Factors, in order of importance that influence their return to Ireland include equivalence of all Consultants, salary level and availability of flexible work practices. Almost all (131 - 91%) would only consider working in Ireland at Consultant level. These results reveal that the current cohort of specialist trainees do not consider Ireland an attractive place to work, and any further diminution of the current Consultant grade will only serve to worsen this perception.

  17. Self-Inflicted Trauma Secondary to Local Anaesthesia in Children

    Directory of Open Access Journals (Sweden)

    Srikrishna Vempaty

    2017-01-01

    Full Text Available Long acting local anaesthetics and inferior alveolar nerve block in children can cause loss of sensation and proprioception in a large area supplied by that particular nerve. Similar to the maxilla in mandible also, adequate level of anaesthesia can be achieved in the desired site of treatment by using a short acting local anaesthetic. Early return of normal sensory feedback after using short acting anaesthetics can be helpful in preventing self-harm.

  18. Variation of tumour radiosensitivity with time after anaesthetic

    Energy Technology Data Exchange (ETDEWEB)

    Nias, A.H.W.; Perry, P.M. (Saint Thomas' Hospital, London (UK). Richard Dimbleby Research Lab.)

    1989-10-01

    Transplanted C{sub 3}H mouse mammary tumours were given single doses of X irradiation in air or oxygen at 1 atmosphere (atm) with or without anaesthesia of recipient mice by ketamine and diazepam. The radiation response to single doses of 25 Gy was determined in terms of time taken to reach 3.5 times the treatment volume. Under all conditions there was more growth delay in tumours irradiated in pure oxygen than in air. In air and oxygen, the radiation response for anaestheitized animals tended to fall below the level for non-anaesthetized ones when only 10 min had elapsed after administration of anaesthesia. After 25 min, the response in air was back to the level for non-anaesthetized animals but the oxygen group then showed significant sensitization compared with the oxygen without anaesthetic group. After 40 min, the air group showed slight sensitization and the oxygen group still showed significant sensitization by the anaesthetic. (author).

  19. Anaesthetic and Obstetric challenges of morbid obesity in ...

    African Journals Online (AJOL)

    Anaesthetic and Obstetric challenges of morbid obesity in caesarean ... in morbidly obese parturient that had caesarean delivery in a Nigerian tertiary care centre. ... This mirrors a World Health Organisation report published in the World Health ...

  20. The concept of anaesthetic-induced cardioprotection: clinical relevance

    NARCIS (Netherlands)

    de Hert, Stefan G.

    2005-01-01

    Experimental evidence has clearly demonstrated that volatile anaesthetic agents have direct protective properties against reversible and irreversible ischaemic myocardial damage. These properties have been related to a direct preconditioning effect but also to an effect on the extent of reperfusion

  1. Paravertebral block as a sole technique for the anaesthetic ...

    African Journals Online (AJOL)

    Kinsley Enohumah

    2016-04-11

    Apr 11, 2016 ... anaesthetic management of a ME patient who underwent breast cancer surgery. ... some minor discomfort in the axillary area. Since the patient ... postoperative analgesia without increased toxicity in healthy adults.

  2. Anaesthetic challenges in a patient with Klippel–Feil syndrome ...

    African Journals Online (AJOL)

    The anaesthetic considerations in the management of this patient are also discussed. Keywords: ... based on lean body weight for topical anaesthesia in adults. Co- .... another tool for difficult intubation or a new paradigm in airway.

  3. Anaesthetic effects of Adenia gummifera distillates on Apis mellifera (Honeybee).

    Science.gov (United States)

    Ngarivhume, T; Dzomba, P; Gwizangwe, I; Zendera, C H; Katsvanga, C A T; Jimu, L; Moyo, M; Chagonda, T

    2008-01-01

    The anaesthetic activities of steam distillates of Adenia gummifera stem on Apis mellifera were evaluated by a diffusion method. Live, direct and fractional (61-80 degrees C fraction) distillates had greater anaesthetic effect while vacuum distillates were mild. The anaesthetic activity significantly increased with concentration up to 6% (v/v), and then it levelled off, while excessive exposure was lethal. The number of bees in a given volume had no significant effect on anaesthetic activity but container volume (F(cal) = 66.4; F(3,8) = 4.07) and bee-distillate distance (F(cal) = 31.0; F(2,6) = 5.14) did, suggesting the rate of diffusion of active component could be the determining factor. The active component is likely to contain amines and the rest halogenated alkane.

  4. 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.

  5. Effect of lidocaine-prilocaine eutectic mixture of local anaesthetic ...

    African Journals Online (AJOL)

    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 ...

  6. Historical note: Drumine--a new Australian local anaesthetic.

    Science.gov (United States)

    Bailey, R J

    1977-02-01

    An article in the Australiasian Medical Gazette of October, 1886 indicates the method of extraction, experimentation and therapeutic application of an active principle, prepared from Euphorbia Drummondii. Further correspondence is noted, refining the method of extraction, reporting cases, answering criticisms, and announcing eventually, drumine's commercial preparation. Despite enthusiastic support, the drug soon disappears from the therapeutic scene.

  7. Regional anaesthesia, local anaesthetics and the surgical stress response

    NARCIS (Netherlands)

    Hahnenkamp, Klaus; Herroeder, Susanne; Hollmann, Markus W.

    2004-01-01

    Epidural anaesthesia has the potential to improve patients' outcome after major surgical procedures by reducing postoperative morbidity and duration of recovery. Possible benefits include the attenuation of cardiac complications, an earlier return of gastrointestinal function associated with an

  8. Caesarean section wound infiltration with local anaesthetic for ...

    African Journals Online (AJOL)

    We searched the Cochrane Pregnancy and Childbirth Group's Trials Register ... morphine consumption at 24 hours compared with placebo (morphine dose -1.70 mg; ... Non-steroidal anti-inflammatory drugs may provide additional pain relief.

  9. A review of an anaesthetic led vascular access list.

    Science.gov (United States)

    Galloway, S; Sharma, A; Ward, J; Bodenham, A R

    2005-08-01

    The demand for insertion of long-term central venous (Hickman type) catheters is thought to be increasing. Organisation is required to meet this demand in a safe and efficient manner. This report reviews the results from a dedicated, anaesthetic led vascular access list over the initial 61-month period. One thousand procedures were performed. Nine hundred and twenty catheters were inserted under local anaesthesia, with or without intravenous sedation and analgesia. Eighty catheters were removed. All procedures were performed during a dedicated once weekly, morning list. A total of 53% of all procedures were performed on a day-case basis, 43% on in-patients. Only 1.5% of patients required an unexpected overnight stay (usually medically unfit patients). There were 81 (9%) cancellations on the day of procedure due to neutropaenia, pneumonia or urinary tract infections. Ultrasound guidance was used initially selectively in 14%, latterly in 100% of procedures and fluoroscopy in all insertions to confirm or adjust catheter position. This service has been well received by patients and oncology services. In addition it provides an interesting area of practice for anaesthetists and an ideal environment for teaching more advanced aspects of central venous access. It may provide a template of service for other centres.

  10. [The influence of procaine electrophoresis and mesotherapy on the indices of body components and biochemical characteristics in the subjects above 30 years of age].

    Science.gov (United States)

    Turova, E A; Konchugova, T V; Balaban, E I; Fadeeva, N I; Golovach, A V; Teniaeva, E A

    2013-01-01

    This study has demonstrated the effectiveness of a 2% procaine solution given with a view to improving metabolic parameters of aging, such as the body weight and composition along with the lipid profile in the patients varying in age from 30 years to 75 years. The study involved 95 patients treated with a 2% procaine solution that was administered by different methods (electrophoresis and mesotherapy) into several points of the collar region and upper back. The control group was comprised of the patients who received placebo by means of galvanization and mesotherapy. The results of the study indicate that the introduction of a 2% procaine solution in the treatment of metabolic disorders effectively improves selected metabolic characteristics of ageing and thereby helps to reduce the biological age in comparison with the control patients treated with placebo.

  11. Fundamentals of ionic conductivity relaxation gained from study of procaine hydrochloride and procainamide hydrochloride at ambient and elevated pressure.

    Science.gov (United States)

    Wojnarowska, Z; Swiety-Pospiech, A; Grzybowska, K; Hawelek, L; Paluch, M; Ngai, K L

    2012-04-28

    The pharmaceuticals, procaine hydrochloride and procainamide hydrochloride, are glass-forming as well as ionically conducting materials. We have made dielectric measurements at ambient and elevated pressures to characterize the dynamics of the ion conductivity relaxation in these pharmaceuticals, and calorimetric measurements for the structural relaxation. Perhaps due to their special chemical and physical structures, novel features are found in the ionic conductivity relaxation of these pharmaceuticals. Data of conductivity relaxation in most ionic conductors when represented by the electric loss modulus usually show a single resolved peak in the electric modulus loss M(")(f) spectra. However, in procaine hydrochloride and procainamide hydrochloride we find in addition another resolved loss peak at higher frequencies over a temperature range spanning across T(g). The situation is analogous to many non-ionic glass-formers showing the presence of the structural α-relaxation together with the Johari-Goldstein (JG) β-relaxation. Naturally the analogy leads us to name the slower and faster processes resolved in procaine hydrochloride and procainamide hydrochloride as the primary α-conductivity relaxation and the secondary β-conductivity relaxation, respectively. The analogy of the β-conductivity relaxation in procaine HCl and procainamide HCl with JG β-relaxation in non-ionic glass-formers goes further by the finding that the β-conductivity is strongly related to the α-conductivity relaxation at temperatures above and below T(g). At elevated pressure but compensated by raising temperature to maintain α-conductivity relaxation time constant, the data show invariance of the ratio between the β- and the α-conductivity relaxation times to changes of thermodynamic condition. This property indicates that the β-conductivity relaxation has fundamental importance and is indispensable as the precursor of the α-conductivity relaxation, analogous to the relation found

  12. Cleaning and sterilisation of anaesthetic equipment

    Directory of Open Access Journals (Sweden)

    Chitra Sanjeev Juwarkar

    2013-01-01

    Full Text Available The main purpose of this review article is to bring up what has been known (practiced about decontamination, disinfection, and sterilisation of anaesthetic equipment. It also discusses how this evidence-based information on infection prevention and control impacts care of patient in routine anaesthesia practice. This review underscores the role played by us, anaesthetists in formulating guidelines, implementing the same, monitoring the outcome and training post-graduate trainees and coworkers in this regard. The article re-emphasises that certain guidelines when followed strictly will go a long way in reducing transmission of hospital acquired infection between patient and anaesthetist or between patients. Anaesthetists do not restrict their work to operating room but are involved in disaster management, interventional radiological procedures and in trauma care. They should ensure that the patients are cared for in clean and safe environment so as to reduce healthcare associated infections (HCAIs simultaneously taking preventive measures against the various health hazards associated with clinical practice. They should ensure that the coworkers too adopt all the preventive measures while delivering their duties. For this review, we conducted literature searches in Medline (PubMed and also searched for relevant abstracts and full texts of related articles that we came across. There is much to be learned from the western world where, health care organisations now have legal responsibility to implement changes in accordance with the newer technology to reduce health care associated infection. There is a need to develop evidence-based infection prevention and control programs and set national guidelines for disinfection and sterilisation of anaesthesia equipment which all the institutions should comply with.

  13. Species specific anaesthetics for fish anaesthesia and euthanasia.

    Science.gov (United States)

    Readman, Gareth D; Owen, Stewart F; Knowles, Toby G; Murrell, Joanna C

    2017-08-02

    There is a need to ensure that the care and welfare for fish maintained in the laboratory are to the highest standards. This extends to the use of anaesthetics for both scientific study, humane killing and euthanasia at end of life. An anaesthetic should not induce negative behaviours and fish should not seek to avoid the anaesthetic. Surprisingly little information is available to facilitate a humane choice of anaesthetic agent for fish despite over 100 years of use and the millions of fish currently held in thousands of laboratories worldwide. Using a chemotaxic choice chamber we found different species specific behavioural responses among four closely related fish species commonly held in the laboratory, exposed to three widely used anaesthetic agents. As previously found for zebrafish (Danio rerio), the use of MS-222 and benzocaine also appears to induce avoidance behaviours in medaka (Oryzias latipes); but etomidate could provide an alternative choice. Carp (Cyprinus carpio), although closely related to zebrafish showed avoidance behaviours to etomidate, but not benzocaine or MS-222; and rainbow trout (Oncorhynchus mykiss) showed no avoidance to the three agents tested. We were unable to ascertain avoidance responses in fathead minnows (Pimephales promelas) and suggest different test paradigms are required for that species.

  14. The value of decision tree analysis in planning anaesthetic care in obstetrics.

    Science.gov (United States)

    Bamber, J H; Evans, S A

    2016-08-01

    The use of decision tree analysis is discussed in the context of the anaesthetic and obstetric management of a young pregnant woman with joint hypermobility syndrome with a history of insensitivity to local anaesthesia and a previous difficult intubation due to a tongue tumour. The multidisciplinary clinical decision process resulted in the woman being delivered without complication by elective caesarean section under general anaesthesia after an awake fibreoptic intubation. The decision process used is reviewed and compared retrospectively to a decision tree analytical approach. The benefits and limitations of using decision tree analysis are reviewed and its application in obstetric anaesthesia is discussed. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. The effect of a topical anaesthetic formulation, systemic flunixin and carprofen, singly or in combination, on cortisol and behavioural responses of Merino lambs to mulesing.

    Science.gov (United States)

    Paull, D R; Lee, C; Colditz, I G; Atkinson, S J; Fisher, A D

    2007-03-01

    lambs of mulesing could be improved by use of a combination of local anaesthetic and long acting non-steroidal anti-inflammatory drug.

  16. Anaesthetic efficacy of bupivacaine 2-hydroxypropyl-β-cyclodextrin for dental anaesthesia after inferior alveolar nerve block in rats.

    Science.gov (United States)

    Serpe, L; Franz-Montan, M; Santos, C P dos; Silva, C B da; Nolasco, F P; Caldas, C S; Volpato, M C; Paula, E de; Groppo, F C

    2014-05-01

    Bupivacaine is a long-acting local anaesthetic that is widely used in medicine and dentistry. The duration and intensity of its sensory blockade in animal models is increased by its inclusion in complexes with cyclodextrins. The aim of the present study was to evaluate the anaesthetic efficacy of bupivacaine 2-hydroxypropyl-β-cyclodextrin (HPβCD) inclusion complex for dental anaesthesia after inferior alveolar nerve block in rats. Thirty rats were each given an injection close to the mandibular foramen of 0.2ml of one of the following formulations: 0.5% bupivacaine alone; 0.5% bupivacaine with 1:200,000 epinephrine; and 0.5% bupivacaine-HPβCD inclusion complex (bupivacaine-HPβCD). The other sides were used as controls, with either 0.9% saline or anaesthetic-free HPβCD solution being injected. The onset, success, and duration of pulpal anaesthesia were assessed by electrical stimulation ("pulp tester") on inferior molars. Results were analysed using ANOVA (Tukey), log rank, and chi square tests (α=5%). There were no differences among the formulations in onset of anaesthesia (p=0.59) or between the bupivacaine plus epinephrine and bupivacaine plus HPβCD in duration of anaesthesia, but bupivacaine plus epinephrine gave significantly higher values than bupivacaine alone (p=0.007). Bupivacaine plus epinephrine was a better anaesthetic than bupivacaine alone (p=0.02), while Bupi-HPβCD gave intermediate results, and therefore did not differ significantly from the other 2 groups (p=0.18 with bupivacaine alone; and p=0.44 with bupivacaine plus epinephrine). The bupivacaine-HPβCD complex showed similar anaesthetic properties to those of bupivacaine with epinephrine. Copyright © 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  17. Anaesthetic implications of osteo-odonto-keratoprosthesis surgery.

    Science.gov (United States)

    Skelton, V A; Henderson, K; Liu, C

    2000-06-01

    Patients with bilateral corneal blindness in whom corneal transplantation has either been unsuccessful or inappropriate may be considered for osteo-odonto-keratoprosthesis surgery. During a two-stage procedure the surface of the cornea is removed and covered with a graft of buccal mucosa. An optical cylinder, supported by an osteo-odonto lamina planed from a tooth is then inserted into the mucosa to act as a lens. The anaesthetic implications of this operation include care of patients from a wide age range, often with underlying medical problems undergoing two operations of prolonged duration. The eye can be 'open' during both stages of the operation and anaesthetic techniques directed towards prevention of rises in vitreal pressure are essential. This article outlines the surgical process of osteo-odonto-keratoprosthesis surgery with reference to our anaesthetic experiences from nine cases.

  18. The perspectives of eThekwini public service anaesthetic doctors on ...

    African Journals Online (AJOL)

    ... public service anaesthetic doctors on the informed consent process for anaesthesia. ... in four main areas: the preanaesthetic interview, optimisation of the process, ... the recording of written consent on a specific anaesthetic consent form.

  19. Memory-impairing effects of local anesthetics in an elevated plus-maze test in mice

    Directory of Open Access Journals (Sweden)

    S.L. Blatt

    1998-04-01

    Full Text Available Post-training intracerebroventricular administration of procaine (20 µg/µl and dimethocaine (10 or 20 µg/µl, local anesthetics of the ester class, prolonged the latency (s in the retention test of male and female 3-month-old Swiss albino mice (25-35 g body weight; N = 140 in the elevated plus-maze (mean ± SEM for 10 male mice: control = 41.2 ± 8.1; procaine = 78.5 ± 10.3; 10 µg/µl dimethocaine = 58.7 ± 12.3; 20 µg/µl dimethocaine = 109.6 ± 5.73; for 10 female mice: control = 34.8 ± 5.8; procaine = 55.3 ± 13.4; 10 µg/µl dimethocaine = 59.9 ± 12.3 and 20 µg/µl dimethocaine = 61.3 ± 11.1. However, lidocaine (10 or 20 µg/µl, an amide class type of local anesthetic, failed to influence this parameter. Local anesthetics at the dose range used did not affect the motor coordination of mice exposed to the rota-rod test. These results suggest that procaine and dimethocaine impair some memory process(es in the plus-maze test. These findings are interpreted in terms of non-anesthetic mechanisms of action of these drugs on memory impairment and also confirm the validity of the elevated plus-maze for the evaluation of drugs affecting learning and memory in mice

  20. The anaesthetic potency of benzocaine-hydrochloride in three ...

    African Journals Online (AJOL)

    The suitability of this substance in fish physiological research was assessed and it compared very favourably with MS 222 in inducing anaesthesia in freshwater fishes (Ferreira et al. 1979a). We have now compared the anaesthetic potency of four different concentrations of BH on three freshwater fish species at three ...

  1. Radiation induced changes in the airway - anaesthetic implications ...

    African Journals Online (AJOL)

    Radiation induced changes in the airway - anaesthetic implications: case report. Mallika Balakrishnan, Renju Kuriakose, Rachel Cherian Koshy. Abstract. Radiation induces a variety of changes in the airway that can potentially lead to difficult intubation. Osteoradionecrosis (ORN) of the mandible, a severe consequence of ...

  2. Cleft lip and palate surgery in children: Anaesthetic considerations ...

    African Journals Online (AJOL)

    Background: The Care of cleft patients is very challenging. Team cleft care is usually lacking in many developing countries due to shortage of qualified manpower. This study is aimed at highlighting anaesthetic challenges in the management of cleft in children. Patients and Methods: This was a study of cleft lip and palate ...

  3. Occupational exposure to anaesthetic gases: a role for TIVA.

    Science.gov (United States)

    Irwin, Michael G; Trinh, Theresa; Yao, Che-Lin

    2009-07-01

    Modern anaesthesia is still mostly administered by the inhalational route and there is increasing concern over its potential for pollution. One of the first gaseous anaesthetic agents was nitrous oxide and this is still widely used today despite being associated with adverse effects caused by depression of vitamin B(12) function and diminished reproductive health. The use of halothane is associated with hepatitis but the adverse effects of newer halogenated hydrocarbons are less well recognised. Chronic exposure may cause reduction in antioxidant activity in plasma and erythrocytes, inhibition of neutrophil apoptosis, depression of central neuro-respiratory activity, increased DNA breaks, effects on cerebral blood circulation and altered renal function. Inhalational anaesthetics also have adverse environmental effects, including ozone damage and greenhouse gas effects. Levels of inhalational anaesthetics in the ambient air of operating theatres and recovery rooms often exceed those stated in national guidelines. Anaesthetic procedures can be modified and air-conditioning and air scavenging systems should be used to minimise the risks from occupational exposure and threats to the environment. Such contamination could be avoided with the use of total intravenous anaesthesia.

  4. Strengthening Surgical and Anaesthetic Services at District Level in ...

    African Journals Online (AJOL)

    ADMIN

    treatable conditions, with Southeast Asia and Africa accounting for 54% of these cases. .... 22http://dcp-3.org/disease-control-priorities-third-edition ... to surgical and anaesthetic services in a cost-effective manner.28 It is essential, of course,.

  5. Case Report: Anaesthetic management of a Rare Oesophageal ...

    African Journals Online (AJOL)

    Foreign body impaction is a common and potentially fatal condition encountered by both anaesthetists and surgeons. Skilled airway management is vital to avoid catastrophic outcomes. Children less than five years of age are particularly vulnerable. We report the anaesthetic challenges and management of a 2 year old boy ...

  6. anaesthetic challenges in a high risk parturient with myasthenia

    African Journals Online (AJOL)

    2013-10-10

    Oct 10, 2013 ... Intraoperative myasthenia crisis was managed with neostigmine infusion. She was managed in ... but world-wide, it is twice as common in women as in men and frequently .... could be a challenge when they present for surgery. The ideal anaesthetic ... intravenous opioids, neuromuscular blocking drugs,.

  7. Anaesthetic Management of Homozygous Sickle Cell Patients at ...

    African Journals Online (AJOL)

    Background: Sickle cell disease is a common comorbidity in patient presenting for surgical care in our hospitals. The aim of this study was to evaluate the outcome of anaesthetic management of sickle cell disease patients in our hospital. Patients and method: A prospective audit was conducted for a period of 12 months, ...

  8. special position for the anaesthetic management of a patient with ...

    African Journals Online (AJOL)

    2010-03-01

    Mar 1, 2010 ... was too huge to allow adoption of the supine position for induction of anaesthesia. In order to achieve a suit- ... Keywords: Anaesthetic position, Operating table, Gi- ant mass, Airway management, General .... tions of stroke and death related to shoulder sur- gery in the sitting position. Arthroscopy 2008.

  9. Evaluation of anaesthetic protocols for laboratory adult zebrafish (Danio rerio.

    Directory of Open Access Journals (Sweden)

    Tânia Martins

    Full Text Available In the last decades, the use of zebrafish (Danio rerio in biomedical research has increased. Anaesthesia is daily used in fish during experimental procedures to avoid discomfort, stress or pain. Also, fish welfare and the reliability of results can be compromised if an unsuitable anaesthetic protocol is used. Therefore, we aimed to refine anaesthetic protocols to be used in adult zebrafish by evaluating the efficacy of different anaesthetics, used alone or in combination. For that, zebrafish were randomly assigned to 8 different groups: 100 μg/mLMS-222 (MS; 0.2 μg/mL etomidate (E; 0.2 μg/mL etomidate + 100 μg/mL lidocaine (E+L; 1.25 μg/mL propofol (P; 1.25 μg/mL propofol + 100 μg/mL lidocaine (P+L; 100 μg/mL ketamine (K; 100 μg/mL ketamine + 1.25 μg/mL medetomidine (K+M; and 100 μg/mL ketamine + 1.25 μg/mL medetomidine/3.125 μg/mL atipamezole (K+M/A. The animals were placed in an anaesthetic water bath, then, the following parameters were registered: time for equilibrium loss and anaesthesia induction, loss of sensitivity to soft and painful stimuli, respiratory rate, recovery time, and activity after recovery. The combined forms of E+L, P+L and K+M were the fastest to induce a surgical anaesthetic stage. Nevertheless, E+L induced respiratory depression, while K+M was shown to have the longer recovery time compared to MS-222, even when atipamezole was added. In conclusion, the P+L combination was shown to provide good anaesthesia with analgesia, without causing a major respiratory depression, providing as well a quick recovery, similar to MS-222.

  10. 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.

  11. Anaesthetic Management of Mentosternal Contractures Where ...

    African Journals Online (AJOL)

    Six of the cases had laryngeal mask airway (LMA) inserted while one patient had a tracheostomy under local anaesthesia. After adequate release endotracheal tubes were inserted except in those who had LMA which were maintained to the end of the surgery. The rest of the procedure was then continued under general ...

  12. Anaesthetic practice for groin hernia repair--a nation-wide study in Denmark 1998-2003

    DEFF Research Database (Denmark)

    Kehlet, Henrik; Bay-Nielsen, M

    2005-01-01

    -effects and is without documented advantages on morbidity in this small operation. METHODS: To describe the use of the three anaesthetic techniques for elective open groin hernia surgery in Denmark from January 1st 1998 to December 31st 2003, based on the Danish Hernia Database collaboration. RESULTS: In a total of 57......,505 elective open operations 63.6% were performed in general anaesthesia, 18.3% in regional anaesthesia and 18.1% in local anaesthesia. Regional anaesthesia was utilized with an increased rate in elderly and hospitalized patients. Outpatient surgery was most common with local infiltration anaesthesia...

  13. Anaesthetic Considerations of Awake Craniotomy: An Upcoming Entity

    Directory of Open Access Journals (Sweden)

    Jui Lagoo

    2014-08-01

    Full Text Available Awake craniotomy was historically advocated for resistant epilepsy surgery. Presently, its role has widened for resection of lesions abutting or invading the eloquent cortex. It aims at maximizing resection while minimizing neurological damage. Anaesthetic challenges include providing sufficient depth of anaesthesia, full cooperation and consciousness during cortical mapping, smooth transition between anaesthesia and consciousness, airway protection, haemodynamic stability, patient immobility and co-operation. Communication and co-operation between the patient and surgical and anaesthesia teams is vital. We report safe conduct of monitored anaesthesia care by the combined use of dexmedetomidine and scalp nerve blocks for tumour resection. This technique ensured haemodynamic stability, decreased stress response to painful stimuli and improved patient tolerance. As awake craniotomy is an upcoming technique, knowledge about anaesthetic implications, challenges and techniques will help in optimum management.

  14. 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.

  15. Anaesthetic Efficacy of Sodium Bicarbonate and its Effects on the ...

    African Journals Online (AJOL)

    Anaesthetic efficacy of Sodium bicarbonate (NaHC03) and its effects on haematology of African Catfish (Clarias gariepinus) in five different concentrations [0.00 g/L (control), 50.00, 100.00, 150.00 and 200.00 g/L] were determined in two sizes: juvenile (mean length 26.64 cm ± 3.11SD; mean weight 356.21 g ± 12.91SD) ...

  16. 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. Copyright © 2011 Elsevier Ltd. All rights reserved.

  17. [Local anaesthesia in ruminants].

    Science.gov (United States)

    Nuss, Karl; Schwarz, Andrea; Ringer, Simone

    2017-06-20

    The use of local anaesthesia in ruminants allows many surgical procedures to be conducted free of pain, efficiently and inexpensively in the field. Local anaesthesia combined with sedation and immobilisation of the animal can replace general anaesthesia for many procedures (e. g. castration, claw amputation). The level of difficulty differs among various local anaesthetic techniques: local infiltration of tissue or anaesthesia of the cornual nerve are easily performed, whereas local anaesthesia of the eye, regional anaesthesia in limbs or anaesthesia for umbilical surgery are more difficult to carry out. This article presents an illustrated overview of the most common local anaesthetic procedures in cattle as well as in small ruminants and serves as a practical guide for veterinarians in the field. In principle, these techniques can likewise be applied in other ruminants or artiodactyls.

  18. Anaesthetic Management of a Patient with Pseudo-TORCH Syndrome

    Directory of Open Access Journals (Sweden)

    Derya Berk

    2013-09-01

    Full Text Available Background: Pseudo-TORCH syndrome is a rare, chronic disorder that is characterised by dimorphic features such as microcephaly, intracranial calcification, seizures, mental retardation, hepatosplenomegaly and coagulation disorders. Case Report: We present the anaesthetic management of a forty day-old boy with Pseudo-TORCH syndrome during magnetic resonance imaging. Microcephaly, growth failure, high palate and bilateral rales in the lungs were detected in pre-anaesthetic physical examination. The peripheral oxygen saturation was 88-89% in room-air and was 95% in a hood with 5 L/min oxygen. We planned general anaesthesia to ensure immobility during magnetic resonance imaging. After standard monitoring, general anaesthesia was induced with 8% sevoflurane in 100% O2. After an adequate depth of anaesthesia was reached, we inserted a supraglottic airway device to avoid intubation without the use of a muscle relaxant. Conclusion: In patients with Pseudo-TORCH syndrome, the perioperative anaesthetic risk was increased. We believe that using a supraglottic airway device to secure the airway is less invasive than intubation, and can be performed without the need of muscle relaxants.

  19. Anaesthetic Management of a Patient with Pseudo-TORCH Syndrome.

    Science.gov (United States)

    Berk, Derya; Kuş, Alparslan; Sahin, Tülay; Solak, Mine; Toker, Kamil

    2013-09-01

    Pseudo-TORCH syndrome is a rare, chronic disorder that is characterised by dimorphic features such as microcephaly, intracranial calcification, seizures, mental retardation, hepatosplenomegaly and coagulation disorders. We present the anaesthetic management of a forty day-old boy with Pseudo-TORCH syndrome during magnetic resonance imaging. Microcephaly, growth failure, high palate and bilateral rales in the lungs were detected in pre-anaesthetic physical examination. The peripheral oxygen saturation was 88-89% in room-air and was 95% in a hood with 5 L/min oxygen. We planned general anaesthesia to ensure immobility during magnetic resonance imaging. After standard monitoring, general anaesthesia was induced with 8% sevoflurane in 100% O2. After an adequate depth of anaesthesia was reached, we inserted a supraglottic airway device to avoid intubation without the use of a muscle relaxant. In patients with Pseudo-TORCH syndrome, the perioperative anaesthetic risk was increased. We believe that using a supraglottic airway device to secure the airway is less invasive than intubation, and can be performed without the need of muscle relaxants.

  20. 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.

  1. Metabolism of aspirin and procaine in mice pretreated with O-4-nitrophenyl methyl(phenyl)phosphinate or O-4-nitrophenyl diphenylphosphinate

    International Nuclear Information System (INIS)

    Joly, J.M.; Brown, T.M.

    1986-01-01

    Concentrations of [carboxyl- 14 C]procaine in blood of mice were increased threefold for 27 min by exposure to O-4-nitrophenyl diphenylphosphinate 2 hr prior to [carboxyl- 14 C]procaine injection ip, while there was no effect of O-4-nitrophenyl methyl(phenyl)phosphinate pretreatment. There was no effect of either organophosphinate on the primary hydrolysis of [acetyl-l- 14 C]aspirin when assessed by the expiration of [ 14 C]carbon dioxide; however, O-4-nitrophenyl diphenylphosphinate pretreatment produced transient increases in blood concentrations of both [carboxyl- 14 C]aspirin and [carboxyl- 14 C]salicylic acid following administration of [carboxyl- 14 C]aspirin. Liver carboxylesterase activity in O-4-nitrophenyl diphenylphosphinate pretreated mice was 11% of control activity. These results indicate the potential for drug interaction with O-4-nitrophenyl diphenylphosphinate but not with O-4-nitrophenyl methyl(phenyl)phosphinate. It appears that liver carboxylesterase activity has a minor role in hydrolysis of aspirin in vivo, but may be more important in procaine metabolism

  2. Preparation and characterization of the titanium dioxide thin films used for pH electrode and procaine drug sensor by sol-gel method

    International Nuclear Information System (INIS)

    Liao Yihung; Chou, J.-C.

    2009-01-01

    We used titanium dioxide (TiO 2 ) as the sensing layer of an ion selective pH sensor electrode, and as the substrate for a procaine drug sensitive membrane sensor. The TiO 2 thin films were prepared using sol-gel spin coating technology. We adopted the Ti(OC 4 H 9 ) 4 as the precursor, and added an ethanol solute to obtain the TiO 2 sol. The sol-gel was spun coated onto the indium tin oxide (ITO) substrate. The drug sensitive membrane was coated on the TiO 2 film. We then measured the I DS -V G curves of the TiO 2 ion selective electrode (ISE) pH sensor in pH buffer solutions that had different pH concentrations using a Keithley 236 Semiconductor Parameter Analyzer instrument. The procaine concentration was measured from 10 -2 M to 10 -6 M with the drug sensitive membrane using a HP 34401A Digital Multimeter. We prepared the TiO 2 ISE pH sensor and obtained a high pH sensitivity of 58.73 mV/pH. Uniform TiO 2 films surface structures, with an average roughness (Ra) of 10.211 nm and root mean square roughness (Rms) of 13.01 nm were obtained. The drift effect of the titanium dioxide ion selective pH sensor electrode is 1.97 mV h -1 . The sensitivity of the procaine drug sensor is 55.03 mV pC -1 between 1.0 x 10 -2 mol L -1 and 1.0 x 10 -6 mol L -1 procaine concentrations. The detection limit is 5.0 x 10 -6 mol L -1 . The response time to reach 90% output voltage is 16 s. Forty seconds are required to reach 95% output voltage. The procaine drug sensor 1 x 10 -3 mol L -1 drift test is 3.64 mV h -1 and the variation in output voltage of the repeated measurement is less than 7.4 mV

  3. Optimised NLC: a nanotechnological approach to improve the anaesthetic effect of bupivacaine.

    Science.gov (United States)

    Rodrigues da Silva, Gustavo H; Ribeiro, Lígia N M; Mitsutake, Hery; Guilherme, Viviane A; Castro, Simone R; Poppi, Ronei J; Breitkreitz, Márcia C; de Paula, Eneida

    2017-08-30

    The short time of action and systemic toxicity of local anaesthetics limit their clinical application. Bupivacaine is the most frequently used local anaesthetic in surgical procedures worldwide. The discovery that its S(-) enantiomeric form is less toxic than the R(+) form led to the introduction of products with enantiomeric excess (S75:R25 bupivacaine) in the market. Nevertheless, the time of action of bupivacaine is still short; to overcome that, bupivacaine S75:R25 (BVC S75 ) was encapsulated in nanostructured lipid carriers (NLC). In this work, we present the development of the formulation using chemometric tools of experimental design to study the formulation factors and Raman mapping associated with Classical Least Squares (CLS) to study the miscibility of the solid and the liquid lipids. The selected formulation of the nanostructured lipid carrier containing bupivacaine S75:R25 (NLC BVC ) was observed to be stable for 12 months under room conditions regarding particle size, polydispersion, Zeta potential and encapsulation efficiency. The characterisation by DSC, XDR and TEM confirmed the encapsulation of BVC S75 in the lipid matrix, with no changes in the structure of the nanoparticles. The in vivo analgesic effect elicited by NLC BVC was twice that of free BVC S75 . Besides improving the time of action , no statistical difference in the blockage of the sciatic nerve of rats was found between 0.125% NLC BVC and 0.5% free BVC S75 . Therefore, the formulation allows a reduction in the required anaesthesia dose, decreasing the systemic toxicity of bupivacaine, and opening up new possibilities for different clinical applications. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Anaesthetic injection versus ischemic compression for the pain relief of abdominal wall trigger points in women with chronic pelvic pain.

    Science.gov (United States)

    Montenegro, Mary L L S; Braz, Carolina A; Rosa-e-Silva, Julio C; Candido-dos-Reis, Francisco J; Nogueira, Antonio A; Poli-Neto, Omero B

    2015-12-01

    Chronic pelvic pain is a common condition among women, and 10 to 30 % of causes originate from the abdominal wall, and are associated with trigger points. Although little is known about their pathophysiology, variable methods have been practiced clinically. The purpose of this study was to evaluate the efficacy of local anaesthetic injections versus ischemic compression via physical therapy for pain relief of abdominal wall trigger points in women with chronic pelvic pain. We conducted a parallel group randomized trial including 30 women with chronic pelvic pain with abdominal wall trigger points. Subjects were randomly assigned to one of two intervention groups. One group received an injection of 2 mL 0.5 % lidocaine without a vasoconstrictor into a trigger point. In the other group, ischemic compression via physical therapy was administered at the trigger points three times, with each session lasting for 60 s, and a rest period of 30 s between applications. Both treatments were administered during one weekly session for four weeks. Our primary outcomes were satisfactory clinical response rates and percentages of pain relief. Our secondary outcomes are pain threshold and tolerance at the trigger points. All subjects were evaluated at baseline and 1, 4, and 12 weeks after the interventions. The study was conducted at a tertiary hospital that was associated with a university providing assistance predominantly to working class women who were treated by the public health system. Clinical response rates and pain relief were significantly better at 1, 4, and 12 weeks for those receiving local anaesthetic injections than ischemic compression via physical therapy. The pain relief of women treated with local anaesthetic injections progressively improved at 1, 4, and 12 weeks after intervention. In contrast, women treated with ischemic compression did not show considerable changes in pain relief after intervention. In the local anaesthetic injection group, pain threshold

  5. 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.

  6. Distinct molecular sites of anaesthetic action: pentobarbital block of human brain sodium channels is alleviated by removal of fast inactivation

    NARCIS (Netherlands)

    Wartenberg, H. C.; Urban, B. W.; Duch, D. S.

    1999-01-01

    Fast inactivation of sodium channel function is modified by anaesthetics. Its quantitative contribution to the overall anaesthetic effect is assessed by removing the fast inactivation mechanism enzymatically. Sodium channels from human brain cortex were incorporated into planar lipid bilayers. After

  7. 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

  8. Fentanyl bolus induces muscle tremors in sevoflurane-anaesthetized piglets.

    Science.gov (United States)

    Ringer, S K; Spielmann, N; Weiss, M; Mauch, J Y

    2016-08-01

    Intravenous fentanyl (10 mcg/kg) or saline (control) was randomly administered to 10 healthy sevoflurane-mono-anaesthetized piglets. Trembling was assessed by two blinded observers using a visual analogue scale (VAS) and a simple ordinal scale at baseline and 5 min (T5) after drug administration. If no trembling was observed at that time point, the opposite treatment was administered and piglets were re-evaluated after another 5 min (T10). Four out of five piglets showed trembling after fentanyl (T5), while none given saline showed any trembling. With fentanyl the VAS scores were significantly higher at T5 compared either with baseline or with the control treatment. Control animals received fentanyl after the 5 min evaluation and all piglets showed clear trembling afterwards. The median time after fentanyl administration until first muscle tremors was 51 (20-840) s. In summary, nine out of 10 sevoflurane-anaesthetized piglets showed muscle tremors after intravenous fentanyl. Tremors subsided over time and no specific treatment was necessary. © The Author(s) 2015.

  9. Burnout and the learning environment of anaesthetic trainees.

    Science.gov (United States)

    Castanelli, D J; Wickramaarachchi, S A; Wallis, S

    2017-11-01

    Burnout has a high prevalence among healthcare workers and is increasingly recognised as an environmental problem rather than reflecting a personal inability to cope with work stress. We distributed an electronic survey, which included the Maslach Burnout Inventory Health Services Survey and a previously validated learning environment instrument, to 281 Victorian anaesthetic trainees. The response rate was 50%. We found significantly raised rates of burnout in two of three subscales. Ninety-one respondents (67%) displayed evidence of burnout in at least one domain, with 67 (49%) reporting high emotional exhaustion and 57 (42%) reporting high depersonalisation. The clinical learning environment tool demonstrated a significant negative correlation with burnout (r=-0.56, P Burnout was significantly more common than when previously measured in Victoria in 2008 (62% versus 38%). Trainees rated examination preparation the most stressful aspect of the training program. There is a high prevalence of burnout among Victorian anaesthetic trainees. We have shown a significant correlation exists between the clinical learning environment measure and the presence of burnout. This correlation supports the development of interventions to improve the clinical learning environment, as a means to improve trainee wellbeing and address the high prevalence of burnout.

  10. 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.

  11. A novel method of measuring the concentration of anaesthetic vapours using a dew-point hygrometer.

    Science.gov (United States)

    Wilkes, A R; Mapleson, W W; Mecklenburgh, J S

    1994-02-01

    The Antoine equation relates the saturated vapour pressure of a volatile substance, such as an anaesthetic agent, to the temperature. The measurement of the 'dew-point' of a dry gas mixture containing a volatile anaesthetic agent by a dew-point hygrometer permits the determination of the partial pressure of the anaesthetic agent. The accuracy of this technique is limited only by the accuracy of the Antoine coefficients and of the temperature measurement. Comparing measurements by the dew-point method with measurements by refractometry showed systematic discrepancies up to 0.2% and random discrepancies with SDS up to 0.07% concentration in the 1% to 5% range for three volatile anaesthetics. The systematic discrepancies may be due to errors in available data for the vapour pressures and/or the refractive indices of the anaesthetics.

  12. local

    Directory of Open Access Journals (Sweden)

    Abílio Amiguinho

    2005-01-01

    Full Text Available The process of socio-educational territorialisation in rural contexts is the topic of this text. The theme corresponds to a challenge to address it having as main axis of discussion either the problem of social exclusion or that of local development. The reasons to locate the discussion in this last field of analysis are discussed in the first part of the text. Theoretical and political reasons are there articulated because the question is about projects whose intentions and practices call for the political both in the theoretical debate and in the choices that anticipate intervention. From research conducted for several years, I use contributions that aim at discuss and enlighten how school can be a potential locus of local development. Its identification and recognition as local institution (either because of those that work and live in it or because of those that act in the surrounding context are crucial steps to progressively constitute school as a partner for development. The promotion of the local values and roots, the reconstruction of socio-personal and local identities, the production of sociabilities and the equation and solution of shared problems were the dimensions of a socio-educative intervention, markedly globalising. This scenario, as it is argued, was also, intentionally, one of transformation and of deliberate change of school and of the administration of the educative territoires.

  13. Interference of anaesthetics with radioligand binding in neuroreceptor studies

    Energy Technology Data Exchange (ETDEWEB)

    Elfving, Betina; Knudsen, Gitte Moos [Neurobiology Research Unit N9201, University hospital Rigshospitalet, 9 Blegdamsvej, 2100, Copenhagen (Denmark); Bjoernholm, Berith [Department of Computational Chemistry, H. Lundbeck A/S, Copenhagen-Valby (Denmark)

    2003-06-01

    Evaluations of new emission tomography ligands are usually carried out in animals. In order to keep the animals in a restricted position during the scan session, anaesthesia is almost inevitable. In ex vivo rat studies we investigated the interference of ketamine/xylazine, zoletile mixture, isoflurane and halothane with the serotonin re-uptake site, the serotonin{sub 2A} receptor and the dopamine re-uptake site by use of [{sup 3}H]-(S)-citalopram, [{sup 18}F]altanserin and [{sup 125}I]PE2I, respectively. Ketamine/xylazine decreased the target-to-background ratio (mean {+-} SD) of [{sup 3}H]-(S)-citalopram from 1.5{+-}0.19 to 0.81{+-}0.19 (P<0.05), whereas isoflurane and halothane increased the ratio from 1.5{+-}0.19 to 1.9{+-}0.24 and 2.1{+-}0.13 (P<0.05), respectively. Only with the zoletile mixture did the ratio remain unaltered. None of the tested anaesthetics affected the target-to-background ratio of [{sup 18}F]altanserin. The [{sup 125}I]PE2I target-to-background ratio decreased with both ketamine/xylazine (from 12.4{+-}0.81 to 10.1{+-}1.4, P<0.05) and isoflurane (from 12.4{+-}0.81 to 9.5{+-}1.1, P<0.05) treated rats, whereas treatment with zoletile mixture and halothane left the ratio unaltered. It is concluded that prior to performance of neuroreceptor radioligand studies, the possible interaction between radioligands and anaesthetics should be carefully evaluated. (orig.)

  14. The effects of multiple anaesthetic episodes on equine recovery quality.

    Science.gov (United States)

    Platt, J P; Simon, B T; Coleman, M; Martinez, E A; Lepiz, M A; Watts, A E

    2018-01-01

    Although rare, 70% of equine fatalities during recovery from general anaesthesia (GA) are due to catastrophic fractures from poor recovery quality. To determine the effect of repeated GA recovery on GA recovery quality. Experimental blinded trial. Eight adult horses underwent six GA events on sevoflurane for distal limb MRI examination over a 14-week period. Prior to GA recovery, xylazine was administered. Randomly ordered video-recorded GA recoveries were scored by three blinded board certified veterinary anaesthesiologists, unaware of patient identity or GA event number, for nine parameters using a 100 mm visual analogue scale (VAS) where 0 = worst and 100 = best. The number of attempts to stand, duration of lateral and sternal recumbency, total recovery duration and physiologic parameters during each GA event were recorded. Repeated measures ANOVA were used to detect differences. Agreement between observer VAS scores was determined via inter-rater reliability using an intraclass correlation. With GA recovery experience, VAS scores for balance and coordination, knuckling, and overall quality of recovery were improved and the duration of lateral recumbency was increased. There were no differences in total recovery duration, number of attempts to stand, physiologic parameters other than heart rate during GA, or VAS scores for activity in lateral recumbency, move to sternal, move to stand, or strength. Each GA event was relatively short and there was no surgical stimulation. The same results may not occur if there was surgical stimulation and pain during each GA event. Recovery from GA improves with multiple anaesthetic episodes in horses. Clinicians can advise clients that horses are likely to have better GA recovery on repeated GA recovery due to improved balance and coordination and reduced knuckling. Additionally, there is no change in anaesthetic morbidity with six repeated GA events over a 14-week period. © 2017 EVJ Ltd.

  15. Efficacy of Clove flower bud powder as anaesthetic for three life ...

    African Journals Online (AJOL)

    ADOWIE PERE

    plastic aquaria and induction and recovery times were recorded. ... respectively. The induction time in juveniles across the concentrations was generally lower than ... The use of some of these anaesthetics has health ..... Poster presentation at.

  16. 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.

  17. Application of a topical vapocoolant spray decreases pain at the site of initial intradermal anaesthetic injection during ultrasound-guided breast needle biopsy

    International Nuclear Information System (INIS)

    Collado-Mesa, F.; Net, J.M.; Arheart, K.; Klevos, G.A.; Yepes, M.M.

    2015-01-01

    Aim: To assess whether the application of a topical vapocoolant spray immediately prior to initial intradermal anaesthetic injection during ultrasound-guided breast biopsy decreases pain at the site of the initial injection. Materials and methods: In this institutional review board-approved, Health Insurance Portability and Accountability Act (HIPAA)-compliant study, 50 women aged 49.1 ± 1.6 years (mean ± standard error) were recruited and provided written informed consent. Participants served as their own controls and were blinded as to whether a topical vapocoolant spray or a placebo was used immediately prior to the initial local anaesthetic injection at two separate biopsy sites. With the exception of the application of vapocoolant or placebo, the entire ultrasound-guided procedure was performed according to a routine protocol. Participants recorded pain at initial injection site on a visual analogue scale. General linear mixed models for repeated measures analysis of variance and a 0.05 significance level were used. Results: Application of topical vapocoolant spray was shown to significantly decrease pain at the site of initial intradermal anaesthetic injection as compared to placebo (p<0.001). Treatment effect was independent of age of the subject, race/ethnicity, operator, type of biopsy device, and histopathology result. No complications from vapocoolant spray use were reported. Conclusion: Application of a topical vapocoolant spray immediately prior to initial intradermal anaesthetic injection during ultrasound-guided breast biopsy significantly decreases pain at the site of the initial injection and could contribute to improve the patient's overall procedural experience. -- Highlights: •Topical vapocoolant spray decreased pain at site of initial anesthetic injection (

  18. Efficacy of paediatric anaesthetic trolleys: A call for a basic standard and layout.

    Science.gov (United States)

    Griffiths, Sian E; Boleat, Elizabeth; Goodwin, Alison; Sheikh, Asme; Goonasekera, Chulananda

    2015-01-01

    Providing safe anaesthesia to children especially in emergency situations goes hand in hand with instant availability of appropriately sized equipment and monitoring. This is best achieved using a designated paediatric anaesthetic trolley containing essential equipment. Guidance for the contents of such trolleys is neither explicit nor standard. We used a survey and a qualitative enquiry to develop a checklist suitable for standardisation of contents and layout of paediatric anaesthetic trolleys. We conducted an observational study of our current practice and paediatric anaesthetic trolleys in a tertiary care hospital. We also performed a qualitative enquiry from experienced paediatric anaesthetists and operating department practitioners.We developed an empirical checklist to ensure the minimum 'essential' equipment is available on these trolleys and implemented a standard layout to facilitate its use. We identified 11 areas in our hospital where anaesthesia is provided to children, each with a designated paediatric anaesthetic trolley. There were considerable deficiencies of items in all areas with no standard pattern or layout. Different types of trolleys contributed to the confusion. In addition, overstocking of inappropriate items hindered its efficient use. Standardising the contents and layout of the paediatric anaesthetic trolley is an essential pre-requisite for safer paediatric anaesthetic practice.

  19. Comparison of stress in anaesthetic trainees between Hong Kong and Victoria, Australia.

    Science.gov (United States)

    Chia, A C L; Irwin, M G; Lee, P W H; Lee, T H W; Man, S E

    2008-11-01

    A postal survey was sent to anaesthetic trainees in Hong Kong and Victoria, Australia to compare work-related stress levels. Demographic data were collected. Anaesthetist-specific stressors, Maslach Burnout Inventory and Global Job Satisfaction scores were used for psychological testing. The response rates from Hong Kong and Melbourne were 64 of 133 (48.1%) and 108 of 196 (55.1%), respectively. Victorian respondents were older with greater family commitments, but more advanced in fulfilling training requirements. Hong Kong respondents, being faced with both the challenge of dual College requirements, exhibited consistently higher indices of stress (P stress scores observed in Hong Kong trainees related to service provision and a perceived lack of resources. Despite the complex nature of stress, its antecedents and manifestations, an inverse relationship between emotional exhaustion and job satisfaction was evident in correlation analysis (P stress was present in some trainees in both areas. Hong Kong trainees may benefit from local development to address mental wellbeing as being important to fulfil this highly competitive training program.

  20. Chemical restraint and anaesthetic effects of a tiletamine-zolazepam/ketamine/detomidine combination in cattle.

    Science.gov (United States)

    Re, Michela; Blanco-Murcia, Francisco J; Gómez de Segura, Ignacio A

    2011-10-01

    The immobilisation and anaesthesia of free-ranging cattle requires the administration of appropriate drugs in small volume via rifle or dart. The objective of this randomised controlled study was to test the capacity of a concentrated combination of tiletamine-zolazepam (TZ), ketamine (K) and detomidine (D) (TZKD) to immobilise/anaesthetise calves. Following administration of low, medium and high doses of TZKD to six healthy animals IM, the time-of-onset and duration of anaesthesia were recorded, in addition to standard cardio-respiratory parameters. Two noxious stimuli were applied to assess the analgesic effect of the combination. TZKD produced a dose-dependent anaesthetic action associated with respiratory depression and moderate hypoxaemia. Total recumbency lasted from 1h (with low dose) to 2h (with medium and high doses). The findings indicate that TZKD induces anaesthesia in calves, suitable not only for animal immobilisation, but also to carry out minor surgical procedures with or without additional local analgesia. Respiratory depression was the most severe side-effect and careful patient monitoring is recommended when using this drug combination. Copyright © 2010 Elsevier Ltd. All rights reserved.

  1. Interference of anaesthetics with radioligand binding in neuroreceptor studies

    International Nuclear Information System (INIS)

    Elfving, Betina; Knudsen, Gitte Moos; Bjoernholm, Berith

    2003-01-01

    Evaluations of new emission tomography ligands are usually carried out in animals. In order to keep the animals in a restricted position during the scan session, anaesthesia is almost inevitable. In ex vivo rat studies we investigated the interference of ketamine/xylazine, zoletile mixture, isoflurane and halothane with the serotonin re-uptake site, the serotonin 2A receptor and the dopamine re-uptake site by use of [ 3 H]-(S)-citalopram, [ 18 F]altanserin and [ 125 I]PE2I, respectively. Ketamine/xylazine decreased the target-to-background ratio (mean ± SD) of [ 3 H]-(S)-citalopram from 1.5±0.19 to 0.81±0.19 (P 18 F]altanserin. The [ 125 I]PE2I target-to-background ratio decreased with both ketamine/xylazine (from 12.4±0.81 to 10.1±1.4, P<0.05) and isoflurane (from 12.4±0.81 to 9.5±1.1, P<0.05) treated rats, whereas treatment with zoletile mixture and halothane left the ratio unaltered. It is concluded that prior to performance of neuroreceptor radioligand studies, the possible interaction between radioligands and anaesthetics should be carefully evaluated. (orig.)

  2. Parents' experiences of their child's first anaesthetic in day surgery.

    Science.gov (United States)

    Andersson, Lisbet; Johansson, Ingrid; Almerud Österberg, Sofia

    Parents play an important part in their child's anaesthesia. When a child has to receive anaesthesia, it is of great importance that parents are there by his/her side as children depend on them for support. Many parents worry and experience fear before their child's anaesthesia and studies show that there is a correlation between a worried parent and a worried child. The purpose of this study was to illustrate the meaning of being a parent at one's child's first anaesthesia in day surgery. Six parents were interviewed and data were analysed using a descriptive qualitative approach inspired by phenomenology. The phenomenon, 'a child's first anaesthesia in day surgery as experienced by parents' is based on the following components: ambivalence between worry and relief, a feeling of losing control, needing to be prepared, being able to be present and a need of emotional support. Specific individually-adapted information with a compulsory preoperative visit, presence and participation from, if possible, both parents at their child's anaesthesia but also designated staff from the anaesthetic team to focus solely on supporting the parents at their child's anaesthesia induction can improve the conditions for security.

  3. 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.

  4. Local anesthesia in dentistry - Clinical Considerations

    OpenAIRE

    Sharmraaj Subramaniam; Prasanna Neelakantan

    2013-01-01

    Local anaesthesia is commonly employed prior to most dental procedures. It is imperative to understand the mechanisms by which local anaesthetics work, so that their efficacy can be improved for painless dental care. Local anaesthesia also has major clinical implications in that it can precipitate emergencies in patients with an underlying systemic disease. It is imperative that a dentist have a thorough knowledge of the considerations one must take when administering local anaesthesia in pat...

  5. The perils of dental vacation: possible anaesthetic and medicolegal consequences.

    Science.gov (United States)

    Feltracco, Paolo; Gaudio, Rosa Maria; Barbieri, Stefania; Tiano, Letizia; Iacobone, Maurizio; Viel, Giovanni; Tonetti, Tommaso; Galligioni, Helmut; Bortolato, Andrea; Ori, Carlo; Avato, Francesco Maria

    2013-01-01

    The aim of this paper is to emphasize anaesthesiologists' difficulty in detecting poor dentition in cases of poorly applied prostheses and/or advanced periodontal disease, and to establish whether it is possible, and in which conditions, to calculate compensation in cases of dental damage postlaryngoscopy and/or intubation. The main complex problem here lies in trying to reconstruct exactly what the dental situation was before the teeth were damaged. For this reason the important preoperative factors (dental prostheses, crown fractures, parodontal disease, etc.) must be clearly shown before surgery on a dental chart. Two cases of interest, both to anaesthesiologists practising intubation and medicolegal physicians who have to deal with potential claims, are briefly reported. The first patient was a 55-year-old diabetic patient, who underwent emergency surgery for acute abdominal pathology. He had gone outside Italy for dental treatment three years previously and now presented with very poor pre-existing dentition, carefully noted on an anaesthetic chart. He now demanded compensation for dental damage due to intubation in Italy; the resulting dental treatment was very expensive because substantial remedial work was required. The second patient had received treatment outside Italy, work which involved cosmetic coating of the teeth. After surgery in Italy, she demanded compensation because one tooth, which had been coated and appeared to be healthy, was broken after emergency intubation. In both cases, the patients demanded very high compensation. Dental tourism alone accounts for more than 250,000 patients each year who combine a holiday with dental treatment in Eastern Europe. However, if prosthetic devices or conservative treatments are not applied correctly, it should be noted that durability may be poorer than expected, but iatrogenic damage may also be caused.

  6. Teicoplanin allergy - an emerging problem in the anaesthetic allergy clinic.

    Science.gov (United States)

    Savic, L C; Garcez, T; Hopkins, P M; Harper, N J N; Savic, S

    2015-10-01

    Anaphylaxis to teicoplanin appears to be extremely rare, with only one confirmed case report worldwide. Two anaesthetic allergy clinics in the UK have received a number of suspected cases referred for investigation, and we present here the first case series of teicoplanin allergy. We investigated 20 cases of suspected teicoplanin allergy, identified from the two clinics over a period of two years. We devised a set of five criteria to categorize the certainty of their diagnosis. These included: (1) reaction within 15 min of administration of teicoplanin, (2) ≥2 features of anaphylaxis present, (3) positive skin testing or challenge testing, (4) raised serum mast cell tryptase (MCT), (5) alternative diagnosis excluded. Based on these criteria we defined the likelihood of IgE-mediated allergy to teicoplanin as: definite-met all criteria; probable-met criteria 1.2 and 5, plus 3 or 4; uncertain-met criteria 1.2 and 5; excluded- any others. We identified 7 'definite', 7 'probable' and 2 'uncertain' cases of teicoplanin allergy. Four cases were excluded. IgE-mediated anaphylaxis to teicoplanin appears to be more common than previously thought. This is true even if only definitive cases are considered. Investigation of teicoplanin allergy is hampered by the lack of standardized skin test concentrations. In some cases, there was a severe clinical reaction, but without any skin test evidence of histamine release. The mechanism of reaction in these cases is not known and requires further study. © The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  7. Post-anaesthetic myelomalacia in a horse : clinical communication

    Directory of Open Access Journals (Sweden)

    K.E. Joubert

    2005-06-01

    Full Text Available This article describes a rare neurological complication of anaesthesia in a 2 year-old Clydesdale colt undergoing castration. Anaesthesia was induced with glyceryl guaiacol ether and ketamine and maintained with halothane. Following an uneventful anaesthetic of 40 minutes, the horse recovered from anaesthesia in a padded recovery stall. After approximately 70 minutes in the recovery stall, the horse attempted to stand and adopted a dog sitting position. One hundred and fifty minutes later, the horse became distressed and was sedated with xylazine. Clinical examination of the horse did not reveal any evidence of myositis or fractures. A neurological examination revealed an intact anal reflex, deep pain response in the hind legs, tail tone and voluntary movement of the hind legs was possible. The horse deteriorated neurologically over the next 24 hours and was euthanased on humane grounds. The horse was submitted for necropsy. Gross pathology was unremarkable except for a small amount of haemorrhage around the right kidney. Histopathology revealed no abnormalities in any muscle groups or peripheral nerves. Congestion and axonal swelling of the spinal cord was evident from T16 to S1. Ischaemic neurons were evident from L 1 to L 6. The most prominent lesions were at L4 and L5. A diagnosis of myelomalacia was made. This is a rare complication of anaesthesia in horses with 9 case studies appearing in the literature since 1979. This is the 1st case to be reported in South Africa. The speculated pathophysiology and risk factors for this complication are discussed.

  8. 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 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.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.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.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.ClinicalTrials.gov NCT01044979.

  9. 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......-frequency patterns for each of the three anaesthetic drugs. These EEG patterns were assigned to a colour code corresponding to similar clinical states. A common learning set could be used for all patients anaesthetized with the same drug. The classification process could be performed on-line and the results were...

  10. 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.

  11. The effect of dexmedetomidine on cerebral perfusion and oxygenation in healthy piglets with normal and lowered blood pressure anaesthetized with propofol-remifentanil total intravenous anaesthesia

    DEFF Research Database (Denmark)

    Mikkelsen, Mai Louise Grandsgaard; Ambrus, Rikard; Rasmussen, Rune

    2017-01-01

    Background During anaesthesia and surgery, in particular neurosurgery, preservation of cerebral perfusion and oxygenation (CPO) is essential for normal postoperative brain function. The isolated effects on CPO of either individual anaesthetic drugs or entire anaesthetic protocols are of importance...

  12. 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.

  13. Neuropeptide Y-enhanced diuresis and natriuresis in anaesthetized rats is independent of renal blood flow reduction

    NARCIS (Netherlands)

    Bischoff, A.; Erdbrügger, W.; Smits, J.; Michel, M. C.

    1996-01-01

    1. Neuropeptide Y (NPY) has been reported to enhance diuresis and natriuresis in anaesthetized rats although it is a potent renal vasoconstrictor in vitro in vivo in several species. Therefore, we have investigated anaesthetized rats to see whether reduction in renal blood flow (RBF) and enhancement

  14. 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

    The present investigation aimed to study two methodological concerns of an experimental model, where a spinal loop dialysis probe is used for administration of substances to the spinal cord and sampling of neurotransmitters by microdialysis from the same area of anaesthetized rats. [(3)H]Epibatid......The present investigation aimed to study two methodological concerns of an experimental model, where a spinal loop dialysis probe is used for administration of substances to the spinal cord and sampling of neurotransmitters by microdialysis from the same area of anaesthetized rats. [(3)H...... intraspinal administration of substances through the spinal loop dialysis probe....

  15. 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.

  16. Anaesthetic management for emergency caesarean section in a patient with an untreated recently diagnosed phaeochromocytoma

    Directory of Open Access Journals (Sweden)

    Anil Agarwal

    2011-01-01

    Full Text Available Phaeochromocytoma is a rare cause of hypertension during pregnancy with potentially fatal consequences. If not detected and treated early in pregnancy, it is catastrophic for both the mother and the baby. Management requires close co-ordination between the obstetrician, anaesthesiologist, paediatrician and the endocrinologist. Perioperative management for an emergency caesarean section in a parturient with untreated phaeochromocytoma is an anaesthetic challenge and no standard recommendations have been reported till date. In this case report, we present anaesthetic management in such a case with successful maternal and foetal outcome.

  17. Instant centre frequency at anaesthetic induction--a new way to analyse sympathovagal balance.

    Science.gov (United States)

    de Souza Neto, Edmundo Pereira; Cerutti, Catherine; Loufoua, Joseph; Saroul, Christine; Chiari, Pascal; Custaud, Marc-Antoine; Lehot, Jean-Jacques

    2003-02-01

    The instant centre frequency (ICF) of RR interval has been proposed as a global index to analyse the sympathovagal interaction in the heart. The aim of this study was to assess the ICF during anaesthesia to test if it can reliably capture the neural control of the cardiovascular system. Twenty-four ASA II or III patients scheduled for cardiac surgery were included in the study. They were allocated in two groups: control, no treatment (group 1, n = 12), and beta-adrenergic blockade by atenolol (group 2, n = 12). Spectra of pulse interval series were computed with a time-frequency method and they were divided into: very low frequency (VLF, 0.000-0.040 Hz), low frequency (LF, 0.050-0.150 Hz) and high frequency (HF, 0.160-0.500 Hz). Normalized power was obtained by dividing the cumulative power within each frequency band (LF or HF) by the sum of LF and HF; the ratio of LF/HF was also calculated. Instant centre frequency is a time-varying parameter that the evolution along time of the gravity centrum of a local spectrum. All spectral indexes were recorded at the following time points: before induction, after induction and before intubation, during intubation, and after intubation. The atenolol group had lower normalized LF and the LF/HF ratio (P ICF was higher in atenolol group at all times. The ICF shifted towards HF frequency after induction and before intubation and shifted towards LF during intubation in both groups. The autonomic nervous system control on the heart through the interaction of sympathetic and parasympathetic reflex mechanisms could be studied by the ICF. The ICF may assess the autonomic cardiac modulation and may provide useful information for anaesthetic management.

  18. Advanced paediatric conscious sedation: an alternative to dental general anaesthetic in the U.K.

    Science.gov (United States)

    Hand, Darren; Averley, Paul; Lyne, John; Girdler, Nick

    2011-01-01

    Child dental anxiety is widespread, and it is not always possible to treat children using traditional methods such as behavioural management, local anaesthesia and even relative analgesia. In such cases a dental general anaesthetic (DGA) is the only option available to facilitate dental treatment in anxious children. This study describes an advanced conscious sedation protocol which allows invasive treatment to be carried out in anxious children. It incorporates the use of titrated intravenous midazolam and fentanyl and inhalation agents, sevoflurane and nitrous oxide/oxygen, which is administered by a Consultant Anaesthetist. The aim is to produce an evidence- based study which can offer a sedation technique as a safe and effective alternative to a DGA. Retrospective audit. 267 clinical records were audited retrospectively from a specialist sedation-based clinic, for children aged 5-15 years old. The subjects all underwent invasive dental procedures with this technique between August and November 2008 as an alternative to a DGA. 262/267 (98%) of the subjects were treated safely and successfully and without the loss of verbal communication using this technique. This included many treatments requiring four quadrant dentistry, with both restorations and extractions as necessary being carried out in one visit. 5 subjects (2%) did not tolerate treatment and had to be referred for a DGA. No medical emergencies occurred. Based on the evidence for this group of patients, this advanced conscious sedation technique, offers a safe and effective alternative to DGA. This technique must be carried out in an appropriate environment by an appropriately trained and experienced team who are able to comply with the recommendations for "alternative" sedation techniques.

  19. Local anesthetics: New insights into risks and benefits

    NARCIS (Netherlands)

    Lirk, P.

    2014-01-01

    Conventional local anesthetics in contemporary use block the voltage-gated sodium channel by binding to a specific site on the inner facet of the channel pore. Only little fractions of local anaesthetic are thought to participate in nerve blockade, the rest is absorbed into surrounding tissues or

  20. Pharmacokinetics and pharmacodynamics of eltanolone (pregnanolone), a new steroid intravenous anaesthetic, in humans

    DEFF Research Database (Denmark)

    Carl, Peder; Høgskilde, S; Lang-Jensen, T

    1994-01-01

    Eltanolone, a new intravenous steroid anaesthetic agent was administered intravenously in a dose of 0.6 mg.kg-1 over 45 s to eight healthy male volunteers to evaluate some of its pharmacokinetic and pharmacodynamic effects. Drug concentration-time data were analysed by PCNONLIN, a non...

  1. Inflammatory response and cardioprotection during open-heart surgery: the importance of anaesthetics.

    Science.gov (United States)

    Suleiman, M-S; Zacharowski, K; Angelini, G D

    2008-01-01

    Open-heart surgery triggers an inflammatory response that is largely the result of surgical trauma, cardiopulmonary bypass, and organ reperfusion injury (e.g. heart). The heart sustains injury triggered by ischaemia and reperfusion and also as a result of the effects of systemic inflammatory mediators. In addition, the heart itself is a source of inflammatory mediators and reactive oxygen species that are likely to contribute to the impairment of cardiac pump function. Formulating strategies to protect the heart during open heart surgery by attenuating reperfusion injury and systemic inflammatory response is essential to reduce morbidity. Although many anaesthetic drugs have cardioprotective actions, the diversity of the proposed mechanisms for protection (e.g. attenuating Ca(2+) overload, anti-inflammatory and antioxidant effects, pre- and post-conditioning-like protection) may have contributed to the slow adoption of anaesthetics as cardioprotective agents during open heart surgery. Clinical trials have suggested at least some cardioprotective effects of volatile anaesthetics. Whether these benefits are relevant in terms of morbidity and mortality is unclear and needs further investigation. This review describes the main mediators of myocardial injury during open heart surgery, explores available evidence of anaesthetics induced cardioprotection and addresses the efforts made to translate bench work into clinical practice.

  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.

    .J., Ryu, B.M., Kim, M.M., Kim, S.K., 2008. Free Radical and Reactive Oxygen Species Scavenging Activities of the Extracts from Seahorse, Hippocampus kuda, Bleeler. Biotechnol. Bioprocess Eng. 13, 705- 715. 20. Ross, L.G., Ross, B., 1999. Anaesthetic...

  3. 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.

  4. Medication errors in anaesthetic practice: a report of two cases and ...

    African Journals Online (AJOL)

    EB

    2013-09-03

    Sep 3, 2013 ... Key words: Medication errors, anaesthetic practice, vigilance, safety .... reports in the Australian Incident Monitoring Study. (AIMS). ... contribute to systems failure and prescription errors were most ... being due to equipment error.17 Previous studies have ... errors reported occurred during day shifts and they.

  5. 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.

  6. Improving needle tip identification during ultrasound-guided procedures in anaesthetic practice

    NARCIS (Netherlands)

    Scholten, H.J.; Pourtaherian, A.; Mihajlovic, N.; Korsten, H.; Bouwman, R.A.

    2017-01-01

    Ultrasound guidance is becoming standard practice for needle-based interventions in anaesthetic practice, such as vascular access and peripheral nerve blocks. However, difficulties in aligning the needle and the transducer can lead to incorrect identification of the needle tip, possibly damaging

  7. 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.

    155.1±9.8 mm Ht (as in Lourie et al., 1999) and weighing, 11.15±1.68 g wet weight were selected. Seahorses from two different FRP tanks were used to avoid a possible tank effect and were starved 24 h prior to the initiation of anaesthetic...

  8. 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.

  9. Prepubertal gonadectomy in cats: different injectable anaesthetic combinations and comparison with gonadectomy at traditional age.

    Science.gov (United States)

    Porters, Nathalie; de Rooster, Hilde; Moons, Christel P H; Duchateau, Luc; Goethals, Klara; Bosmans, Tim; Polis, Ingeborgh

    2015-06-01

    Anaesthetic and analgesic effects of three different injectable anaesthetic combinations for prepubertal gonadectomy (PPG) in cats were studied. One anaesthetic protocol was compared with a similar one for gonadectomy at traditional age (TAG). Kittens were randomly assigned to PPG or TAG. For PPG, three different protocols were compared: (1) intramuscular (IM) administration of 60 μg/kg dexmedetomidine plus 20 μg/kg buprenorphine followed by an IM injection of the anaesthetic agent (20 mg/kg ketamine) (DB-IM protocol); (2) oral transmucosal (OTM) administration of 80 μg/kg dexmedetomidine plus 20 μg/kg buprenorphine followed by an IM injection of 20 mg/kg ketamine combined with 20 µg/kg dexmedetomidine (DB-OTM protocol); (3) IM injection of a 40 μg/kg medetomidine-20 μg/kg buprenorphine-20 mg/kg ketamine combination (MBK-IM protocol). For TAG, a DB-IM protocol was used, but with different doses for dexmedetomidine (40 μg/kg) and ketamine (5 mg/kg). All cats (PPG and TAG) received a non-steroidal anti-inflammatory before surgery. Anaesthetic and analgesic effects were assessed pre- and postoperatively (until 6 h). Cumulative logit, linear and logistic regression models were used for statistical analysis. Compared with the DB-OTM protocol, the DB-IM and MBK-IM protocols provided better anaesthesia with fewer adverse effects in PPG cats. Postoperative pain was not significantly different between anaesthetic protocols. PPG and TAG cats anaesthetised with the two DB-IM protocols differed significantly only for sedation and pain scores, but sedation and pain scores were generally low. Although there were no anaesthesia-related mortalities in the present study and all anaesthetic protocols for PPG in cats provided a surgical plane of anaesthesia and analgesia up to 6 h postoperatively, our findings were in favour of the intramuscular (DB-IM and MBK-IM) protocols. © ISFM and AAFP 2014.

  10. The hairy lizard: heterothermia affects anaesthetic requirements in the Arabian oryx (Oryx leucoryx).

    Science.gov (United States)

    Bertelsen, Mads F; Mohammed, Osama; Wang, Tobias; Manger, Paul R; Scantlebury, David Michael; Ismael, Khairi; Bennett, Nigel C; Alagaili, Abdulaziz

    2017-07-01

    To study the effect of heterothermia on anaesthetic drug requirements in semi-free ranging Arabian oryx and to assess the temperature quotient (Q 10 ) of oxygen consumption. Prospective observational study and controlled metabolic experiment. Sixty-eight anaesthetic events in 59 Arabian oryx from Mahazat As-Sayd protected area, Saudi Arabia METHODS: Anaesthesia was induced by remote injection of 25 mg ketamine, 10 mg midazolam and 0.5 mg medetomidine with a variable amount of etorphine based on a target dosage of 20 μg kg -1 and subjective assessment of body mass. Animals not recumbent within 15 minutes or insufficiently anaesthetized were physically restrained and administered supplementary etorphine intravenously depending on the anaesthetic depth. Body temperature (Tb) was measured rectally immediately upon handling of each animal. From six anaesthetized oryx, expiratory gasses for oxygen analysis and metabolic rate calculation were collected at two Tbs; before and after submersion in ice water for approximately 30 minutes. Forty-two animals (62%) became recumbent with the initial dose, with a mean induction time (± standard deviation) of 9 ± 2 minutes. The remaining animals could be handled but needed 0.3 ± 0.1 mg etorphine intravenously to reach the desired level of anaesthesia. There was a significant positive correlation between Tb and effective etorphine dosage (R 2  = 0.48, p 0.5°C immediately after induction to 35.5 ± 0.5°C after cooling. This reduction was associated with a reduction in oxygen uptake from 3.11 ± 0.33 to 2.22 ± 0.29 mL O 2 minute -1 kg -1 , reflected in Q 10 of 2.17 ± 0.14. Tb significantly affects anaesthetic requirements in Arabian oryx and should be considered when selecting dosages for anaesthetic induction for species showing diurnal heterothermy. Copyright © 2017 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights

  11. ANAESTHETIC CHALLENGES IN THE MANAGEMENT OF PEDIATRIC ENCEPHALOCOELE REPAIR: RETROSPECTIVE CASE SERIES

    Directory of Open Access Journals (Sweden)

    Ravindra Giri

    2015-02-01

    Full Text Available INTRODUCTION: Encephalocele is the protrusion of the cranial contents beyond the normal confines of the skull through a defect in the calvarium and is far less common than spinal dysraphism. 1 Anaesthetic challenges in management of occipital meningoencephalocele include securing the airway with intubation in lateral position, intraoperative prone position and its associated complications, careful securing of the endotracheal tube and accurate assessment of blood loss. These babies also have associated congenital anomalie s, gastrointestinal malrotation, renal anomalies, cardiac malformations and tracheoesophageal fistula, making anaesthetic management even more difficult. Meticulous anaesthetic management is crucial for early repair of encephalocoele to prevent any sequel. 2 METHODS: To identify the anaesthetic challenges, perioperative and postoperative complications during encephalocele repair, 20 cases were studied retrospectively from 2012 to 2014 at Department of Anaesthesia , Department of Neurosurgery, MR Medical College, Gulbarga. RESULTS: 20 cases of encephalocoele repair were undertaken during the study period. Out of these 12 (60% were male and 8(40% female. Age range was 1 day to 6 years. Most common type of encephalocele was occipital 12(60%, which posed a difficulty during positioning & intubation, followed by occipito - cervical 4(20%, Parietal 2(10%, Fronto - nasal 1(5% & Fronto - naso - ethmoidal 1(5%. Most of the patients were extubated successfully on table, only one patient required post - operative ventilator support for a day. Peri - operative complications included bronchospasm (15%, followed by hypotension, tachycardia, laryngospasm, hypoxia, accidental extubation (10% each & bradycardia, endobronchial intubation (5%. CONCLUSION: Children with Encephalocoele are prone to have peri - operative complications which can be managed by meticulous anaesthetic managenement. 3 Early surgical management of encephalocoele is not

  12. 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

    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 ropivacaine injection 6 h postoperatively. The median (IQR [range]) dose of oxycodone administered...

  13. 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

    was evaluated versus placebo and versus an active comparator (ilioinguinal block and wound infiltration). DESIGN: Randomised controlled trial. SETTING: Single centre trial. Study period from June 2010 to November 2011. PATIENTS: Adults (18 to 75 years) with American Society of Anesthesiologists' status 1...

  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. Anaesthetics stop diverse plant organ movements, affect endocytic vesicle recycling and ROS homeostasis, and block action potentials in Venus flytraps.

    Science.gov (United States)

    Yokawa, K; Kagenishi, T; Pavlovic, A; Gall, S; Weiland, M; Mancuso, S; Baluška, F

    2017-12-11

    Anaesthesia for medical purposes was introduced in the 19th century. However, the physiological mode of anaesthetic drug actions on the nervous system remains unclear. One of the remaining questions is how these different compounds, with no structural similarities and even chemically inert elements such as the noble gas xenon, act as anaesthetic agents inducing loss of consciousness. The main goal here was to determine if anaesthetics affect the same or similar processes in plants as in animals and humans. A single-lens reflex camera was used to follow organ movements in plants before, during and after recovery from exposure to diverse anaesthetics. Confocal microscopy was used to analyse endocytic vesicle trafficking. Electrical signals were recorded using a surface AgCl electrode. Mimosa leaves, pea tendrils, Venus flytraps and sundew traps all lost both their autonomous and touch-induced movements after exposure to anaesthetics. In Venus flytrap, this was shown to be due to the loss of action potentials under diethyl ether anaesthesia. The same concentration of diethyl ether immobilized pea tendrils. Anaesthetics also impeded seed germination and chlorophyll accumulation in cress seedlings. Endocytic vesicle recycling and reactive oxygen species (ROS) balance, as observed in intact Arabidopsis root apex cells, were also affected by all anaesthetics tested. Plants are sensitive to several anaesthetics that have no structural similarities. As in animals and humans, anaesthetics used at appropriate concentrations block action potentials and immobilize organs via effects on action potentials, endocytic vesicle recycling and ROS homeostasis. Plants emerge as ideal model objects to study general questions related to anaesthesia, as well as to serve as a suitable test system for human anaesthesia. © The Authors 2017. Published by Oxford University Press on behalf of the Annals of Botany Company. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  16. Anaesthetic technique during awake craniotomy. Case report and literature review

    Directory of Open Access Journals (Sweden)

    M.M. Madriz-Godoy

    2016-07-01

    Results: This case was managed with a scalp nerve block as local anaesthesia plus intravenous sedation without airway instrumentation. We reviewed the literature about patient management during awake craniotomy.

  17. An observational study of patient care outcomes sensitive to handover quality in the Post-Anaesthetic Care Unit.

    Science.gov (United States)

    Lillibridge, Nichole; Botti, Mari; Wood, Beverley; Redley, Bernice

    2017-12-01

    To identify patient care outcome indicators sensitive to the quality of interprofessional handover between the anaesthetist and the Post-Anaesthetic Care Unit nurse. The relationship between interprofessional clinical handover when patients are transferred from the operating theatre to the Post-Anaesthetic Care Unit and patient outcomes of subsequent patient care delivery is not well understood. Naturalistic, exploratory descriptive design using observation. Observations of 31 patient journeys through Post-Anaesthetic Care Units across three public and private hospitals. Characteristics of interprofessional handover on arrival in the Post-Anaesthetic Care Unit, the trajectory of patient care activities in Post-Anaesthetic Care Unit and patient outcomes were observed. Of the 821 care activities observed across 31 "patient journeys" in the Post-Anaesthetic Care Unit, observations (assessments and vital signs) (52.5 %), communication (15.8 %) and pain management (assessment of pain and analgesic administration) (10.3%) were most common. Examination of patterns in handover communications and subsequent trajectories of patient care activities revealed three patient trajectory typologies and two patient outcome indicators expected to be sensitive to the quality of interprofessional handover communication in the Post-Anaesthetic Care Unit: pain on discharge from the Post-Anaesthetic Care Unit and timely response to clinical deterioration. An additional process indicator, seeking missing information, was also identified. Patient's pain on discharge from Post-Anaesthetic Care Unit, escalation of care in response to early signs of deterioration and the need for nurses to seek out missing information to deliver care are indicators expected to be sensitive to the quality of interprofessional handover communication in the Post-Anaesthetic Care Unit. Future research should test these indicators. Patient outcomes sensitive to the quality of interprofessional handover on patient

  18. Comparing charcoal and zeolite reflection filters for volatile anaesthetics: A laboratory evaluation.

    Science.gov (United States)

    Sturesson, Louise W; Frennström, Jan O; Ilardi, Marcella; Reinstrup, Peter

    2015-08-01

    A modified heat-moisture exchanger that incorporates a reflecting filter for use with partial rebreathing of exhaled volatile anaesthetics has been commercially available since the 1990 s. The main advantages of the device are efficient delivery of inhaled sedation to intensive care patients and reduced anaesthetic consumption during anaesthesia. However, elevated arterial CO2 values have been observed with an anaesthetic conserving device compared with a conventional heat and moisture exchanger, despite compensation for larger apparatus dead space. The objective of this study is to thoroughly explore the properties of two reflecting materials (charcoal and zeolites). A controlled, prospective, observational laboratory study. Lund University Hospital, Sweden, from December 2011 to December 2012. None. Three filters, with identical volumes, were compared using different volatile anaesthetics at different conditions of temperature and moisture. The filtering materials were charcoal or zeolite. Glass spheres were used as an inert control. Consumption of volatile anaesthetics using different reflecting materials in filters at different conditions regarding temperature and moisture. CO2 reflection by the filtering materials: glass spheres, charcoal or zeolite. Isoflurane consumption in an open system was 60.8 g h(-1). The isoflurane consumption in dry, warm air was 39.8 g h(-1) with glass spheres. Changing to charcoal and zeolite had a profound effect on isoflurane consumption, 11.8 and 10.7 g h(-1), respectively. Heating and humidifying the air as well as the addition of N2O created only minor changes in consumption. The percentage of isoflurane conserved by the charcoal filter was independent of the isoflurane concentration (0.5 to 4.5%). Reflection of sevoflurane, desflurane and halothane by the charcoal filter was similar to reflection of isoflurane. Both charcoal and zeolite filters had CO2 reflecting properties and end-tidal CO2 increased by 3 to 3.7% compared

  19. Anaesthetic efficacy of articaine versus lidocaine in children's dentistry: a systematic review and meta-analysis.

    Science.gov (United States)

    Tong, Huei Jinn; Alzahrani, Fatma Salem; Sim, Yu Fan; Tahmassebi, Jinous F; Duggal, Monty

    2018-04-10

    Over the last few years, numerous reviews and studies have awarded articaine hydrochloride local anaesthetic (LA) a superior reputation, with outcomes of different studies demonstrating a general tendency for articaine hydrochloride to outperform lidocaine hydrochloride for dental treatment. Nevertheless, there seems to be no clear agreement on which LA solution is more efficacious in dental treatment for children. There is no previous publication systematically reviewing and summarising the current best evidence with respect to the success rates of LA solutions in children. To evaluate the available evidence on the efficacy of lidocaine and articaine, used in paediatric dentistry. A systematic search was conducted on Cochrane CENTRAL Register of Controlled Trials, MEDLINE (OVID; 1950 to June 2017), Cumulative Index to Nursing and Allied Health Literature (CINAHL; EBSCOhost; 1982 to June 2017), EMBASE (OVID; 1980 to June 2017), SCI-EXPANDED (ISI Web of Knowledge; 1900 to June 2017), key journals, and previous review bibliographies through June 2017. Original research studies that compared articaine with lidocaine for dental treatment in children were included. Methodological quality assessment and assessment of risk of bias were carried out for each of the included studies. Electronic searching identified 525 publications. Following the primary and secondary assessment process, six randomised controlled trials (RCT) were included in the final analysis. There was no difference between patient self-reported pain between articaine and lidocaine during treatment procedures (SMD = 0.06, P-value = 0.614), and no difference in the occurrence of adverse events between articaine and lidocaine injections following treatment in paediatric patients (RR = 1.10, P-value = 0.863). Yet, patients reported significantly less pain post-procedure following articaine injections (SMD = 0.37, P-value = 0.013). Substantial heterogeneity was noted in the reporting of outcomes among studies

  20. 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

    insufficiency and time of discharge readiness. RESULTS: The structured regime consisting of total intravenous anaesthesia (propofol-remifentanil), well defined fluid administration, prophylactic antiemetics (dexamethasone, ondansetron, droperidol), weak analgesics (celecoxib, paracetamol) and intraoperative......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......, was seen in 52%. CONCLUSION: We conclude that a structured multimodal anaesthetic regime is feasible in daily clinical practice and advantageous, and that postoperative pain and oxygen requirements (to sustain an SpO2 >92%) are the major determinants for length of stay in the postanaesthesia care unit...

  1. 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.

  2. Anaesthetic management of a patient with microvillus inclusion disease for intestinal transplantation.

    Science.gov (United States)

    Goldman, Luis J; Santamaría, Manuel López; Gámez, Manuel

    2002-03-01

    We report the anaesthetic management of a 3-year-old-child with microvillus inclusion disease undergoing isolated small bowel transplantation. He required long-term total parenteral nutrition which was complicated with numerous episodes of catheter related sepsis. This resulted in thrombosis of the major blood vessels which critically restricted vascular access available for intravenous nutrition, becoming a life-threatening condition for the patient. Haemodynamic, respiratory parameters and urinary output were well preserved throughout the procedure. Besides a transitory increase in potassium following graft revascularization, biochemical changes were small. Anaesthetic management included comprehensive preoperative assessment, central venous angiography to depict accessibility of central and peripheral veins, assurance of additional vascular access through the intraoperative catheterization of the left renal vein, perioperative epidural analgesia and preservation of splanchnic perfusion to ensure implant viability.

  3. The history of anaesthetic equipment evaluation in the United Kingdom: lessons for developing future strategy.

    Science.gov (United States)

    Wilkes, A R; Pandit, J J; O'Sullivan, E

    2011-12-01

    Recent guidance published by the Association of Anaesthetists of Great Britain and Ireland encourages the purchase of equipment based on evidence of safety and performance. For many years, evidence of the safety and performance of anaesthetic equipment was published by various government departments and agencies. However, these schemes were gradually eroded over time such that many devices entered the market with little or no clinical evidence of their efficacy. This recently led to the Difficult Airway Society's issuing guidance to its members on how best to select new airway devices; guidance that was based on the available evidence. This article provides a short history of the evaluation of anaesthetic equipment in the United Kingdom. © 2011 The Authors. Anaesthesia © 2011 The Association of Anaesthetists of Great Britain and Ireland.

  4. Emergency Surgery in a Patient with Scleroderma - Anaesthetic Challenges: A Case Report

    Directory of Open Access Journals (Sweden)

    Teena Bansal

    2013-06-01

    Full Text Available Scleroderma (progressive systemic sclerosis is a multisystem disease involving the skin, airway, musculoskeletal, gastrointestinal, pulmonary, renal and cardiac systems that can pose a significant challenge for the anaesthetist. The multisystem involvement of scleroderma can impact on every aspect of anaesthetic care especially airway management. There are no specific contraindications to the use of any type of anaesthesia, although the selection must be guided by identification of organ dysfunction. The anaesthetist must be aware of the organs involved, the severity of the disease and the associated anaesthetic considerations and potential risks in order to safely & skilfully manage the patient with scleroderma. We hereby present a case report of a patient with scleroderma for emergency orbital decompression because of orbital cellulitis.

  5. Anaesthetic Management of Caesarean Section in a Patient with Large Mediastinal Mass

    International Nuclear Information System (INIS)

    Kashif, S.; Saleem, J.

    2015-01-01

    Pregnancy is associated with both anatomical and physiological changes in the body, especially in cardiovascular and respiratory systems. Patients with anterior and middle mediastinal masses are recognized to be at risk for cardiorespiratory compromise. Likewise, pregnancy has a widely known constellation of potential complications that confront the anaesthesiologist. The combination of both (pregnancy and mediastinal mass) in a single patient presents an unusual anaesthetic challenge. Caesarean sections are usually the mode of delivery, therefore, the cardio-respiratory stability is very important. The following is the report of a 31 weeks pregnant patient with a large, symptomatic anterior and middle mediastinal mass, who required anaesthesia for emergency caesarean section. The anaesthetic management entailed Combined Spinal and Epidural (CSE) technique with safe feto-maternal outcome. (author)

  6. 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.

  7. Using screen-based simulation of inhaled anaesthetic delivery to improve patient care.

    Science.gov (United States)

    Philip, J H

    2015-12-01

    Screen-based simulation can improve patient care by giving novices and experienced clinicians insight into drug behaviour. Gas Man(®) is a screen-based simulation program that depicts pictorially and graphically the anaesthetic gas and vapour tension from the vaporizer to the site of action, namely the brain and spinal cord. The gases and vapours depicted are desflurane, enflurane, ether, halothane, isoflurane, nitrogen, nitrous oxide, sevoflurane, and xenon. Multiple agents can be administered simultaneously or individually and the results shown on an overlay graph. Practice exercises provide in-depth knowledge of the subject matter. Experienced clinicians can simulate anaesthesia occurrences and practices for application to their clinical practice, and publish the results to benefit others to improve patient care. Published studies using this screen-based simulation have led to a number of findings, as follows: changing from isoflurane to desflurane toward the end of anaesthesia does not accelerate recovery in humans; vital capacity induction can produce loss of consciousness in 45 s; simulated context-sensitive decrement times explain recovery profiles; hyperventilation does not dramatically speed emergence; high fresh gas flow is wasteful; fresh gas flow and not the vaporizer setting should be reduced during intubation; re-anaesthetization can occur with severe hypoventilation after extubation; and in re-anaesthetization, the anaesthetic redistributes from skeletal muscle. Researchers using screen-based simulations can study fewer subjects to reach valid conclusions that impact clinical care. © The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  8. Usefulness of an injectable anaesthetic protocol for semen collection through urethral catheterisation in domestic cats.

    Science.gov (United States)

    Pisu, Maria Carmela; Ponzio, Patrizia; Rovella, Chiara; Baravalle, Michela; Veronesi, Maria Cristina

    2017-10-01

    Objectives Although less often requested in comparison with dogs, the collection of semen in cats can be necessary for artificial insemination, for semen evaluation in tom cats used for breeding and for semen storage. Urethral catheterisation after pharmacological induction with medetomidine has proved to be useful for the collection of semen in domestic cats. However, most of the previously used protocols require the administration of high doses of medetomidine that can increase the risk of side effects, especially on the cardiovascular system. In routine clinical practice, one safe and useful injectable anaesthetic protocol for short-term clinical investigations or surgery in cats involves premedication with low intramuscular doses of dexmedetomidine with methadone, followed by intravenous propofol bolus injection. We aimed to assess the usefulness of this injectable anaesthetic protocol for semen collection, via urethral catheterisation, in domestic cats. Methods The study was performed on 38 purebred, adult cats, during the breeding season, and semen was collected via urethral catheterisation using an injectable anaesthesia protocol with methadone (0.2 mg/kg) and dexmedetomidine (5 µg/kg) premedication, followed by induction with propofol. Results The anaesthetic protocol used in the present study allowed the collection of large-volume semen samples, characterised by good parameters and without side effects. Conclusions and relevance The results from the present study suggest that the injectable anaesthetic protocol using methadone and dexmedetomidine premedication, followed by induction with propofol, could be suitable and safe for the collection of a good-quality semen sample, via urethral catheterisation, in domestic cats. It can therefore be used as an alternative to previous medetomidine-based sedation protocols.

  9. Review of hypoxaemia in anaesthetized horses: predisposing factors, consequences and management.

    Science.gov (United States)

    Auckburally, Adam; Nyman, Görel

    2017-05-01

    To discuss how hypoxaemia might be harmful and why horses are particularly predisposed to developing it, to review the strategies that are used to manage hypoxaemia in anaesthetized horses, and to describe how successful these strategies are and the adverse effects associated with them. Google Scholar and PubMed, using the search terms horse, pony, exercise, anaesthesia, hypoxaemia, oxygen, mortality, morbidity and ventilation perfusion mismatch. Although there is no evidence that hypoxaemia is associated with increased morbidity and mortality in anaesthetized horses, most anaesthetists would agree that it is important to recognise and prevent or treat it. Favourable anatomical and physiological adaptations of a horse for exercise adversely affect gas exchange once the animal is recumbent. Hypoxaemia is recognised more frequently in horses than in other domestic species during general anaesthesia, although its incidence in healthy horses remains unreported. Management of hypoxaemia in anaesthetized horses is challenging and often unsuccessful. Positive pressure ventilation strategies to address alveolar atelectasis in humans have been modified for implementation in recumbent anaesthetized horses, but are often accompanied by unpredictable and unacceptable cardiopulmonary adverse effects, and some strategies are difficult or impossible to achieve in adult horses. Furthermore, anticipated beneficial effects of these techniques are inconsistent. Increasing the inspired fraction of oxygen during anaesthesia is often unsuccessful since much of the impairment in gas exchange is a direct result of shunt. Alternative approaches to the problem involve manipulation of pulmonary blood away from atelectatic regions of the lung to better ventilated areas. However, further work is essential, with particular focus on survival associated with general anaesthesia in horses, before any technique can be accepted into widespread clinical use. Copyright © 2017 Association of

  10. Effects of some anaesthetics on honeybees: nitrous oxide, carbon dioxide, ammonium nitrate smoker fumes

    Energy Technology Data Exchange (ETDEWEB)

    Simpson, J

    1954-08-01

    Honeybees were apparently unaffected by atmospheric oxygen concentrations between 7% and 100%, and only became motionless when the oxygen concentration was less than 2%. The effects of nitrous oxide-oxygen mixtures differed little, if at all, from those nitrogen-oxygen mixtures. Bees were not visibly affected by carbon dioxide concentrations up to 10-15% but they became motionless if the concentration exceeded 40-45%. Fumes produced by adding ammonium nitrate to the fuel in a beekeeper's smoker were found to contain hydrogen cyanide or cyanogen. Their effectiveness as an anaesthetic may be due to this or to some unidentified component, but not to nitrous oxide. All three anaesthetics caused foraging bees to stop collecting pollen, and accelerated the retrogression of the pharyngeal glands of young bees. Anaesthesia of a few bees in a colony with nitrous oxide, carbon dioxide, or ammonium nitrate smoker fumes did not appear to inhibit their drift back to the original site when their hive was moved, nor was any reduction in drifting observed when a whole colony was moved while anaesthetized with ammonium nitrate smoker fumes. 4 tables.

  11. 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.

  12. Effects of Topical Anaesthetic and Buccal Meloxicam Treatments on Concurrent Castration and Dehorning of Beef Calves.

    Science.gov (United States)

    Van der Saag, Dominique; White, Peter; Ingram, Lachlan; Manning, Jaime; Windsor, Peter; Thomson, Peter; Lomax, Sabrina

    2018-02-28

    The use of pain relief during castration and dehorning of calves on commercial beef operations can be limited by constraints associated with the delivery of analgesic agents. As topical anaesthetic (TA) and buccal meloxicam (MEL) are now available in Australia, offering practical analgesic treatments for concurrent castration and dehorning of beef calves, a study was conducted to determine their efficacy in providing pain relief when applied separately or in combination. Weaner calves were randomly allocated to; (1) no castration and dehorning/positive control (CONP); (2) castration and dehorning/negative control (CONN); (3) castration and dehorning with buccal meloxicam (BM); (4) castration and dehorning with topical anaesthetic (TA); and (5) castration and dehorning with buccal meloxicam and topical anaesthetic (BMTA). Weight gain, paddock utilisation, lying activity and individual behaviours following treatment were measured. CONP and BMTA calves had significantly greater weight gain than CONN calves ( p castrated calves spent more time walking ( p = 0.024) and less time eating ( p castration and amputation dehorning.

  13. Anaesthetic neurotoxicity and neuroplasticity: an expert group report and statement based on the BJA Salzburg Seminar

    Science.gov (United States)

    Jevtovic-Todorovic, V.; Absalom, A. R.; Blomgren, K.; Brambrink, A.; Crosby, G.; Culley, D. J.; Fiskum, G.; Giffard, R. G.; Herold, K. F.; Loepke, A. W.; Ma, D.; Orser, B. A.; Planel, E.; Slikker, W.; Soriano, S. G.; Stratmann, G.; Vutskits, L.; Xie, Z.; Hemmings, H. C.

    2013-01-01

    Although previously considered entirely reversible, general anaesthesia is now being viewed as a potentially significant risk to cognitive performance at both extremes of age. A large body of preclinical as well as some retrospective clinical evidence suggest that exposure to general anaesthesia could be detrimental to cognitive development in young subjects, and might also contribute to accelerated cognitive decline in the elderly. A group of experts in anaesthetic neuropharmacology and neurotoxicity convened in Salzburg, Austria for the BJA Salzburg Seminar on Anaesthetic Neurotoxicity and Neuroplasticity. This focused workshop was sponsored by the British Journal of Anaesthesia to review and critically assess currently available evidence from animal and human studies, and to consider the direction of future research. It was concluded that mounting evidence from preclinical studies reveals general anaesthetics to be powerful modulators of neuronal development and function, which could contribute to detrimental behavioural outcomes. However, definitive clinical data remain elusive. Since general anaesthesia often cannot be avoided regardless of patient age, it is important to understand the complex mechanisms and effects involved in anaesthesia-induced neurotoxicity, and to develop strategies for avoiding or limiting potential brain injury through evidence-based approaches. PMID:23722106

  14. Job satisfaction, stress and burnout in anaesthetic technicians in New Zealand.

    Science.gov (United States)

    Kluger, M T; Bryant, J

    2008-03-01

    Anaesthetic technicians play a key role in the operating room, yet little is known about their levels of job satisfaction or workplace stress. A blinded, confidential single mail-out survey was posted to anaesthetic technicians in New Zealand. The survey consisted of demographic information, a job satisfaction survey, the Maslach Burnout Inventory and the Short Form 12. At total of 154 forms were returned (51% response rate). Respondents worked predominantly in public hospitals and many had duties outside the operating room. Job satisfaction was related to teamwork, practical nature of work and patient contact, while dissatisfaction was related to lack of respect from nurses and limited career pathway. High to moderate levels of emotional exhaustion (48%), depersonalisation (39%) and low levels of personal accomplishment (58%) were indicators of burnout. The Short Form 12 revealed high levels of physical impairment in 24% and emotional impairment in 35% of respondents. These data suggest that work is needed to evaluate anaesthetic assistants' job structure and actively manage their important physical and emotional sequelae.

  15. Effect of some radiosensitising drugs on human erythrocyte membrane - - spin label study

    Energy Technology Data Exchange (ETDEWEB)

    Mishra, K P [Bhabha Atomic Research Centre, Bombay (India). Biology and Agriculture Div.

    1982-02-01

    Electron spin resonance and spin label techniques have been employed to study the effects of local anaesthetic drugs, procaine and tetracaine, on human erythrocyte membrane. Both the drugs altered the protein and lipid arrangements in the membrane and these changes were reversible. Procaine had greater effect on the labels attached to proteins while tetracaine fluidized interior of lipid bilayer to a greater extent. The differential effects of these drugs on the protein and lipid labels have been interpreted in terms of their relative penetrability in the membrane. Present results have explained that radiation induced enhanced killing of cells in the presence of these drugs might be due to the alterations in membrane, particularly proteins both structural and enzymatic. In addition, these results indicate a possible relationship between drug-induced structural changes in membrane and their anaesthetic potency.

  16. Ventricular rhythm in atrial fibrillation under anaesthetic infusion with propofol

    International Nuclear Information System (INIS)

    Cervigón, R; Moreno, J; Pérez-Villacastín, J; Reilly, R B; Castells, F

    2009-01-01

    Changes in patients' autonomic tone and specific pharmacologic interventions may modify the ventricular response (actual heart rate) during atrial fibrillation (AF). Hypnotic agents such as propofol may modify autonomic balance as they promote a sedative state. It has been shown that propofol slightly slows atrial fibrillatory activity, but the net global effect on the ventricular response remains unknown. We aimed to evaluate in patients in AF the effect of a propofol bolus on the ventricular rate and regularity at ECG. We analysed the possible relation with local atrial fibrillatory activities, as ratios between atrial and ventricular rates (AVRs), analysing atrial activity from intracardiac electrograms at the free wall of the right and left atria and at the interatrial septum. We compared data at the baseline and after complete hypnosis. Propofol was associated with a more homogeneous ventricular response and lower AVR values at the interatrial septum

  17. Anaesthetic effects of alfaxalone administered intraperitoneally alone or combined with dexmedetomidine and fentanyl in the rat.

    Science.gov (United States)

    Arenillas, Mario; Gomez de Segura, Ignacio A

    2018-01-01

    Alfaxalone is a neuroactive steroid used as a general anaesthetic in several species including dogs, cats, rabbits and ferrets. It has a wide margin of safety and a similar anaesthetic profile to propofol. To increase its aqueous solubility, a new formulation with cyclodextrins has been marketed recently. The objective of this study was to evaluate the anaesthetic effect of several doses of alfaxalone alone, considering differences between sexes, and alfaxalone combined with dexmedetomidine and fentanyl in the rat administered by the intraperitoneal route. A total of 40 Sprague Dawley rats, involved in three studies, were used. Firstly, 25, 35 and 45 mg kg -1 of alfaxalone alone were tested. In a second study, alfaxalone (25 mg kg -1 , females; 75 mg kg -1 , males) was combined with dexmedetomidine (0.05 mg kg -1 ). Finally, alfaxalone (20 mg kg -1 , females; 60 mg kg -1 , males) was combined with dexmedetomidine (0.05 mg kg -1 ) and fentanyl (0.1 mg kg -1 ). Times of onset and duration of anaesthesia, and analgesia, deemed as losing of withdrawal pedal reflex, were recorded. Alfaxalone alone produced a 2 - to 3-fold longer time of anaesthesia in females, although surgical anaesthesia was not achieved in either sex. The addition of dexmedetomidine and fentanyl to alfaxalone produced a similar time of analgesia as well as increased time of anaesthesia in both sexes. In conclusion, alfaxalone produces light anaesthesia in rats, and males required a higher dose. The combination with other sedatives or analgesics, such as dexmedetomidine or fentanyl, allows a more prolonged anaesthesia with analgesic effects, potentially suitable for invasive procedures.

  18. First administration to man of Org 25435, an intravenous anaesthetic: A Phase 1 Clinical Trial.

    Science.gov (United States)

    Rigby-Jones, Ann E; Sneyd, J Robert; Vijn, Peter; Boen, Patrick; Cross, Maurice

    2010-06-29

    Org 25435 is a new water-soluble alpha-amino acid ester intravenous anaesthetic which proved satisfactory in animal studies. This study aimed to assess the safety, tolerability and efficacy of Org 25435 and to obtain preliminary pharmacodynamic and pharmacokinetic data. In the Short Infusion study 8 healthy male volunteers received a 1 minute infusion of 0.25, 0.5, 1.0, or 2.0 mg/kg (n = 2 per group); a further 10 received 3.0 mg/kg (n = 5) or 4.0 mg/kg (n = 5). Following preliminary pharmacokinetic modelling 7 subjects received a titrated 30 minute Target Controlled Infusion (TCI), total dose 5.8-20 mg/kg. Within the Short Infusion study, all subjects were successfully anaesthetised at 3 and 4 mg/kg. Within the TCI study 5 subjects were anaesthetised and 2 showed signs of sedation. Org 25435 caused hypotension and tachycardia at doses over 2 mg/kg. Recovery from anaesthesia after a 30 min administration of Org 25435 was slow (13.7 min). Pharmacokinetic modelling suggests that the context sensitive half-time of Org 25435 is slightly shorter than that of propofol in infusions up to 20 minutes but progressively longer thereafter. Org 25435 is an effective intravenous anaesthetic in man at doses of 3 and 4 mg/kg given over 1 minute. Longer infusions can maintain anaesthesia but recovery is slow. Hypotension and tachycardia during anaesthesia and slow recovery of consciousness after cessation of drug administration suggest this compound has no advantages over currently available intravenous anaesthetics.

  19. Effects of Topical Anaesthetic and Buccal Meloxicam Treatments on Concurrent Castration and Dehorning of Beef Calves

    Directory of Open Access Journals (Sweden)

    Dominique Van der Saag

    2018-02-01

    Full Text Available The use of pain relief during castration and dehorning of calves on commercial beef operations can be limited by constraints associated with the delivery of analgesic agents. As topical anaesthetic (TA and buccal meloxicam (MEL are now available in Australia, offering practical analgesic treatments for concurrent castration and dehorning of beef calves, a study was conducted to determine their efficacy in providing pain relief when applied separately or in combination. Weaner calves were randomly allocated to; (1 no castration and dehorning/positive control (CONP; (2 castration and dehorning/negative control (CONN; (3 castration and dehorning with buccal meloxicam (BM; (4 castration and dehorning with topical anaesthetic (TA; and (5 castration and dehorning with buccal meloxicam and topical anaesthetic (BMTA. Weight gain, paddock utilisation, lying activity and individual behaviours following treatment were measured. CONP and BMTA calves had significantly greater weight gain than CONN calves (p < 0.001. CONN calves spent less time lying compared to BMTA calves on all days (p < 0.001. All dehorned and castrated calves spent more time walking (p = 0.024 and less time eating (p < 0.001 compared to CONP calves. There was a trend for CONP calves to spend the most time standing and CONN calves to spend the least time standing (p = 0.059. There were also trends for the frequency of head turns to be lowest in CONP and BMTA calves (p = 0.098 and tail flicks to be highest in CONN and BM calves (p = 0.061. The findings of this study suggest that TA and MEL can potentially improve welfare and production of calves following surgical castration and amputation dehorning.

  20. Adrenaline reveals the torsadogenic effect of combined blockade of potassium channels in anaesthetized guinea pigs.

    Science.gov (United States)

    Michael, G; Kane, K A; Coker, S J

    2008-08-01

    Torsade de pointes (TdP) can be induced in several species by a reduction in cardiac repolarizing capacity. The aim of this study was to assess whether combined I(Kr) and I(Ks) blockade could induce TdP in anaesthetized guinea pigs and whether short-term variability (STV) or triangulation of action potentials could predict TdP. Experiments were performed in open-chest, pentobarbital-anaesthetized, adrenaline-stimulated male Dunkin Hartley guinea pigs, which received three consecutive i.v. infusions of either vehicle, the I(Kr) blocker E-4031 (3, 10 and 30 nmol kg(-1) min(-1)), the I(Ks) blocker HMR1556 (75, 250, 750 nmol kg(-1) min(-1)) or E-4031 and HMR1556 combined. Phenylephrine-stimulated guinea pigs were also treated with the K(+) channel blockers in combination. Arterial blood pressure, ECGs and epicardial monophasic action potential (MAP) were recorded. TdP was observed in 75% of adrenaline-stimulated guinea pigs given the K(+) channel blockers in combination, but was not observed in guinea pigs treated with either I(K) blocker alone, or in phenylephrine-stimulated guinea pigs. Salvos and ventricular tachycardia occurred with adrenaline but not with phenylephrine. No changes in STV or triangulation of the MAP signals were observed before TdP. Combined blockade of both I(Kr) and I(Ks) plus the addition of adrenaline were required to induce TdP in anaesthetized guinea pigs. This suggests that there must be sufficient depletion of repolarization reserve and an appropriate trigger for TdP to occur.

  1. Anaesthetic management of supratentorial tumor craniotomy using awake-throughout approach

    International Nuclear Information System (INIS)

    Shafiq, F.; Salim, F.; Parkash, J.

    2017-01-01

    The authors are reporting an anaesthetic management of patient presenting with left parietal lobe space occupying lesion and scheduled for Awake-craniotomy. Awake-throughout approach using scalp block was planned. Among techniques reported for keeping patient awake during the surgery, this one is really underutilized. The successful conduct requires thorough preoperative assessment and psychological preparation. We used powerpoint presentation as a preoperative teaching tool. The anatomical landmark technique was used to institute scalp block, where individual nerves were targeted bilaterally. Patient remained stable throughout and participated actively in intraoperative neurological monitoring. Postoperative period showed remarkable recovery, better pain control, and shorter length of stay in hospital. (author)

  2. Anaesthetic Management of Supratentorial Tumor Craniotomy Using Awake-Throughout Approach.

    Science.gov (United States)

    Shafiq, Faraz; Salim, Fahad; Enam, Ather; Parkash, Jai; Faheem, Mohammad

    2017-12-01

    The authors are reporting an anaesthetic management of patient presenting with left parietal lobe space occupying lesion and scheduled for Awake-craniotomy. Awake-throughout approach using scalp block was planned. Among techniques reported for keeping patient awake during the surgery, this one is really underutilized. The successful conduct requires thorough preoperative assessment and psychological preparation. We used powerpoint presentation as a preoperative teaching tool. The anatomical landmark technique was used to institute scalp block, where individual nerves were targeted bilaterally. Patient remained stable throughout and participated actively in intraoperative neurological monitoring. Postoperative period showed remarkable recovery, better pain control, and shorter length of stay in hospital.

  3. The Effects of Some Anaesthetics on the Electrocardiograms of Guinea Pigs

    OpenAIRE

    PİŞKİN, İlksin; ŞİRELİ, Meltem; SAĞMANLIGİL, Vedat; EMRE, Bahri

    1998-01-01

    This study was carried out to observe the effects on electrocardiography of using droperidol-fentanyl and ketamine-xylazine combinations, urethane and pentothal sodium as anaesthetic doses. In this study, thirty-five 4-5 months-old quinea pigs of both sexes weighing 540-600 g were used. The quinea pigs were divided equally into 5 groups. The first group was used as the control group and nothing was given to this group. The combination of droperidol (20 mg/ml)-fentanyl (0.4 mg/ml) in a dose o...

  4. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  7. 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.

  8. 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.

  9. Efficacy of 2-Phenoxyethanol as an Anaesthetic for Adult Redline Torpedo Fish, Sahyadria denisonii (Day 1865

    Directory of Open Access Journals (Sweden)

    Anna Mercy Thoranam Varkey

    2014-01-01

    Full Text Available Efficacy of 2-phenoxyethanol for redline torpedo fish exposed to five concentrations (200, 300, 400, 500, and 600 μlL−1 was evaluated. The time periods necessary for each characteristic stage of induction and recovery were recorded. Results indicated that the induction time of the fish exposed to five anaesthetic concentrations significantly (P<0.05 decreased with increasing concentration but recovery time was independent of concentration. Concentration of 500 μlL−1 (induction time: 173 ± 7 and recovery time: 129 ± 41 seconds was determined as the minimum effective concentration that induces anaesthesia in less than 3 minutes.

  10. A critical test of Drosophila anaesthetics: Isoflurane and sevoflurane are benign alternatives to cold and CO2.

    Science.gov (United States)

    MacMillan, Heath A; Nørgård, Mikkel; MacLean, Heidi J; Overgaard, Johannes; Williams, Catherine J A

    2017-08-01

    Anaesthesia is often a necessary step when studying insects like the model organism Drosophila melanogaster. Most studies of Drosophila and other insects that require anaesthesia use either cold exposure or carbon dioxide exposure to induce a narcotic state. These anaesthetic methods are known to disrupt physiology and behavior with increasing exposure, and thus ample recovery time is required prior to experimentation. Here, we examine whether two halogenated ethers commonly used in vertebrate anaesthesia, isoflurane and sevoflurane, may serve as alternative means of insect anaesthesia. Using D. melanogaster, we generated dose-response curves to identify exposure times for each anaesthetic (cold, CO 2 , isoflurane and sevoflurane) that allow for five-minutes of experimental manipulation of the animals after the anaesthetic was removed (i.e. 5min recovery doses). We then compared the effects of this practical dose on high temperature, low temperature, starvation, and desiccation tolerance, as well as locomotor activity and fecundity of female flies following recovery from anaesthesia. Cold, CO 2 and isoflurane each had significant or near significant effects on the traits measured, but the specific effects of each anaesthetic differed, and effects on stress tolerance generally did not persist if the flies were given 48h to recover from anaesthesia. Sevoflurane had no measureable effect on any of the traits examined. Care must be taken when choosing an anaesthetic in Drosophila research, as the impacts of specific anaesthetics on stress tolerance, behavior and reproduction can widely differ. Sevoflurane may be a practical alternative to cold and CO 2 anaesthesia in insects - particularly if flies are to be used for experiments shortly after anesthesia. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    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.

  12. [Anaesthetic management in a paediatric patient with a difficult airway due to epidermolysis bullosa dystrophica].

    Science.gov (United States)

    Blázquez Gómez, E; Garcés Aletá, A; Monclus Diaz, E; Manen Berga, F; García-Aparicio, L; Ontanilla López, A

    2015-05-01

    Dystrophic epidermolysis bullosa (DEB) is a rare inherited disorder characterized by blistering after minimal trauma. These blisters tend to form dystrophic scars, leading to limiting and life-threatening sequelae. The anaesthetic management of patients with DEB is a challenge, even for the most experienced anaesthesiologists, but basic principles can help us prepare the plan of care. The main goals are to prevent trauma/infection of skin/mucous, and to establish a secure airway without causing bullae. Patient positioning and the instruments used to monitor vital signs and administering anaesthetic agents can cause new lesions. It is advisable to lubricate the instruments and to avoid adhesive material and shearing forces on the skin. Besides the implications of the comorbidities, there is a potential difficult intubation and difficult vascular access. Acute airway obstruction can occur due to airway instrumentation. We report the case of a patient diagnosed with EBD difficult airway and undergoing correction of syndactylyl and dental extractions. Copyright © 2014 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. Halogenated anaesthetics and cardiac protection in cardiac and non-cardiac anaesthesia

    Directory of Open Access Journals (Sweden)

    Landoni Giovanni

    2009-01-01

    Full Text Available Volatile anaesthetic agents have direct protective properties against ischemic myocardial damage. The implementation of these properties during clinical anaesthesia can provide an additional tool in the treatment or prevention, or both, of ischemic cardiac dysfunction in the perioperative period. A recent meta-analysis showed that desflurane and sevoflurane reduce postoperative mortality and incidence of myocardial infarction following cardiac surgery, with significant advantages in terms of postoperative cardiac troponin release, need for inotrope support, time on mechanical ventilation, intensive care unit and overall hospital stay. Multicentre, randomised clinical trials had previously demonstrated that the use of desflurane can reduce the postoperative release of cardiac troponin I, the need for inotropic support, and the number of patients requiring prolonged hospitalisation following coronary artery bypass graft surgery either with and without cardiopulmonary bypass. The American College of Cardiology/American Heart Association Guidelines recommend volatile anaesthetic agents during non-cardiac surgery for the maintenance of general anaesthesia in patients at risk for myocardial infarction. Nonetheless, e vidence in non-coronary surgical settings is contradictory and will be reviewed in this paper together with the mechanisms of cardiac protection by volatile agents.

  14. Anaesthetic management and perioperative complications during deep brain stimulation surgery: Our institutional experience

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    Renu Bala

    2016-01-01

    Full Text Available Background: Deep brain stimulation (DBS surgery is an established therapeutic option for alleviating movement disorders. It represents unique challenges for anaesthesiologists. We retrospectively reviewed the patients, who underwent this surgery at our institution, to study anaesthetic management and perioperative complications. Materials and Methods: After taking approval from the Institutional Ethics Committee, medical, surgical and anaesthesia records of 67 patients who were admitted to undergo DBS surgery during 11 years period (January 2001 to December 2011 were retrieved and reviewed. Sixty-five patients underwent the procedure. Various anaesthetic events and perioperative complications were noted and appropriate statistical analysis was carried out to analyse the data. Results: Electrode placement under monitored anaesthesia care (MAC was the most commonly used technique (86% of patients. Intra-operative complications occurred in 16 patients (24% whereas post-operative complication occurred in 10 patients (15.4%. There was one mortality. Though age >60 years and American Society of Anesthesiologists status > II were found to be the risk factors for post-operative complications in the bivariate analysis; they were not significant in multivariate analysis. Conclusions: We report our experience of DBS surgery, which was performed using MAC in majority of patients, though general anaesthesia is also feasible. Further prospective randomised studies comprising large number of patients are warranted to corroborate our finding and to find out the most suitable sedative agent.

  15. Meningomyelocele Repair in a Premature Newborn with Hydrocephalus: Anaesthetic Confronts and Management

    Directory of Open Access Journals (Sweden)

    Sandhya Ghodke

    2017-07-01

    Full Text Available Deficit of neural tube closure in the initial phases of intrauterine development leads to a gamut of abnormalities ranging from spina-bifida occulta, a relatively benign condition, to encephalocele and meningomyelocele, an anomaly in vertebral bodies, spinal cord and sometimes involving brainstem (in cervical meningomyelocele. Meningomyelocele is the most common nonlethal malformation in the spectrum of neural tube deficits. The intrinsic challenges associated with the latter disorder warrants tailor-made approaches for providing anaesthesia to the requisite therapeutic surgical interventions. Pediatric patients pose a set of natural barriers because of their ever budding and maturing neurophysiological status, apart from the central neural disease process. Hence, in order to provide optimal neuro-anaesthetic care, the anaesthesiologist must have the knowledge of the outcomes of various pharmacologic interventions on cerebral aerodynamics apart from his professional experience in pediatric neuroanaesthesia. The current case report accounts for a challenging anaesthetic management in a premature newborn having hydrocephalus and lumbosacral meningomyelocele, presented for surgical repair within four hours of delivery.

  16. Randomized trial of anaesthetic interventions in external cephalic version for breech presentation.

    Science.gov (United States)

    Khaw, K S; Lee, S W Y; Ngan Kee, W D; Law, L W; Lau, T K; Ng, F F; Leung, T Y

    2015-06-01

    Successful external cephalic version (ECV) for breech presenting fetus reduces the need for Caesarean section (CS). We aimed to compare the success rate of ECV with either spinal anaesthesia (SA) or i.v. analgesia using remifentanil. In a double-phased, stratified randomized blinded controlled study we compared the success rates of ECV, performed under spinal anaesthesia (SA), i.v. analgesia (IVA) using remifentanil or no anaesthetic interventions. In phase I, 189 patients were stratified by parity before randomization to ECV, performed by blinded operators, under SA using either hyperbaric bupivacaine 9 mg with fentanyl 15 µg, i.v. remifentanil infusion 0.1 µg kg min(-1), or Control (no anaesthetic intervention). Operators performing ECV were blinded to the treatment allocation. In phase 2, patients in the Control group in whom the initial ECV failed were further randomized to receive either SA (n=9) or IVA (n=9) for a re-attempt. The primary outcome was the incidence of successful ECV. The success rate in Phase 1 was greatest using SA [52/63 (83%)], compared with IVA [40/63 (64%)] and Control [40/63 (64%)], (P=0.027). Median [IQR] pain scores on a visual analogue scale (range 0-100), were 0 [0-0] with SA, 35 [0-60] with IVA and 50 [30-75] in the Control group (P<0.001). Median [IQR] VAS sedation scores were highest with IVA [75 (50-80)], followed by SA, [0 (0-50)] and Control [0 (0-0)]. In phase 2, 7/9 (78%) of ECV re-attempts were successful with SA, whereas all re-attempts using IVA failed (P=0.0007). The incidence of fetal bradycardia necessitating emergency CS within 30 min, was similar among groups; 1.6% (1/63) in the SA and IVA groups and 3.2% (2/63) in the Control group. SA increased the success rate and reduced pain for both primary and re-attempts of ECV, whereas IVA using remifentanil infusion only reduced the pain. There was no significant increase in the incidence of fetal bradycardia or emergency CS, with ECV performed under anaesthetic

  17. A New Anaesthetic Protocol for Adult Zebrafish (Danio rerio: Propofol Combined with Lidocaine.

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    Ana M Valentim

    Full Text Available The increasing use of zebrafish model has not been accompanied by the evolution of proper anaesthesia for this species in research. The most used anaesthetic in fishes, MS222, may induce aversion, reduction of heart rate, and consequently high mortality, especially during long exposures. Therefore, we aim to explore new anaesthetic protocols to be used in zebrafish by studying the quality of anaesthesia and recovery induced by different concentrations of propofol alone and in combination with different concentrations of lidocaine.In experiment A, eighty-three AB zebrafish were randomly assigned to 7 different groups: control, 2.5 (2.5P, 5 (5P or 7.5 μg/ml (7.5P of propofol; and 2.5 μg/ml of propofol combined with 50, (P/50L, 100 (P/100L or 150 μg/ml (P/150L of lidocaine. Zebrafish were placed in an anaesthetic water bath and time to lose the equilibrium, reflex to touch, reflex to a tail pinch, and respiratory rate were measured. Time to gain equilibrium was also assessed in a clean tank. Five and 24 hours after anaesthesia recovery, zebrafish were evaluated concerning activity and reactivity. Afterwards, in a second phase of experiments (experiment B, the best protocol of the experiment A was compared with a new group of 8 fishes treated with 100 mg/L of MS222 (100M.In experiment A, only different concentrations of propofol/lidocaine combination induced full anaesthesia in all animals. Thus only these groups were compared with a standard dose of MS222 in experiment B. Propofol/lidocaine induced a quicker loss of equilibrium, and loss of response to light and painful stimuli compared with MS222. However zebrafish treated with MS222 recovered quickly than the ones treated with propofol/lidocaine.In conclusion, propofol/lidocaine combination and MS222 have advantages in different situations. MS222 is ideal for minor procedures when a quick recovery is important, while propofol/lidocaine is best to induce a quick and complete anaesthesia.

  18. [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.

  19. Quantification of anaesthetic effects on atrial fibrillation rate by partial least-squares

    International Nuclear Information System (INIS)

    Cervigón, R; Moreno, J; Pérez-Villacastín, J; Reilly, R B; Castells, F

    2012-01-01

    The mechanism underlying atrial fibrillation (AF) remains poorly understood. Multiple wandering propagation wavelets drifting through both atria under hierarchical models are not understood. Some pharmacological drugs, known as antiarrhythmics, modify the cardiac ionic currents supporting the fibrillation process within the atria and may modify the AF propagation dynamics terminating the fibrillation process. Other medications, theoretically non-antiarrhythmic, may slightly affect the fibrillation process in non-defined mechanisms. We evaluated whether the most commonly used anaesthetic agent, propofol, affects AF patterns. Partial least-squares (PLS) analysis was performed to reduce significant noise into the main latent variables to find the differences between groups. The final results showed an excellent discrimination between groups with slow atrial activity during the propofol infusion. (paper)

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

    Science.gov (United States)

    Kabade, Savitri D; Sheikh, Safiya; Periyadka, Bhavya

    2011-01-01

    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. PMID:22013256

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

    Directory of Open Access Journals (Sweden)

    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.

  2. Anaesthetic management of two Bengal tiger (Panthera tigris tigris cubs for fracture repair

    Directory of Open Access Journals (Sweden)

    Gareth E. Zeiler

    2013-11-01

    Full Text Available This case series describes the anaesthetic management of two sibling Bengal tiger (Panthera tigris tigris cubs that were found to have spontaneous femur fractures due to severe nutritional secondary hyperparathyroidism. Both cubs received a combination of medetomidine (25 µg/kg and ketamine (4 mg/kg intramuscularly and were maintained with isoflurane in oxygen. An epidural injection of morphine (0.1 mg/kg and ropivacaine (1.6 mg/kg was administered to both tigers, which allowed a low end-tidal isoflurane concentration to be maintained throughout the femur fracture reduction operations. Both cubs experienced profound bradycardia and hypotension during general anaesthesia, and were unresponsive to anticholinergic treatment. Possible causes for these cardiovascular complications included: drug pharmacodynamics (medetomidine, morphine, isoflurane, decreased sympathetic tone due to the epidural (ropivacaine and hypothermia. These possible causes are discussed in detail.

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

    Directory of Open Access Journals (Sweden)

    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.

  4. Anaesthetic management of shoulder arthroscopic repair in Parkinson′s disease with deep brain stimulator

    Directory of Open Access Journals (Sweden)

    Ranju Gandhi

    2014-01-01

    Full Text Available We describe the anaesthetic management of arthroscopic repair for complete rotator cuff tear of shoulder in a 59-year-old female with Parkinson′s disease (PD with deep brain stimulator (DBS using a combination of general anaesthesia with interscalene approach to brachial plexus block. The DBS consists of implanted electrodes in the brain connected to the implantable pulse generator (IPG normally placed in the anterior chest wall subcutaneously. It can be programmed externally from a hand-held device placed directly over the battery stimulator unit. In our patient, IPG with its leads was located in close vicinity of the operative site with potential for DBS malfunction. Implications of DBS in a patient with PD for shoulder arthroscopy for anaesthesiologist are discussed along with a brief review of DBS.

  5. Monitoring variables affecting positron emission tomography measurements of cerebral blood flow in anaesthetized pigs

    DEFF Research Database (Denmark)

    Alstrup, Aage Kristian Olsen; Zois, Nora Elisabeth; Simonsen, Mette

    2018-01-01

    Background Positron emission tomography (PET) imaging of anaesthetized pig brains is a useful tool in neuroscience. Stable cerebral blood flow (CBF) is essential for PET, since variations can affect the distribution of several radiotracers. However, the effect of physiological factors regulating...... and the monitoring parameters. Results No significant statistical correlations were found between CBF and the nine monitoring variables. However, we found that arterial carbon dioxide tension (PaCO2) and body temperature were important predictors of CBF that should be observed and kept constant. In addition, we...... found that long-duration anaesthesia was significantly correlated with high heart rate, low arterial oxygen tension, and high body temperature, but not with CBF. Conclusions The findings indicate that PaCO2 and body temperature are crucial for maintaining stable levels of CBF and thus optimizing PET...

  6. Anaesthetic management of craniotomy for intracranial lesion in a child with uncorrected Tetrology of Fallot

    International Nuclear Information System (INIS)

    Rafique, N. B.; Hamid, M.

    2013-01-01

    The case of a 16 years old female with uncorrected Tetrology of Fallot, who operated for intracranial lesion in parieto frontal area with midline shift is presented. She had right ventricular hypertrophy, clubbing, central and peripheral cyanosis. Patient was anaesthetized keeping all measures required to avoid haemodynamic swings, tachycardia, desaturation, acidosis and dehydration. Pre-operative antibiotic cover was given to prevent bacterial endocarditis. Neurosurgeon, Paediatric cardiologist, Anaesthesiologist and Intensivist were involved in the preoperative planning and management of the patient. Haemodynamics were maintained and managed by monitoring continuous arterial line secured pre-induction and central line after induction. During surgery pain was controlled with fentanyl boluses intra-operatively and post operatively by tramadol infusion. Patient was extubated post operatively in the recovery room fulfilling the extubation criteria. She remained haemodynamically stable throughout the course. She was discharged on 5th post operative day from the hospital on SpO/sub 2/ of 70-80% at room air. (author)

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

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    Jacques P. Ferreira

    2015-06-01

    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.

  8. 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.

  9. Measurement of tidal volume using respiratory ultrasonic plethysmography in anaesthetized, mechanically ventilated horses.

    Science.gov (United States)

    Russold, Elena; Ambrisko, Tamas D; Schramel, Johannes P; Auer, Ulrike; Van Den Hoven, Rene; Moens, Yves P

    2013-01-01

    To compare tidal volume estimations obtained from Respiratory Ultrasonic Plethysmography (RUP) with simultaneous spirometric measurements in anaesthetized, mechanically ventilated horses. Prospective randomized experimental study. Five experimental horses. Five horses were anaesthetized twice (1 week apart) in random order in lateral and in dorsal recumbency. Nine ventilation modes (treatments) were scheduled in random order (each lasting 4 minutes) applying combinations of different tidal volumes (8, 10, 12 mL kg(-1)) and positive end-expiratory pressures (PEEP) (0, 10, 20 cm H(2)O). Baseline ventilation mode (tidal volume=15 mL kg(-1), PEEP=0 cm H(2)O) was applied for 4 minutes between all treatments. Spirometry and RUP data were downloaded to personal computers. Linear regression analyses (RUP versus spirometric tidal volume) were performed using different subsets of data. Additonally RUP was calibrated against spirometry using a regression equation for all RUP signal values (thoracic, abdominal and combined) with all data collectively and also by an individually determined best regression equation (highest R(2)) for each experiment (horse versus recumbency) separately. Agreement between methods was assessed with Bland-Altman analyses. The highest correlation of RUP and spirometric tidal volume (R(2)=0.81) was found with the combined RUP signal in horses in lateral recumbency and ventilated without PEEP. The bias ±2 SD was 0±2.66 L when RUP was calibrated for collective data, but decreased to 0±0.87 L when RUP was calibrated with individual data. A possible use of RUP for tidal volume measurement during IPPV needs individual calibration to obtain limits of agreement within ±20%. © 2012 The Authors. Veterinary Anaesthesia and Analgesia. © 2012 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesiologists.

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

    Directory of Open Access Journals (Sweden)

    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. National survey on perioperative anaesthetic management in the endovascular treatment of acute ischaemic stroke.

    Science.gov (United States)

    Romero Kräuchi, O; Valencia, L; Iturri, F; Mariscal Ortega, A; López Gómez, A; Valero, R

    2018-01-01

    To assess the anaesthetic management of treatment for endovascular acute ischaemic stroke (AIS) in Spain. A survey was designed by the SEDAR Neuroscience Section and sent to the Spanish anaesthesiology departments with a primary stroke centre between July and November 2016. Of the 47 hospitals where endovascular treatment of AIS is performed, 37 anaesthesiology departments participated. Thirty responses were obtained; three of which were eliminated due to duplication (response rate of 72.9%). Health coverage for AIS endovascular treatment was available 24hours a day in 63% of the hospitals. The anaesthesiologist in charge of the procedure was physically present in the hospital in 55.3%. There was large inter-hospital variability in non-standard monitoring and type of anaesthesia. The most important criterion for selecting type of anaesthesia was multidisciplinary choice made by the anaesthesiologist, neurologist and neuroradiologist (59.3%). The duration of time from arrival to arterial puncture was 10-15minutes in 59.2%. In 44.4%, systolic blood pressure was maintained between 140-180mmHg, and diastolic blood pressure<105mmHg. Glycaemic levels were taken in 81.5% of hospitals. Intravenous heparinisation was performed during the procedure in 66.7% with different patterns of action. In cases of moderate neurological deterioration with no added complications, 85.2% of the included hospitals awakened and extubated the patients. The wide variability observed in the anaesthetic management and the organization of the endovascular treatment of AIS demonstrates the need to create common guidelines for anaesthesiologists in Spain. Copyright © 2017 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  12. 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.

  13. Pharmacoeconomics of volatile inhalational anaesthetic agents: an 11-year retrospective analysis.

    Science.gov (United States)

    Weinberg, L; Story, D; Nam, J; McNicol, L

    2010-09-01

    With continuously increasing expenditure on health care resources, various cost containment strategies have been suggested in regard to controlling the cost of inhalational anaesthetic agents. We performed a cost identification analysis assessing inhalational anaesthetic agent expenditure at a tertiary level hospital, along with an evaluation of strategies to contain the cost of these agents. The number of bottles of isoflurane, sevoflurane and desflurane used during the financial years 1997 to 2007 was retrospectively determined and the acquisition costs and cumulative drug expenditure calculated. Pharmacoeconomic modelling using low fresh gas flow anaesthesia was performed to evaluate practical methods of cost reduction. The use of isoflurane decreased from 384 bottles during 1997 to 204 in 2007. In contrast, use of sevoflurane increased from 226 bottles during 1998 to 875 during 2007. Desflurane use increased from 34 bottles per year during 2002 (its year of introduction) to 163 bottles per year in 2007. While the inflation-adjusted cumulative expenditure for these inhalational agents (Australian dollars) increased from $132,000 in 1997 to over $326,000 in 2007, an increase of 168%, patient workload over the same period increased by only 11%. Pharmacoeconomic modelling demonstrated that sevoflurane at 2 l/minute costs 19 times more than isoflurane at 0.5 l/minute. For the financial years 1997 to 2007, we found a progressive shift from the cheaper isoflurane to the more expensive agents, sevoflurane and desflurane, a shift associated with marked increases in costs. Low flow anaesthesia with isoflurane is one strategy to reduce costs.

  14. Localization of thermogenesis induced by single infusion of ephedrine in dog

    DEFF Research Database (Denmark)

    Madsen, J; Bülow, J; Larsen, O G

    1993-01-01

    The localization of the thermogenic effect of ephedrine (1 mg.kg-1 infused intravenously over 10 min.) was studied in 6 fasted dogs anaesthetized with etorfin-acepromazin-N2O. Three experiments were performed in each animal to determine the effect of ephedrine on a) splanchnic oxygen uptake, b...

  15. Neuromuscular blocking and cardiovascular effects of Org 9487, a new short-acting aminosteroidal blocking agent, in anaesthetized animals and in isolated muscle preparations

    NARCIS (Netherlands)

    Muir, A.W.; Sleigh, T.; Marshall, R.J.; Pow, E.; Anderson, K.; Booij, L.H.D.J.; Hill, D.R.

    1998-01-01

    This study was undertaken to investigate the neuromuscular blocking profile and cardiovascular effects of Org 9487, a new aminosteroidal, non-depolarizing, neuromuscular blocking agent structurally related to vecuronium, in anaesthetized animals and in isolated muscle preparations. In in vitro

  16. Ensuring availability of in date and fit for purpose emergency guidelines in all anaesthetic areas throughout the South East Scotland deanery

    OpenAIRE

    Hindle, Elise

    2016-01-01

    Our aim was to institute a system whereby emergency anaesthetic guidelines are available in >90% of appropriate clinical areas throughout each of the acute hospital sites in three health board administrative regions, and whereby >90% of available guidelines are deemed to be in date and fit for purpose. Our objective was to achieve these targets within 6 months. Using quality improvement methodology, we inventoried available emergency anaesthetic guidelines in 132 locations throughout seven ac...

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

    Directory of Open Access Journals (Sweden)

    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

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

    Science.gov (United States)

    Bowhay, Andrew R

    2008-08-12

    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. 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. 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. The majority of anaesthetic SpRs in the Mersey Deanery have not welcomed the changes brought by the EWTD to their training, experience and quality of life

  19. Paediatric minor oral surgical procedures under inhalation sedation and general anaesthetic: a comparison of variety and duration of treatment.

    Science.gov (United States)

    Foley, J

    2008-03-01

    To develop baseline data in relation to paediatric minor oral surgical procedures undertaken with both general anaesthesia and nitrous oxide inhalation sedation within a Hospital Dental Service. Data were collected prospectively over a three-year period from May 2003 to June 2006 for patients attending the Departments of Paediatric Dentistry, Dundee Dental Hospital and Ninewells Hospital, NHS Tayside, Great Britain, for all surgical procedures undertaken with either inhalation sedation or general anaesthetic. Both operator status and the procedure being undertaken were noted. In addition, the operating time was recorded. Data for 166 patients (F: 102; M: 64) with a median age of 12.50 (inter-quartile range 10.00, 14.20) years showed that 195 surgical procedures were undertaken. Of these 160 and 35 were with general anaesthetic and sedation respectively. The surgical removal of impacted, carious and supernumerary unit(s) accounted for 53.8% of all procedures, whilst the exposure of impacted teeth and soft tissue surgery represented 34.9% and 11.3% of procedures respectively. The median surgical time for techniques undertaken with sedation was 30.00 (inter-quartile range 25.00, 43.50) minutes whilst that for general anaesthetic was similar at 30.00 (inter-quartile range 15.25, 40.00) minutes (not statistically significant, (Mann Whitney U, W = 3081.5, P = 0.331). The majority of paediatric minor oral surgical procedures entail surgical exposure or removal of impacted teeth. The median treatment time for most procedures undertaken with either general anaesthetic or nitrous oxide sedation was 30 minutes.

  20. The decision to delivery interval in emergency caesarean sections: Impact of anaesthetic technique and work shift [version 2; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Anette Hein

    2017-12-01

    Full Text Available Background: One important task of the emergency anaesthesia service is to provide rapid, safe and effective anaesthesia for emergency caesarean sections (ECS. A Decision to Delivery Interval (DDI <30 minutes for ECS is a quality indicator for this service. The aim of this study was to assess the DDI and the impact of chosen anaesthetic technique (general anaesthesia (GA, spinal anaesthesia (SPA with opioid supplementation, or “top-up” of labour epidural analgesia (tEDA with local anaesthesia and fentanyl mixture and work shift for ECS at Danderyds Hospital, Sweden. Methods: A retrospective chart review of ECS at Danderyds Hospital was performed between January and October 2016. Time between decision for CS, start of anaesthesia, time for incision and delivery, type of anaesthetic technique, and time of day, working hours or on call and day of week, Monday – Friday, and weekend was compiled and analysed. Time events are presented as mean ± standard deviation. Non-parametric tests were used. Results: In total, 135 ECS were analysed: 92% of the cases were delivered within 30 minutes and mean DDI for all cases was 17.3±8.1 minutes. GA shortened the DDI by 10 and 13 minutes compared to SPA and tEDA (p<0.0005. DDI for SPA and tEDA did not differ. There was no difference in DDI regarding time of day or weekday. Apgar <7 at 5’ was more commonly seen in ECS having GA (11 out of 64 compared to SPA (2/30 and tEDA (1/41 (p<0.05. Conclusion: GA shortens the DDI for ECS, but the use of SPA as well as tEDA with opioid supplementation maintains a short DDI and should be considered when time allows. Top-up epidural did not prolong the DDI compared to SPA. The day of week or time of ECS had no influence on the anaesthesia service as measured by the DDI.

  1. The decision to delivery interval in emergency caesarean sections: Impact of anaesthetic technique and work shift [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Anette Hein

    2017-11-01

    Full Text Available Background: One important task of the emergency anaesthesia service is to provide rapid, safe and effective anaesthesia for emergency caesarean sections (ECS. A Decision to Delivery Interval (DDI <30 minutes for ECS is a quality indicator for this service. The aim of this study was to assess the DDI and the impact of chosen anaesthetic technique (general anaesthesia (GA, spinal anaesthesia (SPA with opioid supplementation, or “top-up” of labour epidural analgesia (tEDA with local anaesthesia and fentanyl mixture and work shift for ECS at Danderyds Hospital, Sweden. Methods: A retrospective chart review of ECS at Danderyds Hospital was performed between January and October 2016. Time between decision for CS, start of anaesthesia, time for incision and delivery, type of anaesthetic technique, and time of day, working hours or on call and day of week, Monday – Friday, and weekend was compiled and analysed. Time events are presented as mean ± standard deviation. Non-parametric tests were used. Results: In total, 135 ECS were analysed: 92% of the cases were delivered within 30 minutes and mean DDI for all cases was 17.3±8.1 minutes. GA shortened the DDI by 10 and 13 minutes compared to SPA and tEDA (p<0.0005. DDI for SPA and tEDA did not differ. There was no difference in DDI regarding time of day or weekday. Apgar <7 at 5’ was more commonly seen in ECS having GA (11 out of 64 compared to SPA (2/30 and tEDA (1/41 (p<0.05. Conclusion: GA shortens the DDI for ECS, but the use of SPA as well as tEDA with opioid supplementation maintains a short DDI and should be considered when time allows. Top-up epidural did not prolong the DDI compared to SPA. The day of week or time of ECS had no influence on the anaesthesia service as measured by the DDI.

  2. 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.

  3. Does the anaesthetic infl uence behavioural transmission of the monogenean Gyrodactylus gasterostei Gläser, 1974 off the host?

    Directory of Open Access Journals (Sweden)

    Grano-Maldonado M. I.

    2015-06-01

    Full Text Available The aim of this study was to investigate the use of the anaesthetic 2-phenoxyethanol on the transmission factors of gyrodactylid and to ascertain how this may affect in the colonisation of new hosts using the Gyrodactylus gasterostei Gläser, 1974 - Gasterosteus aculeatus L. model which is a simple and successful system to examine aspects of transmission of parasites from live and dead fish. Laboratory experiments include determining the maturity (presence of male copulate organ and reproductive (presence of daughter status of transmitting worms, in order to consider the factors that influence parasite option to migrate to a new individual of the same host species. This study demonstrates that parasites with a Male Copulate Organ (MCO present are more likely to abandon the host and attempt a host transfer. The use of the anaesthetic 2-phenoxyethanol does not affect transmission of gyrodactylids which leave the host to colonise a new host. Finally, the use of other anaesthetic although its relative importance with respect to transmission remains uncertain.

  4. A simplified concept for controlling oxygen mixtures in the anaesthetic machine--better, cheaper and more user-friendly?

    Science.gov (United States)

    Berge, J A; Gramstad, L; Grimnes, S

    1995-05-01

    Modern anaesthetic machines are equipped with several safety components to prevent delivery of hypoxic mixtures. However, such a technical development has increased the complexity of the equipment. We report a reconstructed anaesthetic machine in which a paramagnetic oxygen analyzer has provided the means to simplify the apparatus. The new machine is devoid of several components conventionally included to prevent hypoxic mixtures: oxygen failure protection device, reservoir O2 alarm, N2O/air selector, and proportioning system for oxygen/nitrous oxide delivery. These devices have been replaced by a simple safety system using a paramagnetic oxygen analyzer at the common gas outlet, which in a feed-back system cuts off the supply of nitrous oxide whenever the oxygen concentration falls below 25%. The simplified construction of the anaesthetic machine has important consequences for safety, cost and user-friendliness. Reducing the complexity of the construction also simplifies the pre-use checkout procedure, and an efficient 5-point check list is presented for the new machine.

  5. Comparison of Anaesthetic Efficacy of 4 percent Articaine Primary Buccal Infiltration Versus 2 percent Lidocaine Inferior Alveolar Nerve Block in Symptomatic Mandibular First Molar Teeth

    International Nuclear Information System (INIS)

    Zain, M.; Khattak, S. U. R.; Shah, S. A.; Fayyaz, M.; Sikandar, H.

    2016-01-01

    Objective: To evaluate success of pulpal anaesthesia of mandibular 1st molar by using 4 percentage articaine in buccal infiltration versus 2 percentage lidocaine in inferior alveolar nerve block. Study Design: Randomized control trial. Place and Duration of Study: Department of Operative Dentistry, Sardar Begum Dental College, Gandhara University, Peshawar, from March to August 2014. Methodology: One hundred and fifty-six emergency patients, who had 1st molar diagnosed with irreversible pulpitis, participated in the study. Subjects were divided into two groups by random allocation. One group received 4 percentage articaine buccal infiltration and the other group received inferior alveolar nerve block of 2 percentage lidocaine. Subjects self-reported pain response was recorded on Heft Parker Visual Analogue Scale after local anaesthetic administration during access cavity preparation and pulp extirpation. Results: Mean age of subjects was 31.46 ±10.994 years. The success rate of 4 percentage buccal infiltration was 76.9 percentage; whereas the success rate of 2 percentage lidocaine inferior alveolar nerve block was 62.8 percentage. There was no statistically significant difference between the two groups. Conclusion: 4 percentage articaine buccal infiltration can be considered a viable alternative to 2 percentage lidocaine inferior alveolar nerve block in securing successful pulpal anaesthesia for endodontic therapy. (author)

  6. Comparison of Anaesthetic Efficacy of 4% Articaine Primary Buccal Infiltration Versus 2% Lidocaine Inferior Alveolar Nerve Block in Symptomatic Mandibular First Molar Teeth.

    Science.gov (United States)

    Zain, Muhammad; Rehman Khattak, Shakeel Ur; Sikandar, Huma; Shah, Shafqat Ali; Fayyaz

    2016-01-01

    To evaluate success of pulpal anaesthesia of mandibular 1st molar by using 4% articaine in buccal infiltration versus 2% lidocaine in inferior alveolar nerve block. Randomized control trial. Department of Operative Dentistry, Sardar Begum Dental College, Gandhara University, Peshawar, from March to August 2014. One hundred and fifty-six emergency patients, who had 1st molar diagnosed with irreversible pulpitis, participated in the study. Subjects were divided into two groups by random allocation. One group received 4% articaine buccal infiltration and the other group received inferior alveolar nerve block of 2% lidocaine. Subjects’self-reported pain response was recorded on Heft Parker Visual Analogue Scale after local anaesthetic administration during access cavity preparation and pulp extirpation. Mean age of subjects was 31.46 ±10.994 years. The success rate of 4% buccal infiltration was 76.9%; whereas the success rate of 2% lidocaine inferior alveolar nerve block was 62.8%. There was no statistically significant difference between the two groups. 4% articaine buccal infiltration can be considered a viable alternative to 2% lidocaine inferior alveolar nerve block in securing successful pulpal anaesthesia for endodontic therapy.

  7. Anaesthesia in Dental Medicine with Local Infiltrative Anaesthetic Technique Versus Diploe Anaesthesia Delivery Systems: Efficacy and Behaviour, an Experimental Study

    Directory of Open Access Journals (Sweden)

    Manuel Marques-Ferreira

    2017-12-01

    Conclusion: Diploe anaesthesia demonstrated better results in terms of analgesia than the infiltrative anaesthesia. It has been reported to be easy, safe and an effective procedure that allows anaesthesia in almost all clinical situations. This approach may offer particular advantages for endodontic therapy, providing greater comfort for the patient.

  8. Systematic review of the systemic concentrations of local anaesthetic after transversus abdominis plane block and rectus sheath block

    NARCIS (Netherlands)

    Rahiri, J.; Tuhoe, J.; Svirskis, D.; Lightfoot, N. J.; Lirk, P. B.; Hill, A. G.

    2017-01-01

    Background. Safe and efficacious modalities of perioperative analgesia are essential for enhanced recovery after surgery. Truncal nerve blocks are one potential adjunct for analgesia of the abdominal wall, and in recent years their popularity has increased. Transversus abdominis plane block (TAPB)

  9. 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...

  10. [Design and validation of an oral health questionnaire for preoperative anaesthetic evaluation].

    Science.gov (United States)

    Ruíz-López Del Prado, Gema; Blaya-Nováková, Vendula; Saz-Parkinson, Zuleika; Álvarez-Montero, Óscar Luis; Ayala, Alba; Muñoz-Moreno, Maria Fe; Forjaz, Maria João

    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. 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. 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. The questionnaire showed sufficient psychometric properties to be considered a reliable tool, valid for measuring the state of oral health in preoperative anaesthetic evaluations. Copyright © 2016 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  11. 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.

  12. 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.

  13. Anaesthetic management of a paediatric patient with congenital fibre type disproportion myopathy.

    Science.gov (United States)

    Buisán, F; de la Varga, O; Flores, M; Sánchez-Ruano, J

    2018-04-23

    Congenital fibre type disproportion (CFTD) is a rare type of myopathy that is characterised by muscle weakness and hypotonia during childhood. Clinical features include motor delay, feeding difficulties, limb weakness, joint contractures, and scoliosis. A report is presented of the anaesthetic management of a 3-year-old girl with CFTD myopathy associated with a mutation of the TPM3 gene, scheduled for adenotonsillectomy because of obstructive sleep apnoea hypopnoea syndrome (OSAHS). The main concerns were the possible susceptibility to malignant hyperthermia, the risk of anaesthesia-induced rhabdomyolysis, a greater sensitivity to non-depolarising muscle relaxants, and the presence of OSAHS. Total intravenous anaesthesia with propofol and the use of rocuronium/sugammadex appear to be safe options. Given the high risk of respiratory compromise and other complications, patients should be closely monitored in the post-operative period. Copyright © 2018 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  14. Direct and indirect cardiovascular actions of cathinone and MDMA in the anaesthetized rat.

    Science.gov (United States)

    Alsufyani, Hadeel A; Docherty, James R

    2015-07-05

    The stimulants cathinone (from Khat leaves) and methylenedioxymeth-amphetamine (MDMA) produce adrenoceptor mediated tachycardia and vasopressor actions that may be the result of direct receptor stimulation, actions on the noradrenaline transporter, and/or displacement of noradrenaline from nerve terminals. Effects of cathinone or MDMA were compared with those of the indirect sympathomimetic tyramine. Male Wistar rats were anaesthetized with pentobarbitone for blood pressure and heart rate recording. Some rats were sympathectomised by treatment with 6-hydroxydopamine. In the anaesthetised rat, cathinone, MDMA and tyramine (all 0.001-1 mg/kg) produced marked tachycardia, tyramine produced marked pressor responses and MDMA produced small pressor responses. The tachycardia to cathinone and MDMA was almost abolished by propranolol (1mg/kg). Pretreatment with cocaine (1mg/kg) did not significantly affect the tachycardia to cathinone or MDMA, but reduced the response to tyramine. However, in sympathectomised rats, the tachycardia to cathinone or MDMA was markedly attenuated, but the tachycardia to tyramine was only partially reduced. Blood pressure effects of tyramine and MDMA were also markedly attenuated by sympathectomy. The results demonstrate firstly that cocaine may not be the most suitable agent for assessing direct versus indirect agonism in cardiovascular studies. Secondly, the use of chemical sympathectomy achieved the desired goal of demonstrating that cardiac β-adrenoceptor mediated actions of cathinone and MDMA are probably largely indirect. Copyright © 2015 Elsevier B.V. All rights reserved.

  15. 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.

  16. Improving needle tip identification during ultrasound-guided procedures in anaesthetic practice.

    Science.gov (United States)

    Scholten, H J; Pourtaherian, A; Mihajlovic, N; Korsten, H H M; A Bouwman, R

    2017-07-01

    Ultrasound guidance is becoming standard practice for needle-based interventions in anaesthetic practice, such as vascular access and peripheral nerve blocks. However, difficulties in aligning the needle and the transducer can lead to incorrect identification of the needle tip, possibly damaging structures not visible on the ultrasound screen. Additional techniques specifically developed to aid alignment of needle and probe or identification of the needle tip are now available. In this scoping review, advantages and limitations of the following categories of those solutions are presented: needle guides; alterations to needle or needle tip; three- and four-dimensional ultrasound; magnetism, electromagnetic or GPS systems; optical tracking; augmented (virtual) reality; robotic assistance; and automated (computerised) needle detection. Most evidence originates from phantom studies, case reports and series, with few randomised clinical trials. Improved first-pass success and reduced performance time are the most frequently cited benefits, whereas the need for additional and often expensive hardware is the greatest limitation to widespread adoption. Novice ultrasound users seem to benefit most and great potential lies in education. Future research should focus on reporting relevant clinical parameters to learn which technique will benefit patients most in terms of success and safety. © 2017 The Association of Anaesthetists of Great Britain and Ireland.

  17. Central respiratory and circulatory effects of Gymnodinium breve toxin in anaesthetized cats

    Science.gov (United States)

    Borison, Herbert L.; Ellis, Sydney; McCarthy, Lawrence E.

    1980-01-01

    1 In cats anaesthetized with pentobarbitone, observations were made on respiration, spontaneous and evoked diaphragmatic electromyograms, blood pressure, heart rate, indirectly-induced contractions of the anterior tibialis muscle and nictitating membrane, and electrical excitability of the inspiratory centre in the medulla oblongata. 2 Gymnodinium breve toxin (GBTX) was administered intravenously, intra-arterially to the brain, and intracerebroventricularly. Physiological effects were recorded while alveolar PCO2 was controlled at a constant level except when changes in gas tension were made in order to measure CO2-ventilatory responsiveness. 3 Adequate doses of GBTX given intravenously by bolus injection elicited a non-tachyphylactic reflex response triad of apnoea, hypotension and bradycardia mediated by the vagus nerves independently of arterial baroreceptor and chemoreceptor innervation. 4 After vagotomy, additional amounts of GBTX (i.v.) resulted in apneustic breathing, hypertension and tachycardia. The cardiovascular effects were abolished by ganglionic blockade with hexamethonium. 5 Smaller doses of GBTX were required intra-arterially and intracerebroventricularly than by the intravenous route of injection to produce respiratory irregularity and cardiovascular hyperactivity. 6 Evoked motor responses, electrical excitability of the medulla oblongata and CO2-ventilatory responsiveness were largely spared even though GBTX caused marked disturbances in respiratory rhythmicity and cardiovascular functions. 7 It is concluded that GBTX acts reflexly on vagally innervated receptors to evoke a Bezold-Jarisch effect but that the toxin further acts centrally to cause irregular breathholding and hypertension with tachycardia, leading ultimately to respiratory and circulatory failure. PMID:7191740

  18. An analysis of the delivery of anaesthetic training sessions in the United Kingdom.

    Science.gov (United States)

    Green, A; Tatham, K C; Yentis, S M; Wilson, J; Cox, M

    2017-11-01

    We analysed data from the electronic rota system CLWRota, covering 2,689,962 anaesthetic sessions between 01/01/2014 and 31/12/2015, in 91 UK Trusts, in order to investigate trainees' supervision. There were 8209 trainee attachments analysed, during which 618,695 sessions were undertaken by trainees. The number of supervised sessions per week that trainees worked varied considerably (median (IQR [range]) 2.6 (1.6-3.6 [0-10]) for all grades combined), with senior trainees more likely than junior trainees to be supervised for fewer than the three sessions per week mandated by the Royal College of Anaesthetists. The number of supervised sessions was unrelated to Trusts' size, suggesting that trainees in smaller hospitals receive the same level of supervision as in larger teaching hospitals. Analysis of a dataset of this size should be a good reflection of the delivery of anaesthesia training in the UK. © 2017 The Association of Anaesthetists of Great Britain and Ireland.

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

    Science.gov (United States)

    Ruíz-López Del Prado, Gema; Blaya-Nováková, Vendula; Saz-Parkinson, Zuleika; Álvarez-Montero, Óscar Luis; Ayala, Alba; Muñoz-Moreno, Maria Fe; Forjaz, Maria João

    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. 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. 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. The questionnaire showed sufficient psychometric properties to be considered a reliable tool, valid for measuring the state of oral health in preoperative anaesthetic evaluations. Copyright © 2016 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  20. Effect of clonidine and magnesium sulphate on anaesthetic consumption, haemodynamics and postoperative recovery: A comparative study

    Directory of Open Access Journals (Sweden)

    Manjushree Ray

    2010-01-01

    Full Text Available This randomised, placebo-controlled, double-blind study was designed to assess the effect of intravenous clonidine and magnesium sulphate on intraoperative haemodynamics, anaesthetic consumption and postoperative recovery. Seventy five patients undergoing elective upper limb orthopaedic surgery were randomised into three groups. Group C received clonidine 3 μg/kg as a bolus before induction and 1μg/kg/hour by infusion intraopertively. Group M received magnesium sulphate 30 mg/kg as a bolus before induction and 10 mg/kg/hour by infusion. Group P received same volume of isotonic saline. Anaesthesia was induced and maintained with fentanyl citrate and propofol. Muscular relaxation was achieved by vecuronium bromide. Induction time, recovery time and consumption of propofol as well as fentanyl citrate were recorded. Induction of anaesthesia was rapid with both clonidine and magnesium sulphate. Time of bispectral index (BIS to reach 60 was significantly lower in Group C and Group M (P < 0.0001. Requirements of propofol and fentanyl were significantly less in Group C and Group M (P < 0.001. Postoperative recovery was slower in Group M compared with other two groups (P < 0.001. Perioperative use of both clonidine and magnesium sulphate significantly reduced the consumption of propofol and fentanyl citrate. Magnesium sulphate caused a delayed recovery.

  1. Evaluation of Masimo signal extraction technology pulse oximetry in anaesthetized pregnant sheep.

    Science.gov (United States)

    Quinn, Christopher T; Raisis, Anthea L; Musk, Gabrielle C

    2013-03-01

    Evaluation of the accuracy of Masimo signal extraction technology (SET) pulse oximetry in anaesthetized late gestational pregnant sheep. Prospective experimental study. Seventeen pregnant Merino ewes. Animals included in study were late gestation ewes undergoing general anaesthesia for Caesarean delivery or foetal surgery in a medical research laboratory. Masimo Radical-7 pulse oximetry (SpO(2) ) measurements were compared to co-oximetry (SaO(2) ) measurements from arterial blood gas analyses. The failure rate of the pulse oximeter was calculated. Accuracy was assessed by Bland & Altman's (2007) limits of agreement method. The effect of mean arterial blood pressure (MAP), perfusion index (PI) and haemoglobin (Hb) concentration on accuracy were assessed by regression analysis. Forty arterial blood samples paired with SpO(2) and blood pressure measurements were obtained. SpO(2) ranged from 42 to 99% and SaO(2) from 43.7 to 99.9%. MAP ranged from 24 to 82 mmHg, PI from 0.1 to 1.56 and Hb concentration from 71 to 114 g L(-1) . Masimo pulse oximetry measurements tended to underestimate oxyhaemoglobin saturation compared to co-oximetry with a bias (mean difference) of -2% and precision (standard deviation of the differences) of 6%. Accuracy appeared to decrease when SpO(2) was oximeter function during extreme hypotension and hypoxaemia. © 2012 The Authors. Veterinary Anaesthesia and Analgesia. © 2012 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesiologists.

  2. Comparison of alfaxalone, ketamine and thiopental for anaesthetic induction and recovery in Thoroughbred horses premedicated with medetomidine and midazolam.

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    Wakuno, A; Aoki, M; Kushiro, A; Mae, N; Kodaira, K; Maeda, T; Yamazaki, Y; Ohta, M

    2017-01-01

    There is limited information on clinical use of the new injectable anaesthetic agent alfaxalone in Thoroughbred horses. To compare anaesthetic induction and recovery characteristics and cardiopulmonary responses between alfaxalone, ketamine and thiopental in Thoroughbred horses premedicated with medetomidine and midazolam. Randomised blinded experimental cross-over study. Six Thoroughbred horses were anaesthetised 3 times with alfaxalone 1 mg/kg bwt, ketamine 2.5 mg/kg bwt or thiopental 4 mg/kg bwt after premedication with medetomidine 6 μg/kg bwt and midazolam 20 μg/kg bwt. Qualities of anaesthetic induction and recovery were scored on a scale of 1 (poor) to 5 (excellent). Induction time and recovery time were recorded. Cardiopulmonary values (heart rate, respiratory rate, arterial blood pressures, and arterial blood gases) were recorded throughout anaesthesia. Data were analysed with nonparametric methods. The anaesthetic induction (P = 0.2) and recovery (P = 0.1) quality scores (median, range) were not different amongst protocols and were 4.0, 3-5; 5.0, 4-5; 4.5, 3-5; and 4.5, 3-5; 3.5, 2-5; 4.0, 2-5 for alfaxalone, ketamine and thiopental, respectively. Induction time for ketamine (67, 53-89 s) was significantly longer than that for alfaxalone (49, 40-51 s, P = 0.01) and thiopental (48, 43-50 s, P = 0.01). Time to standing for alfaxalone (44, 40-63 min, P = 0.01) and thiopental (39, 30-58 min, P = 0.01) was significantly longer than that for ketamine (25, 18-26 min). Cardiovascular values were maintained within the clinically acceptable level throughout anaesthesia. Respiratory rate significantly decreased during anaesthesia for all 3 drugs; however, spontaneous breathing did not disappear, and PaCO 2 values were maintained at approximately 50 mmHg. All 3 drugs showed similar effects in relation to anaesthetic induction and recovery qualities and cardiopulmonary responses. However, alfaxalone and thiopental prolonged recovery time

  3. Ventricular distension and diastolic coronary blood flow in the anaesthetized dog.

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    Gattullo, D; Linden, R J; Losano, G; Pagliaro, P; Westerhof, N

    1993-01-01

    There appears to be no agreement as to whether or not an increase in diastolic left ventricular pressure and/or volume can cause a decrease in diastolic coronary blood flow. We investigated the problem in the anaesthetized dog using a flaccid freely distensible latex balloon inserted into the left ventricle with the animal on extracorporeal circulation and the coronary perfusion pressure constant at about 45 mm Hg. Maximal vasodilatation and suppression of autoregulation in coronary vasculature was obtained by the intracoronary infusion of dipyridamole (10-40 mg/h). Ventricular volume was changed in steps of 10 ml from 10 to 70 ml and back to 10 ml, whilst recording coronary blood flow and left ventricular pressure in the left circumflex coronary artery. Over a range of ventricular volumes from 20 to 50 ml and a concomitant rise in diastolic ventricular pressure to about 20 mm Hg there was no change in the diastolic coronary flow. Only when the ventricular volume was more than two times the control value (i.e. exceeded 50 ml) and left ventricular pressure was more than 20 mm Hg, was there a decrease in coronary flow. During the return of the volume to the control level there was a fall in diastolic flow and ventricular contractility with respect to the values obtained when the volume was increased; these two effects were transient lasting less than 10 min. It was not considered that any of the three models of the coronary circulation, waterfall, intramyocardial pump or varying elastance model could explain our results.(ABSTRACT TRUNCATED AT 250 WORDS)

  4. Acid-base status and cardiovascular function in mink (Mustela vison) anaesthetized with ketamine/midazolam.

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    Wamberg, S; Svendsen, P; Johansen, B

    1996-01-01

    Heart rate, arterial blood pressure and blood acid-base status were determined in 18 adult female mink (mean (+/- SEM) body weight 1052 +/- 34 g) during long-term anaesthesia with either controlled ventilation (n=12) or spontaneous respiration (n=6). Surgical anaesthesia was induced by intramuscular injection of ketamine hydrochloride (Ketaminol Vet, 40.0 +/- 1.7 mg/kg) and midazolam hydrochloride (Dormicum 2.8 +/- 0.1 mg/kg) and maintained for at least 5 h by continuous intravenous infusion of this drug combination in 0.9% saline. For all animals, the mean rates of infusion of ketamine and midazolam were 48.4 +/- 1.6 and 1.61 +/- 0.12 mg/h, respectively. Following continuous infusion of the anaesthetics in isotonic saline, at a rate of 20 ml/h, a moderate 'dilution acidosis' developed, which could be corrected by replacement of part of the saline with sodium bicarbonate to a final concentration of approximately 25 mmol NaHCO3 per litre. However, when the animals were allowed to breathe spontaneously, an increase in heart rate and a combined respiratory and metabolic acidosis occurred, due to severe respiratory depression. Apart from these effects and a few cases of increased salivation, no adverse effects over time were observed on the arterial blood acid-base status and cardiovascular function of the animals during ketamine/midazolam anaesthesia. It is concluded that the procedure described for long-term anaesthesia in mink is convenient and safe for acute physiological experiments in this species, provided normal body temperature and pulmonary gas exchange is sufficiently maintained. Thus, the need for an adequately controlled artificial ventilation is strongly emphasized. Finally, a proposal for the composition of an intravenous solution, containing ketamine and midazolam hydrochloride, and sodium bicarbonate in saline, suitable for long-term anaesthesia in adult mink is presented.

  5. Manipulation under anaesthetic for frozen shoulder using Codman's paradox: a safe and early return of function.

    Science.gov (United States)

    Tsvieli, Oren; Atoun, Ehud; Consigliere, Paolo; Polyzois, Ioannis; Walecka, Joanna; Pradhan, Rajib; Ippolito, Giorgio; Rath, Ehud; Levy, Ofer

    2018-02-01

    Although previously frozen shoulder was thought to resolve by two to three years, recent studies demonstrated the symptoms can remain for much longer. Manipulation under anaesthetic (MUA) has been shown to be successful in relieving pain and restoring function. Yet, concerns have been raised regarding its safety and the risks of complications. We utilise Codman's paradox to manipulate the shoulder, avoiding rotational torque on the humerus. The aim of our study was to asses shoulder function in the early post MUA period. Two hundred twelve consecutive patients (224 shoulders) (mean age 52.4 years) underwent MUA using Codman's paradox for frozen shoulder as sole procedure between 2005 and 2013. All were evaluated clinically, preoperatively and postoperatively, at three weeks and three months, for Constant score (CS), pain, range of motion (ROM), patient satisfaction and subjective shoulder value (SSV). At three weeks and three months, a significant improvement was found in CS from 30.7 to 66 and 70 respectively. Forward elevation improved from 91° to 154° and 160 °, abduction from 69° to 150° and 156 °, internal rotation from 12° to 62° and 66 °, and external rotation from 10° to 46° and 50 °. Pain score improved from 4.4/15 to 9.6/15 and 10.4/15, SSV improved from 1.5/10 to 6.5/10 and 6.7/10. (pparadox provides a safe and efficient way to perform MUA for frozen shoulder. It results in dramatic early improvement in ROM, functional outcomes and high satisfaction, as early as three weeks post-operatively.

  6. Arterial supply, venous drainage and collateral circulation in the nose of the anaesthetized dog.

    Science.gov (United States)

    Lung, M A; Wang, J C

    1987-01-01

    1. In pentobarbitone-anaesthetized dogs, nasal blood flows were measured with electromagnetic flow sensors. 2. The terminal internal maxillary artery was found to supply 22 +/- 2.2 ml min-1 (one side) to the nasal mucosa via the sphenopalatine and major palatine branches; the artery was found to receive multiple supply routes from common carotid, vertebral and subclavian arteries. 3. Nasal mucosa was found to receive collateral flow from contralateral terminal internal maxillary artery (about 5 to 10% of normal flow) and branches of subclavian arteries (about 36% of normal flow). 4. Nasal mucosa was found to have two venous systems: the low-flow (12 +/- 1.0 ml min-1; both sides) and low-pressure (7 +/- 0.6 mmHg) sphenopalatine veins draining the posterior nasal cavity and the high-flow (30 +/- 1.4 ml min-1; both sides) and high-pressure (17 +/- 1.0 mmHg) dorsal nasal veins draining the anterior nasal cavity. 5. PO2 of nasal venous blood was found to range from 62 +/- 2.9 mmHg to 65 +/- 3.4 mmHg. During nitrogen challenge to the nose, the sphenopalatine venous PO2 dropped to 35 +/- 3.0 mmHg while the dorsal nasal venous PO2 remained unchanged, suggesting that the sphenopalatine veins were responsible for draining capillary flow and dorsal nasal veins arteriovenous anastomotic flow as well. 6. Microscopic examination of the vascular casts confirmed that arteriovenous anastomoses were located only in the anterior nasal cavity. Images Fig. 5 Plate 1 Plate 2 PMID:3443958

  7. 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.

  8. 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

  9. Anaesthetic and ICU management of aneurysmal subarachnoid haemorrhage: a survey of European practice.

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    Velly, Lionel J; Bilotta, Federico; Fàbregas, Neus; Soehle, Martin; Bruder, Nicolas J; Nathanson, Michael H

    2015-03-01

    Many aspects of the perioperative management of aneurysmal subarachnoid haemorrhage (SAH) remain controversial. It would be useful to assess differences in the treatment of SAH in Europe to identify areas for improvement. To determine the clinical practice of physicians treating SAH and to evaluate any discrepancy between practice and published evidence. An electronic survey. Physicians identified through each national society of neuroanaesthesiology and neurocritical care. A 31-item online questionnaire was distributed by the ENIG group. Questions were designed to investigate anaesthetic management of SAH and diagnostic and treatment approaches to cerebral vasospasm. The survey was available from early October to the end of November 2012. Completed surveys were received from 268 respondents, of whom 81% replied that aneurysm treatment was conducted early (within 24 h). Sixty-five percent of centres treated more than 60% of SAH by coiling, 19% had high-volume clipping (>60% of aneurysms clipped) and 16% used both methods equally. No clear threshold for arterial blood pressure target was identified during coiling, temporary clipping or in patients without vasospasm after the aneurysm had been secured. Almost all respondents used nimodipine (97%); 21% also used statins and 20% used magnesium for prevention of vasospasm. A quarter of respondents used intra-arterial vasodilators alone, 5% used cerebral angioplasty alone and 48% used both endovascular methods to treat symptomatic vasospasm. In high-volume clipping treatment centres, 58% of respondents used endovascular methods to manage vasospasm compared with 86% at high-volume coiling treatment centres (P practice patterns of European physicians involved in early treatment of SAH. Significant differences were noted among countries and between high and low-volume coiling centres.

  10. The use of anaesthetic agents to provide anxiolysis and sedation in dentistry and oral surgery.

    Science.gov (United States)

    O'Halloran, Michael

    2013-12-31

    Throughout the world there is considerable variation in the techniques used to manage anxious dental patients requiring treatment. Traditionally anxious or phobic dental patients may have been sent for general anaesthesia to allow dental treatment be undertaken. While this is still the case for the more invasive oral surgical procedures, such as wisdom teeth extraction, sedation in general dentistry is becoming more popular. Various sedation techniques using many different anaesthetic agents have gained considerable popularity over the past 30 years. While the practice of sedating patients for dental procedures is invaluable in the management of suitably assessed patients, patient safety must always be the primary concern. Medical, dental and psychosocial considerations must be taken into account when evaluating the patient need and the patient suitability for sedation or general anaesthesia. The regulations that govern the practice of dental sedation vary throughout the world, in particular regarding the techniques used and the training necessary for dental practitioners to sedate patients. It is necessary for medical and dental practitioners to be up to date on current practice to ensure standards of practice, competence and safety throughout our profession. This article, the first in a two-part series, will provide information to practitioners on the practice of sedation in dentistry, the circumstances where it may be appropriate instead of general anaesthesia and the risks involved with sedation. It will also discuss the specific training and qualifications required for dental practitioners to provide sedation. The second article in this series will outline the different techniques used to administer inhalation, oral and intravenous sedation in dentistry and will focus on specific methods that are practiced.

  11. Basil, tea tree and clove essential oils as analgesics and anaesthetics in Amphiprion clarkii (Bennett, 1830

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    A. M. Correia

    2017-11-01

    Full Text Available Abstract In this study were evaluated the anaesthesia and analgesic effects of clove Eugenia caryophyllata, tea tree Melaleuca alternifolia and basil Ocimum basilicum essential oils (EO during handling of yellowtail clownfish Amphiprion clarkii. Juveniles (3.70 ± 0.75 cm and 1.03 ± 0.50 g; mean ± standard deviation were submitted to concentrations of 40, 50, 60, 70 and 80 µl L-1 of clove, 150, 200, 250, 300 and 350 µl L-1 of basil and 200, 300, 400, 500 and 600 µl L-1 of tea tree oils (n=10/concentration, previously defined in pilot tests. Individually and only once, fish from each treatment were placed in a glass recipient containing 1 L of seawater at a temperature of 25 °C, salinity of 35 g L-1 and the specific concentration of diluted EO (stock solution. Control (only seawater and blank (seawater and ethanol at the highest concentration used to dilute the oils treatments were also conducted. After reaching the stage of surgical anaesthesia, fish were submitted to biometry and a sensibility test. After that, they were transferred to clean seawater for anaesthesia recovery. The times of induction needed to reach each anaesthesia stage and anaesthesia recovery were recorded. Animals were observed for 72 hours after the procedures. All the EO provoked anaesthesia and analgesic effects in A. clarkii, but basil oil is not recommended because it caused involuntary muscle contractions and mortality in 100% and 12% of fish, respectively. The lower concentrations that promote suitable induction and recovery times are 50 µl L-1 of clove oil and 500 µl L-1 of tea tree oil. However, due to its complementary high analgesic efficiency, clove oil is recommended as the ideal anaesthetic for A. clarkii.

  12. Anaesthetic induction with alfaxalone in the ball python (Python regius): dose response and effect of injection site.

    Science.gov (United States)

    James, Lauren E; Williams, Catherine Ja; Bertelsen, Mads F; Wang, Tobias

    2018-05-01

    To characterise the minimum dose of intramuscular alfaxalone required to facilitate intubation for mechanical ventilation, and to investigate the impact of cranial versus caudal injection on anaesthetic depth. Randomised crossover study. Six healthy juvenile ball pythons (Python regius). Three dosages (10, 20 and 30 mg kg -1 ) of alfaxalone were administered to each python in a caudal location with a minimum 2 weeks washout. Induction and recovery were monitored by assessing muscle tone, righting reflex, response to a noxious stimulus and the ability to intubate. A subsequent experiment assessed the influence of injection site by comparing administration of 20 mg kg -1 alfaxalone in a cranial location (1 cm cranial to the heart) with the caudal site. Respiration rate was monitored throughout, and when intubation was possible, snakes were mechanically ventilated. Regardless of dose and injection site, maximum effect was reached within 10.0 ± 2.7 minutes. When administered at the caudal injection site, intubation was only successful after a dosage of 30 mg kg- 1 , which is higher than in previous reports for other reptiles. However, intubation was possible in all cases after 7.2 ± 1.6 minutes upon cranial administration of 20 mg kg -1 , and anaesthetic duration was significantly lengthened (p pythons, and may serve as a useful induction agent prior to provision of volatile anaesthetics. The same dosage injected in the cranial site led to deeper anaesthesia than when injected caudally, suggesting that shunting to the liver and first-pass metabolism of alfaxalone occur when injected caudally, via the renal portal system. Copyright © 2018 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.

  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. Development of an anaesthetized-rat model of exercise hyperpnoea: an integrative model of respiratory control using an equilibrium diagram.

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    Miyamoto, Tadayoshi; Manabe, Kou; Ueda, Shinya; Nakahara, Hidehiro

    2018-05-01

    What is the central question of this study? The lack of useful small-animal models for studying exercise hyperpnoea makes it difficult to investigate the underlying mechanisms of exercise-induced ventilatory abnormalities in various disease states. What is the main finding and its importance? We developed an anaesthetized-rat model for studying exercise hyperpnoea, using a respiratory equilibrium diagram for quantitative characterization of the respiratory chemoreflex feedback system. This experimental model will provide an opportunity to clarify the major determinant mechanisms of exercise hyperpnoea, and will be useful for understanding the mechanisms responsible for abnormal ventilatory responses to exercise in disease models. Exercise-induced ventilatory abnormalities in various disease states seem to arise from pathological changes of respiratory regulation. Although experimental studies in small animals are essential to investigate the pathophysiological basis of various disease models, the lack of an integrated framework for quantitatively characterizing respiratory regulation during exercise prevents us from resolving these problems. The purpose of this study was to develop an anaesthetized-rat model for studying exercise hyperpnoea for quantitative characterization of the respiratory chemoreflex feedback system. In 24 anaesthetized rats, we induced muscle contraction by stimulating bilateral distal sciatic nerves at low and high voltage to mimic exercise. We recorded breath-by-breath respiratory gas analysis data and cardiorespiratory responses while running two protocols to characterize the controller and plant of the respiratory chemoreflex. The controller was characterized by determining the linear relationship between end-tidal CO 2 pressure (P ETC O2) and minute ventilation (V̇E), and the plant by the hyperbolic relationship between V̇E and P ETC O2. During exercise, the controller curve shifted upward without change in controller gain, accompanying

  15. Perioperative Anaesthetic Management of a Patient of Gilbert’s Syndrome with Adult Congenital Heart Disease - A Rare Presentation

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    Sambhunath Das

    2014-11-01

    Full Text Available Gilbert's syndrome is a hereditary condition with the genetic mutation of the enzyme uridine diphosphate glucuronosyltransferase, characterized by intermittent jaundice in the absence of hemolysis or underlying liver disease. These patients develop jaundice when subjected to fasting, stress and exercise. Majority of anaesthetics are metabolized by liver. Anaesthesia, surgery and cardiopulmonary bypass (CPB can act as triggers to hepatic injury. The successful perioperative management of an adult congenital heart disease patient for atrial septal defect closure under cardiopulmonary bypass was discussed in this report.

  16. Intermittent hypercapnia-induced phrenic long-term depression is revealed after serotonin receptor blockade with methysergide in anaesthetized rats.

    Science.gov (United States)

    Valic, Maja; Pecotic, Renata; Pavlinac Dodig, Ivana; Valic, Zoran; Stipica, Ivona; Dogas, Zoran

    2016-02-01

    What is the central question of this study? Intermittent hypercapnia is a concomitant feature of breathing disorders. Hypercapnic stimuli evoke a form of respiratory plasticity known as phrenic long-term depression in experimental animals. This study was performed to investigate the putative role of serotonin receptors in the initiation of phrenic long-term depression in anaesthetized rats. What is the main finding and its importance? Phrenic nerve long-term depression was revealed in animals pretreated with the serotonin broad-spectrum antagonist, methysergide. This study highlights that serotonin receptors modulate respiratory plasticity evoked by acute intermittent hypercapnia in anaesthetized rats. This study was performed to test the hypothesis that intermittent hypercapnia can evoke a form of respiratory plasticity known as long-term depression of the phrenic nerve (pLTD) and that 5-HT receptors play a role in the initiation of pLTD. Adult male urethane-anaesthetized, vagotomized, paralysed, mechanically ventilated Sprague-Dawley rats were exposed to an acute intermittent hypercapnia protocol. One group received i.v. injection of the non-selective 5-HT receptor antagonist methysergide and another group received i.v. injection of the selective 5-HT1A receptor antagonist WAY-100635 20 min before exposure to intermittent hypercapnia. A control group received i.v. injection of saline. Peak phrenic nerve activity and respiratory rhythm parameters were analysed at baseline (T0), during each of five hypercapnic episodes, and 15, 30 and 60 min (T60) after the last hypercapnia. Intravenous injection of methysergide before exposure to acute intermittent hypercapnia induced development of amplitude pLTD at T60 (decreased by 46.1 ± 6.9%, P = 0.003). Conversely, in control and WAY-100635-pretreated animals, exposure to acute intermittent hypercapnia did not evoke amplitude pLTD. However, a long-term decrease in phrenic nerve frequency was evoked both in control (42 ± 4

  17. Myasthenia gravis and pregnancy: anaesthetic management--a series of cases.

    Science.gov (United States)

    Almeida, Carlos; Coutinho, Ester; Moreira, Daniela; Santos, Ernestina; Aguiar, José

    2010-11-01

    Myasthenia gravis is an autoimmune neuromuscular disease, usually affecting women in the second and third decades. The course is unpredictable during pregnancy and puerperium. Myasthenia gravis can cause major interference in labour and partum and exacerbations of the disease frequently occur. The aim of this series of cases is to analyse retrospectively the anaesthetic management of myasthenia gravis patients and complications during the peripartum period. Retrospective, single centre study from clinical files of female myasthenia gravis patients who delivered between 1985 and 2007 at Hospital de Santo António, Porto, Portugal. Seventeen myasthenia gravis patients delivered between 1985 and 2007 in Hospital Santo António. Two women were not included in the study as they had a spontaneous abortion in the first trimester. Four patients presented exacerbations of the disease during pregnancy, no exacerbation occurred in eight patients and three patients presented their first symptoms of myasthenia gravis during pregnancy (without diagnosis at time of delivery). Concerning the eight patients without exacerbations of the disease during pregnancy, pregnancy was brought to term in 87.5% of the cases; five women were submitted to nonurgent caesarean section (62.5%); and epidural block was performed in six patients (75%). No complications related to anaesthesia occurred in the peripartum period. Concerning the four patients with exacerbations of the disease, pregnancy was brought to term in three cases (75%); three women were submitted to nonurgent caesarean section (75%); and epidural block was performed in three patients (75%). One patient underwent an uncomplicated thymectomy under general anaesthesia during pregnancy and, in the postpartum period, there was a myasthenic crisis in another patient. Concerning the three patients without a myasthenia gravis diagnosis at partum, one woman already being followed for presenting muscular weakness had a vaginal delivery under

  18. Convergent and reciprocal modulation of a leak K+ current and Ih by an inhalational anaesthetic and neurotransmitters in rat brainstem motoneurones

    Science.gov (United States)

    Sirois, Jay E; Lynch, Carl; Bayliss, Douglas A

    2002-01-01

    Neurotransmitters and volatile anaesthetics have opposing effects on motoneuronal excitability which appear to reflect contrasting modulation of two types of subthreshold currents. Neurotransmitters increase motoneuronal excitability by inhibiting TWIK-related acid-sensitive K+ channels (TASK) and shifting activation of a hyperpolarization-activated cationic current (Ih) to more depolarized potentials; on the other hand, anaesthetics decrease excitability by activating a TASK-like current and inducing a hyperpolarizing shift in Ih activation. Here, we used whole-cell recording from motoneurones in brainstem slices to test if neurotransmitters (serotonin (5-HT) and noradrenaline (NA)) and an anaesthetic (halothane) indeed compete for modulation of the same ion channels - and we determined which prevails. When applied together under current clamp conditions, 5-HT reversed anaesthetic-induced membrane hyperpolarization and increased motoneuronal excitability. Under voltage clamp conditions, 5-HT and NA overcame most, but not all, of the halothane-induced current. When Ih was blocked with ZD 7288, the neurotransmitters completely inhibited the K+ current activated by halothane; the halothane-sensitive neurotransmitter current reversed at the equilibrium potential for potassium (EK) and displayed properties expected of acid-sensitive, open-rectifier TASK channels. To characterize modulation of Ih in relative isolation, effects of 5-HT and halothane were examined in acidified bath solutions that blocked TASK channels. Under these conditions, 5-HT and halothane each caused their characteristic shift in voltage-dependent gating of Ih. When tested concurrently, however, halothane decreased the neurotransmitter-induced depolarizing shift in Ih activation. Thus, halothane and neurotransmitters converge on TASK and Ih channels with opposite effects; transmitter action prevailed over anaesthetic effects on TASK channels, but not over effects on Ih. These data suggest that

  19. The effect of body position on the 'hanging drop' method for identifying the extradural space in anaesthetized dogs.

    Science.gov (United States)

    Naganobu, Kiyokazu; Hagio, Mitsuyoshi

    2007-01-01

    To assess the accuracy of the 'hanging drop method' for identifying the extradural space in anaesthetized dogs positioned in sternal or lateral recumbency. Prospective randomized-experimental study. Seventeen clinically healthy adult dogs, 10 females and seven males weighing 8.4-26.2 kg. Dogs were positioned in either sternal (n = 8) or lateral (n = 9) recumbency under general anaesthesia. A 20 SWG spinal needle pre-filled with 0.9% saline was advanced through the skin into the lumbosacral extradural space and the response of the saline drop recorded, i.e. whether it: 1) was aspirated from the hub into the needle; 2) remained within the hub, or 3) moved synchronously with i) spontaneous respiration, ii) heart beat or iii) manual lung inflation. The position of the needle tip was ultimately determined by positive contrast radiography. One dog positioned in lateral recumbency was excluded from the study because bleeding occurred from the needle hub. Saline was aspirated into the needle in seven of eight dogs held in sternal recumbency but in none of the dogs positioned in lateral recumbency. Accurate needle tip placement in the extradural space was confirmed by positive contrast radiography in all dogs. The 'hanging drop' method, when performed with a spinal needle, appears to be a useful technique for identifying the location of the extradural space in anaesthetized medium-sized dogs positioned in sternal, but not in lateral recumbency. The technique may yield 'false negative' results when performed in dogs positioned in sternal recumbency.

  20. 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 (Pcastration 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.

  1. Decreased spinal synaptic inputs to phrenic motor neurons elicit localized inactivity-induced phrenic motor facilitation

    Science.gov (United States)

    Streeter, K.A.; Baker-Herman, T.L.

    2014-01-01

    Phrenic motor neurons receive rhythmic synaptic inputs throughout life. Since even brief disruption in phrenic neural activity is detrimental to life, on-going neural activity may play a key role in shaping phrenic motor output. To test the hypothesis that spinal mechanisms sense and respond to reduced phrenic activity, anesthetized, ventilated rats received micro-injections of procaine in the C2 ventrolateral funiculus (VLF) to transiently (~30 min) block axon conduction in bulbospinal axons from medullary respiratory neurons that innervate one phrenic motor pool; during procaine injections, contralateral phrenic neural activity was maintained. Once axon conduction resumed, a prolonged increase in phrenic burst amplitude was observed in the ipsilateral phrenic nerve, demonstrating inactivity-induced phrenic motor facilitation (iPMF). Inhibition of tumor necrosis factor alpha (TNFα) and atypical PKC (aPKC) activity in spinal segments containing the phrenic motor nucleus impaired ipsilateral iPMF, suggesting a key role for spinal TNFα and aPKC in iPMF following unilateral axon conduction block. A small phrenic burst amplitude facilitation was also observed contralateral to axon conduction block, indicating crossed spinal phrenic motor facilitation (csPMF). csPMF was independent of spinal TNFα and aPKC. Ipsilateral iPMF and csPMF following unilateral withdrawal of phrenic synaptic inputs were associated with proportional increases in phrenic responses to chemoreceptor stimulation (hypercapnia), suggesting iPMF and csPMF increase phrenic dynamic range. These data suggest that local, spinal mechanisms sense and respond to reduced synaptic inputs to phrenic motor neurons. We hypothesize that iPMF and csPMF may represent compensatory mechanisms that assure adequate motor output is maintained in a physiological system in which prolonged inactivity ends life. PMID:24681155

  2. Decreased spinal synaptic inputs to phrenic motor neurons elicit localized inactivity-induced phrenic motor facilitation.

    Science.gov (United States)

    Streeter, K A; Baker-Herman, T L

    2014-06-01

    Phrenic motor neurons receive rhythmic synaptic inputs throughout life. Since even brief disruption in phrenic neural activity is detrimental to life, on-going neural activity may play a key role in shaping phrenic motor output. To test the hypothesis that spinal mechanisms sense and respond to reduced phrenic activity, anesthetized, ventilated rats received micro-injections of procaine in the C2 ventrolateral funiculus (VLF) to transiently (~30min) block axon conduction in bulbospinal axons from medullary respiratory neurons that innervate one phrenic motor pool; during procaine injections, contralateral phrenic neural activity was maintained. Once axon conduction resumed, a prolonged increase in phrenic burst amplitude was observed in the ipsilateral phrenic nerve, demonstrating inactivity-induced phrenic motor facilitation (iPMF). Inhibition of tumor necrosis factor alpha (TNFα) and atypical PKC (aPKC) activity in spinal segments containing the phrenic motor nucleus impaired ipsilateral iPMF, suggesting a key role for spinal TNFα and aPKC in iPMF following unilateral axon conduction block. A small phrenic burst amplitude facilitation was also observed contralateral to axon conduction block, indicating crossed spinal phrenic motor facilitation (csPMF). csPMF was independent of spinal TNFα and aPKC. Ipsilateral iPMF and csPMF following unilateral withdrawal of phrenic synaptic inputs were associated with proportional increases in phrenic responses to chemoreceptor stimulation (hypercapnia), suggesting iPMF and csPMF increase phrenic dynamic range. These data suggest that local, spinal mechanisms sense and respond to reduced synaptic inputs to phrenic motor neurons. We hypothesize that iPMF and csPMF may represent compensatory mechanisms that assure adequate motor output is maintained in a physiological system in which prolonged inactivity ends life. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Mesotherapy for local fat reduction.

    Science.gov (United States)

    Jayasinghe, S; Guillot, T; Bissoon, L; Greenway, F

    2013-10-01

    Mesotherapy, which is the injection of substances locally into mesodermally derived subcutaneous tissue, developed from empirical observations of a French physician in the 1950s. Although popular in Europe for many medical purposes, it is used for local cosmetic fat reduction in the United States. This paper reviews manuscripts indexed in PubMed/MEDLINE under 'mesotherapy', which pertains to local fat reduction. The history of lipolytic mesotherapy, the physiology of body fat distribution, the mechanism of action of different lipolytic stimulators and their increased efficacy in combination are reviewed. Mesotherapy falls into two categories. Lipolytic mesotherapy using lipolytic stimulators requires more frequent treatments as the fat cells are not destroyed and can refill over time. Ablative mesotherapy destroys fat cells with a detergent, causes inflammation and scarring from the fat necrosis, but requires fewer treatments. The historic and empiric mixing of sodium channel blocking local anaesthetics in mesotherapy solutions inhibits the intended lipolysis. Major mesotherapy safety concerns include injection site infections from poor sterile technique. Cosmetic mesotherapy directs the area from which fat is lost to improve self-image. Studies were of relatively small number, many with limited sample sizes. Future research should be directed towards achieving a Food and Drug Administration indication rather than continuing expansion of off-label use. © 2013 The Authors. obesity reviews © 2013 International Association for the Study of Obesity.

  4. The effect of pre-operative topical anaesthetic cream on the ablative width and coagulative depth of ablative fractional resurfacing laser.

    Science.gov (United States)

    Punyaratabandhu, Preawphan; Wanitphakdeedecha, Rungsima; Pattanaprichakul, Penvadee; Sitthinamsuwan, Panitta; Phothong, Weeranut; Eimpunth, Sasima; Lohsiriwat, Visnu; Manuskiatti, Woraphong

    2017-02-01

    Topical anaesthetic cream (TAC) is commonly used as a pre-treatment of ablative fractional resurfacing (AFR) laser. Most of anaesthetic cream contains distilled water as major component. Therefore, pre-operative TAC may interfere the photothermal reaction in the skin treated with fractional carbon-dioxide (FCO 2 ) laser and fractional erbium-doped yttrium aluminium garnet (FEr:YAG) laser. The objective of the study was to compare the ablative width (AW) and coagulative depth (CD) of AFR laser with and without pre-treatment with TAC. Four Thai females who underwent abdominoplasty were included in the study. The excised skin of each subject was divided into four areas. TAC (eutectic mixture of local anaesthesia; EMLA) with 1-h occlusion was applied only on the first and second areas. The first and third areas were treated with FCO 2 at 15 mj and 5% density. The second and fourth areas were treated with FEr:YAG at 28 J/cm 2 and 5% density. Six biopsied specimens were obtained from each area. A total of 96 specimens (24 specimens from each area) were collected from four patients and examined randomly by two dermatopathologists. The ablative width and coagulative depth from each specimen were determined. In FCO 2 -treated specimens, the mean AW of the specimens that were pre-treated with TAC and control was 174.86 ± 24.57 and 188.52 ± 41.32 μm. The mean CD of the specimens that were pre-treated with TAC and control was 594.96 ± 111.72 and 520.03 ± 147.40 μm. There were no significant differences in AW and CD between both groups (p = 0.53 and p = 0.15). In FEr:YAG-treated specimens, the mean AW of the specimens that were pre-treated with TAC and control was 381.11 ± 48.02 and 423.65 ± 60.16 μm. The mean CD of the specimens that were pre-treated with TAC and control was 86.03 ± 29.44 and 71.59 ± 18.99 μm. There were no significant differences in AW and CD between both groups (p = 0.16 and p = 0.24). The pre

  5. 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 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...

  6. DNA and chromosomal damage in medical workers exposed to anaesthetic gases assessed by the lymphocyte cytokinesis-block micronucleus (CBMN) assay. A critical review

    Czech Academy of Sciences Publication Activity Database

    Vodička, Pavel; Mušák, L.; Fiorito, G.; Vymetálková, Veronika; Vodičková, Ludmila; Naccarati, Alessio

    2016-01-01

    Roč. 770, SI (2016), s. 26-34 ISSN 1383-5742 R&D Projects: GA MŠk(CZ) LD14050; GA ČR(CZ) GA15-14789S Institutional support: RVO:68378041 Keywords : micronuclei * anaesthetics gas exposure * operating room personnel Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 5.500, year: 2016

  7. Effects of AL 107, a novel semisynthetic cardiac glycoside, on the cardiovascular system in anaesthetized beagle dogs with pentobarbital-induced cardiac insufficiency

    NARCIS (Netherlands)

    Kogel, B; Schneider, J; Gleitz, J; Wilffert, B; Peters, Thies

    The inotropic efficacy, arrhythmogenicity and cardiohaemodynamic properties of AL 107 (3-alpha-methyl-digitoxigenin glucoside. CAS 62190-59-4), a novel cardiac glycoside, were studied in anaesthetized dogs with pentobarbital-induced acute cardiac insufficiency. Three groups of dogs received AL 107,

  8. Anaesthetic efficacy of 4% articaine mandibular buccal infiltration compared to 2% lignocaine inferior alveolar nerve block in children with irreversible pulpitis.

    Science.gov (United States)

    Arali, Veena; P, Mytri

    2015-04-01

    Lidocaine is the gold standard anaesthetic solution that has been used since its inception into dentistry till date. Around 80% of failures have been reported when lignocaine has been used for inferior alveolar nerve block in children and adults with irreversible pulpitis. There is a need to use newer drugs which are available which have been reported to be effective like lignocaine, such as articaine. Although articaine has been used in adults, literature supporting its use in children is sparse. The purpose of this study is to compare the anaesthetic efficacy of 4% articaine buccal infiltration and 2% lignocaine inferior alveolar nerve block in children with irreversible pulpitis. It also aims to assess the need for supplemental intrapulpal injections. This study was designed as a randomized double-blind cross over trial comparing the anaesthetic effectiveness of 4% articaine with 1:100,000 epinephrine in buccal infiltration and 2% lignocaine IAN block anaesthesia. The study subject and the pediatric dentist performing the pulpectomy procedures were blinded to the study. A sample size of 40 subjects in the age group of 5-8 y was included in the study. The onset of anaesthesia with 4% articaine was faster as compared to 2% lignocaine. The duration of anaesthesia with articaine infiltration was shorter. The need for supplemental injection in the articaine group was less. Four percent articaine infiltration can be used in children with irreversible pulpitis. It can be used to replace the IAN block in children thereby reducing the post anaesthetic complications like lip biting.

  9. 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; Bodogan, T.; Kaila, Kai K.; Fiumelli, Hubert; Vutskits, Lá szló

    2013-01-01

    . 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

  10. Retrospective Review of the Anaesthetic Management of Maxillectomies and Mandibulectomies for Benign Tumours in Sub-Saharan Africa.

    Directory of Open Access Journals (Sweden)

    Michelle C White

    Full Text Available Safe anaesthesia is a crucial component of safe surgical care, yet anaesthetic complications are common in resource-limited settings. We describe differences in anaesthetic needs for Mandibulectomy vs. Maxillectomy in three sub-Saharan African countries.Retrospective review of patients undergoing minor Mandibulectomy, major Mandibulectomy, or Maxillectomy in Togo, Guinea and Republic of the Congo. Surgeries were performed on the Africa Mercy, an international non-governmental hospital ship. Primary outcomes were need for advanced airway management and intra-operative blood loss. Secondary outcomes were time under general anaesthesia and hospital length of stay. Multivariate regression determined the association between operation type and each outcome measure.105 patients were included (25 minor Mandibulectomy, 58 major Mandibulectomy, 22 Maxillectomy procedures. In-hospital mortality was 0%. 44/105 (41.9% required an advanced airway management technique to achieve intubation, although in all cases this was anticipated prior to the procedure; no differences were noted between surgical procedure (p = 0.72. Operative procedure was a significant risk factor for intra-operative blood loss. Patients undergoing Maxillectomy lost on average 851.5 (413.3, 1289.8, p = 0.0003 mL more blood than patients undergoing minor Mandibulectomy, and 507.3 (150.3, 864.3, p = 0.007 mL more blood than patients undergoing major Mandibulectomy. Patients undergoing Maxillectomy had a significantly higher time under general anaesthesia than those undergoing minor Mandibulectomy. There was no significant difference in hospital length of stay between operation type.Anaesthetic considerations for minor Mandibulectomy, major Mandibulectomy, and Maxillectomy differ with respect to intra-operative blood loss and time under general anaesthesia, but not need for advanced airway management or length of stay. Although advanced airway management was required in 41.9% of patients

  11. Anaesthetic Management of a 1-Month-Old Puppy Undergoing Lateral Thoracotomy for Vascular Ring Anomaly Correction

    Directory of Open Access Journals (Sweden)

    Olga Martin Jurado

    2011-01-01

    Full Text Available A 1-month-old male flat-coated retriever was anaesthetized for correction of oesophageal constriction caused by a vascular ring anomaly. Anaesthesia was uneventfully induced with intravenous fentanyl, diazepam, and propofol and maintained with isoflurane in oxygen and air. An intercostal block with bupivacaine and lidocaine was performed, and additional analgesia with an infusion of fentanyl was provided. Fluid therapy consisted in 5% glucose in lactated Ringer’s solution and hetastarch 6%, which proved adequate to maintain normoglycemia and normovolemia. A lateral thoracotomy was performed, and the ligamentum arteriosum was ligated. Intraoperatively, heart rate (HR varied between 120 and 180 beats min−1 without accompanying changes in blood pressure. No arrhythmias were observed or bleeding occurred. The dog recovered uneventfully. Postoperative analgesia consisted in fentanyl infusion adjusted to the patient's requirement and metamizol. This paper describes for the first time the use of balanced anaesthesia and multimodal analgesia in a paediatric dog undergoing thoracotomy.

  12. [Anaesthetic management of patients in the third trimester of pregnancy undergoing urgent laparoscopic surgery. Experience in a general hospital].

    Science.gov (United States)

    López-Collada Estrada, María; Olvera Martínez, Rosalba

    2016-01-01

    Laparoscopic surgery is well accepted as a safe technique when performed on a third trimester pregnant woman. The aim is to describe the anaesthetic management of a group of patients undergoing this type of surgery. An analysis was made of records of 6 patients in their third trimester of pregnancy and who underwent urgent laparoscopic surgery from 2011 to 2013. The study included 6 patients, with a diagnosis of acute cholecystitis in 4 of them. The other 2 patients had acute appendicitis, both of who presented threatened preterm labour. The most frequent indications for laparoscopic surgery during the last trimester of birth were found to be acute cholecystitis and acute appendicitis. Acute appendicitis is related to an elevated risk of presenting threatened preterm labour. Copyright © 2015 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  13. Comparative clinical evaluation of two different techniques of local anaesthesia in the posterior mandible using 4% articaine with 1:100,000 adrenaline

    Directory of Open Access Journals (Sweden)

    Marjanović Uroš

    2017-01-01

    Full Text Available Background/Aim. Local infiltration anaesthesia (LIA is significantly simpler compared to the inferior alveolar nerve block (IAB and less unpleasant for patients. However, it is not efficient if used in posterior region of the mandible, at least with traditional local anaesthetics. The aim of this study was to compare anaesthetic efficacy of two techniques the LIA in the posterior segment of the mandible, and the IAB, using 4% articaine with 1 : 100,000 adrenaline and to note possible changes in haemodynamic parameters caused by these two techniques. Methods. Sixty pre-informed patients were divided into two study groups. Both groups received 1.8 mL of the same anaesthetic solution, 4% articaine with adrenaline 1 : 100,000, with two different techniques of local anaesthesia. The first group received the LIA in projection of root apex of the first lower molar; the second group received the IAB. The examined parameters were: changes in tooth sensitivity after 5 and 30 minutes in relation to the value recorded before administering the anaes-thetics, onset of anaesthesia, width of anaesthetic field, and duration of anaesthesia. Also, the impact of the applied techniques on cardiovascular parameters was noticed. Results. The LIA group had a statistically significant decrease in sensitivity 5 minutes after application of the local anaesthetic. The decreasing trend continued between 5 and 30 minutes, although without statistical significance. There was no statistically significant difference in sensitivity changes between two groups for the first molar and the first and second premolars. However, there was a statistically significant difference in duration of local anaesthesia in favour of the IAB, while the width of anaesthetic fields was significantly higher after the LIA. Significant changes in hemodynamic parameters were not recorded within the two groups. Conclusion. The effect of the LIA on tooth sensitivity of premolars and first molar is quite

  14. Thermodynamic studies of drug–α-cyclodextrin interactions in water at 298.15 K: Procaine hydrochloride/lidocaine hydrochloride/tetracaine hydrochloride/ranitidine hydrochloride + α-cyclodextrin + H2O systems

    International Nuclear Information System (INIS)

    Shaikh, Vasim R.; Terdale, Santosh S.; Hundiwale, Dilip G.; Patil, Kesharsingh J.

    2014-01-01

    Graphical abstract: The encapsulation of guest tetracaine hydrochloride TC·HCl (C 15 H 24 N 2 O 2 ·HCl), in α-cyclodextrin cavities in aqueous solutions at 298.15 K. -- Highlights: • The osmotic coefficient measurements are reported for PC·HCl/LC·HCl/TC·HCl/RT·HCl + 0.1 m α-CD + water at 298.15 K. • The concentration variation of mean activity coefficients of drug molecules in water–α-CD solutions has been studied. • The transfer Gibbs free energies have been calculated using the activity data. • Pair and triplet interaction parameters and equilibrium constant (log K) values are also estimated. • The results are discussed with emphasis on host–guest interaction concepts. -- Abstract: The osmotic coefficient measurements have been carried out for ternary aqueous solutions containing a fixed concentration of α-cyclodextrin (α-CD) of ∼0.1 mol · kg −1 and varying the concentrations (∼0.012 to ∼0.21 mol · kg −1 ) of drugs Procaine hydrochloride (PC·HCl), Lidocaine hydrochloride (LC·HCl), Tetracaine hydrochloride (TC·HCl) and Ranitidine hydrochloride (RT·HCl) at 298.15 K using vapour pressure osmometry. The water activities for each ternary system were measured and used to obtain the activity coefficients of α-cyclodextrin (α-CD) and drugs following the methodology developed by Robinson and Stokes for isopiestic measurements. The transfer Gibbs free energies of electrolyte (or drug) from water to an aqueous nonelectrolyte (α-CD) solutions (ΔG tr E ) and that of nonelectrolyte (α-CD) from water to an aqueous electrolyte (or drug) solutions (ΔG tr N ) have been calculated using the activity data. These were further used for the estimation of pair and triplet interaction parameters. By applying the method based on the application of the McMillan–Mayer theory of virial coefficients to transfer free energy data, the salting constant (k s ) values have been estimated at 298.15 K. The equilibrium constant (log K) values for the

  15. 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.

  16. 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.

  17. Treatment of lateral epicondilitis using three different local injection modalities: a randomized prospective clinical trial.

    Science.gov (United States)

    Dogramaci, Yunus; Kalaci, Aydiner; Savaş, Nazan; Duman, I Gokhan; Yanat, A Nedim

    2009-10-01

    To determine the effectiveness of three different local injection modalities in the treatment of lateral epicondilitis. In a prospective randomized study on lateral epicondilitis, 75 patients were divided into three equal groups A, B and C (n = 25) and were treated using three different method of local injection. The patients in group A were treated with local injection of a steroid (1 mL triamcinolone) combined with local anaesthetic (1 mL lidocaine), those in group B were treated with injection of local anaesthetic (1 mL lidocaine) combined with peppering technique and those in group C with local injection of a steroid (1 mL triamcinolone) combined with local anaesthetic (1 mL lidocaine) and peppering technique. The outcome was defined by measuring the elbow pain during the activity using a 10-cm visual analogue scale (VAS) and satisfaction with the treatment using a scoring system based on the criteria of the Verhaar et al. at 3 weeks and 6 months after the injection and compared with the pre-treatment condition. There were significant (P = 0.006) differences in the successful outcomes between the three groups at 6 months. In group C in which local steroid + peppering injection technique were used; excellent results were obtained in 84% of patients comparing to 36% and 48% for patients in groups A and B, respectively. The successful outcomes were statistically higher in group C comparing to group A (P = 0.002) and group B (P = 0.011). In all groups, there was a significantly lower pain (VAS) at the 3-week and 6-month follow-ups comparing to the pre-treatment condition. VAS measured at 6-month follow-up were significantly lower in group C comparing to other groups (P = 0.002). In the treatment of lateral epicondilitis, combination of corticosteroid injections with peppering is more effective than corticosteroid injections or peppering injections alone and produces better clinical results.

  18. 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, Jeffery R.; Porcher, Scott T.; Smerud, Justin R.

    2014-01-01

    Studies were conducted to determine the anaesthetic/sedative concentrations and durations that would maximize 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 −1.

  19. 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).

  20. Successful anaesthetic management of a case of hypertrophic obstructive cardiomyopathy posted for elective caesarean section using epidural anaesthesia with 0.75% Ropivacaine

    Directory of Open Access Journals (Sweden)

    Anjali R Bhure

    2011-01-01

    Full Text Available Hypertrophic obstructive cardiomyopathy (HOCM is a complex cardiovascular disorder with autosomal dominant inheritance and an incidence of 0.1-0.5% in pregnant females. Anaesthetic management of a pregnant female with HOCM posted for elective caesarean section is a challenge, as even minor hemodynamic insults may lead to life-threatening complications. We report successful management of one such patient using epidural anaesthesia with 0.75% Ropivacaine.

  1. An embedded checklist in the Anesthesia Information Management System improves pre-anaesthetic induction setup: a randomised controlled trial in a simulation setting.

    Science.gov (United States)

    Wetmore, Douglas; Goldberg, Andrew; Gandhi, Nishant; Spivack, John; McCormick, Patrick; DeMaria, Samuel

    2016-10-01

    Anaesthesiologists work in a high stress, high consequence environment in which missed steps in preparation may lead to medical errors and potential patient harm. The pre-anaesthetic induction period has been identified as a time in which medical errors can occur. The Anesthesia Patient Safety Foundation has developed a Pre-Anesthetic Induction Patient Safety (PIPS) checklist. We conducted this study to test the effectiveness of this checklist, when embedded in our institutional Anesthesia Information Management System (AIMS), on resident performance in a simulated environment. Using a randomised, controlled, observer-blinded design, we compared performance of anaesthesiology residents in a simulated operating room under production pressure using a checklist in completing a thorough pre-anaesthetic induction evaluation and setup with that of residents with no checklist. The checklist was embedded in the simulated operating room's electronic medical record. Data for 38 anaesthesiology residents shows a statistically significant difference in performance in pre-anaesthetic setup and evaluation as scored by blinded raters (maximum score 22 points), with the checklist group performing better by 7.8 points (p<0.01). The effects of gender and year of residency on total score were not significant. Simulation duration (time to anaesthetic agent administration) was increased significantly by the use of the checklist. Required use of a pre-induction checklist improves anaesthesiology resident performance in a simulated environment. The PIPS checklist as an integrated part of a departmental AIMS warrant further investigation as a quality measure. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  2. Different pressor and bronchoconstrictor properties of human big-endothelin-1, 2 (1-38) and 3 in ketamine/xylazine-anaesthetized guinea-pigs.

    OpenAIRE

    Gratton, J P; Rae, G A; Claing, A; Télémaque, S; D'Orléans-Juste, P

    1995-01-01

    1. In the present study, the precursors of endothelin-1, endothelin-2 and endothelin-3 were tested for their pressor and bronchoconstrictor properties in the anaesthetized guinea-pig. In addition, the effects of big-endothelin-1 and endothelin-1 were assessed under urethane or ketamine/xylazine anaesthesia. 2. When compared to ketamine/xylazine, urethane markedly depressed the pressor and bronchoconstrictor properties of endothelin-1 and big-endothelin-1. 3. Under ketamine/xylazine anaesthesi...

  3. A time course study of glucose levels and innate immune response in gilthead seabream (Sparus aurata L.) after exposure to clove oil-eugenol derived anaesthetic.

    Science.gov (United States)

    Bahi, A; Guardiola, F A; Esteban, M A

    2018-06-01

    Clove oil is used as an anaesthetic for many species of fish worldwide; however, relatively few studies have assessed its effects on the innate immune response on these species. The present work aimed to investigate the effects of clove oil-eugenol derived anaesthetic on some humoral and cellular immune response in gilthead seabream (Sparus aurata L.). To compare with an unexposed control group, fish were exposed to 55 ppm clove oil for 5 min, before being sampled at 1, 24 and 48 h post-exposure. Serum glucose level was also measured to obtain information on the fish physiological response after clove oil anaesthesia. One hour after exposure the haemolytic complement activity of fish was lower than in the unexposed group. By contrast, the leucocyte peroxidase activity in head-kidney was significantly stimulated 24 h after exposure to clove oil-eugenol. The rest of innate immune parameters evaluated and the glucose levels not were affected by clove oil exposure at any sampling point. Overall, the use of clove oil at 55 ppm as anaesthetic did not seem to alter the innate immune response and neither did it trigger a stress response. The use of clove oil-eugenol derived had become common practice in aquaculture, and its use with gilthead seabream can be considered safe as it does not cause immunodepression in anesthetized fish. Copyright © 2018 Elsevier Ltd. All rights reserved.

  4. The non-technical skills used by anaesthetic technicians in critical incidents reported to the Australian Incident Monitoring System between 2002 and 2008.

    Science.gov (United States)

    Rutherford, J S; Flin, R; Irwin, A

    2015-07-01

    The outcome of critical incidents in the operating theatre has been shown to be influenced by the behaviour of anaesthetic technicians (ATs) assisting anaesthetists, but the specific non-technical skills involved have not been described. We performed a review of critical incidents (n=1433) reported to the Australian Incident Monitoring System between 2002 and 2008 to identify which non-technical skills were used by ATs. The reports were assessed if they mentioned anaesthetic assistance or had the boxes ticked to identify "inadequate assistance" or "absent supervision or assistance". A total of 90 critical incidents involving ATs were retrieved, 69 of which described their use of non-technical skills. In 20 reports, the ATs ameliorated the critical incident, whilst in 46 they exacerbated the critical incident, and three cases had both positive and negative non-technical skills described. Situation awareness was identified in 39 reports, task management in 23, teamwork in 21 and decision-making in two, but there were no descriptions of issues related to leadership, stress or fatigue management. Situation awareness, task management and teamwork appear to be important non-technical skills for ATs in the development or management of critical incidents in the operating theatre. This analysis has been used to support the development of a non-technical skills taxonomy for anaesthetic assistants.

  5. 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

    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...... 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...

  6. General or Spinal Anaesthetic for Vaginal Surgery in Pelvic Floor Disorders (GOSSIP): a feasibility randomised controlled trial.

    Science.gov (United States)

    Purwar, B; Ismail, K M; Turner, N; Farrell, A; Verzune, M; Annappa, M; Smith, I; El-Gizawy, Zeiad; Cooper, J C

    2015-08-01

    Spinal anaesthesia (SA) and general anaesthesia (GA) are widely used techniques for vaginal surgery for pelvic floor disorders with inconclusive evidence of the superiority of either. We conducted a randomised controlled trial (RCT) to assess the feasibility of a full scale RCT aiming to examine the effect of anaesthetic mode for vaginal surgery on operative, patient reported and length of hospital stay (LOHS) outcomes. Patients undergoing vaginal surgery, recruited through a urogynaecology service in a University teaching hospital, were randomised to receive either GA or SA. Patients were followed up for 12 weeks postoperatively. Pain was measured on a visual analogue scale; nausea was assessed with a four-point verbal rating scale. Patient's subjective perception of treatment outcome, quality of life (QoL) and functional outcomes were assessed using the International Consultation on Incontinence Modular Questionnaire (ICIQ) on vaginal symptoms and the SF-36 questionnaire. Sixty women were randomised, 29 to GA and 31 to SA. The groups were similar in terms of age and type of vaginal surgery performed. No statistically significant differences were noted between the groups with regard to pain, nausea, quality of life (QoL), functional outcomes as well as length of stay in the postoperative recovery room, use of analgesia postoperatively and LOHS. This study has demonstrated that a full RCT is feasible and should focus on the length of hospital stay in a subgroup of patients undergoing vaginal surgery where SA may help to facilitate enhanced recovery or day surgery.

  7. Anaesthetic management of a child with "cor-triatriatum" and multiple ventricular septal defects - A rare congenital anomaly

    Directory of Open Access Journals (Sweden)

    Sriram Sabade

    2010-01-01

    Full Text Available Cor-triatriatum is a rare congenital cardiac anomaly. It accounts for 0.1% of congenital heart diseases. Its association with multiple ventricular septal defects (VSD is even rarer. A five-month-old baby was admitted with respiratory distress and failure to thrive. Clinical examination revealed diastolic murmur over mitral area. Chest X-ray showed cardiomegaly. Haematological and biochemical investigations were within normal limits. Electrocardiogram showed left atrial enlargement. 2D echo showed double-chambered left atrium (cor-triatriatum, atrial septal defect (ASD and muscular VSD with moderate pulmonary arterial hypertension. The child was treated with 100% oxygen, diuretics and digoxin and was stabilized medically. We used balanced anaesthetic technique using oxygen, air, isoflurane, fentanyl, midazolam and vecuronium. Patient was operated under cardiopulmonary bypass (CPB with moderate hypothermia. Through right atriotomy abnormal membrane in the left atrium was excised to make one chamber. VSD were closed with Dacron patches and ASD was closed with autologous pericardial patch. Patient tolerated the whole procedure well and was ventilated electively for 12h in the intensive care unit. He was discharged on the 10 th postoperative day.

  8. Anaesthetic efficacy of intraligamentary injection techniques on mandibular molars diagnosed with asymptomatic irreversible pulpitis: A retrospective study.

    Science.gov (United States)

    Lin, Shaul; Wigler, Ronald; Huber, Ronen; Kaufman, Arieh Y

    2017-04-01

    The objective of this study was to evaluate the success rate of intraligamentary injections (ILI) using a two- or four-site injection technique. One hundred and fifty-one mandibular molars diagnosed with asymptomatic irreversible pulpitis received ILI at the mesiobuccal and distobuccal aspects of the roots. Patients who experienced pain when the access cavity was performed received additional supplemental ILI in the mesiolingual and distolingual aspects. Pulpal anaesthesia was considered successful when complete analgesia was achieved. The data were analysed by means of the Fisher's exact and Pearson's chi-square tests. IL anaesthesia was successful for 92.1% of the teeth. Forty-eight teeth (31.8%) were sufficiently anaesthetised using the two-site ILI and 91 teeth (60.3%) following supplemental IL anaesthesia in two more sites. The results of this study indicate that the use of four-site IL injections as a primary anaesthetic technique may be considered a favourable alternative to the common IANB. © 2016 Australian Society of Endodontology Inc.

  9. 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.

  10. A randomized non-crossover study comparing the ProSeal and Classic laryngeal mask airway in anaesthetized children.

    Science.gov (United States)

    Lopez-Gil, M; Brimacombe, J; Garcia, G

    2005-12-01

    We tested the hypothesis that ease of insertion, oropharyngeal leak pressure, fibreoptic position, gastric insufflation, and the frequency of mucosal trauma differ between the ProSeal laryngeal mask airway (PLMA) and the classic laryngeal mask airway (cLMA) in anaesthetized children. For the PLMA, we also assessed the ease of gastric tube placement via the PLMA drain tube and measure residual gastric volume. 240 consecutive ASA I-III children aged 1-16 yr were randomized for airway management with the ProSeal or cLMA. The time taken to provide an effective airway, the number of insertion attempts, fibreoptic position of the airway tube and frequency of mucosal trauma were similar, but oropharyngeal leak pressure was higher (33 vs 26 cm H(2)O, Ptube insertion was successful at the first attempt in 106 of 120, and at the second attempt in 14 of 120. The mean (sd; range) value for residual gastric volume was 2.2 (5.9; 0-30) ml. There were no differences in performance among sizes for the PLMA and the cLMA. We conclude that ease of insertion, fibreoptic position, and frequency of mucosal trauma are similar for the PLMA and cLMA in children, but oropharyngeal leak pressure is higher and gastric insufflation less common for the PLMA. Gastric tube insertion has a high success rate, provided the PLMA is correctly positioned.

  11. Stimulatory effect of harmane and other beta-carbolines on locus coeruleus neurons in anaesthetized rats.

    Science.gov (United States)

    Ruiz-Durántez, E; Ruiz-Ortega JA; Pineda, J; Ugedo, L

    2001-08-10

    Harmane, harmaline and norharmane are beta-carboline related compounds which have been proposed to be endogenous ligands for imidazoline receptors. The effect of these compounds on the activity of locus coeruleus (LC) neurons was studied by extracellular recordings techniques. Intracerebroventricular administration of harmane and harmaline increased the firing rate of LC neurons. Systemic administration of efaroxan, a mixed alpha(2)-adrenoceptor/I(1)-imidazoline antagonist or vagotomy failed to modify the harmane effect. Furthermore, local applications of harmane and harmaline increased the firing rate of LC neurons in a dose-related manner. Finally, intravenous administration of norharmane also increased the activity of LC neurons. Our results demonstrate that beta-carbolines stimulate LC neuron activity and indicate that this stimulation occurs directly in the LC by a mechanism independent of I(1)- and I(2)-imidazoline receptors.

  12. Health worker exposure risk during inhalation sedation with sevoflurane using the (AnaConDa®) anaesthetic conserving device.

    Science.gov (United States)

    González-Rodríguez, R; Muñoz Martínez, A; Galan Serrano, J; Moral García, M V

    2014-03-01

    Occupational exposure to sevoflurane should not exceed 2 ppm. During inhalation sedation with sevoflurane using the anaesthetic conserving device (AnaConDa(®)) in the post-anaesthesia care unit, waste gases can be reduced by gas extraction systems or scavenging devices such as CONTRAfluran™. However, the efficacy of these methods has not been clearly established. To determine the safest scenario for healthcare workers during inhalation sedation with sevoflurane in the post-surgical intensive care unit. An experimental study on occupational exposure was conducted in a post-cardiothoracic care unit during March-August 2009. The measurements were performed in four post-cardiac surgery sedated adults in post-surgical intensive care unit and four nurses at the bedside, and at four points: scenario A, inhalation sedation without gas extraction system or contrafluran as a reference scenario; scenario B, applying a gas extraction system to the ventilator; scenario C, using contrafluran; and scenario 0, performing intravenous isolation sedation. Sevoflurane concentrations were measured in the nurses' breathing area during patient care, and at 1.5 and 8 m from the ventilator using diffusive passive monitor badges. All badges corresponding to the nurses' breathing area were below 2 ppm. Levels of sevoflurane detected using prevention systems were lower than that in the control situation. Only one determination over 2 ppm was found, corresponding to the monitor placed nearest the gas outlet of the ventilator in scenario A. Trace concentrations of sevoflurane were found in scenario 0 during intravenous sedation. Administration of sevoflurane through the AnaConDa(®) system during inhalation sedation in post-surgical intensive care units is safe for healthcare workers, but gas extraction systems or scavenging systems, such as CONTRAfluran™ should be used to reduce occupational exposure as much as possible. Copyright © 2013 Sociedad Española de Anestesiología, Reanimaci

  13. The effect of pre-anaesthetic fasting time and type of food on gastric content volume and acidity in dogs.

    Science.gov (United States)

    Savvas, Ioannis; Rallis, Timoleon; Raptopoulos, Dimitris

    2009-11-01

    To investigate the effect of pre-anaesthetic fasting time and variety of food on gastric content (GC) volume and pH in dogs. Randomized, cross-over, prospective experimental study. Fifteen mongrel dogs (nine females and six males 1-4 years old, weighing 10-24.5 kg). Each dog received the same seven treatments in random order: dry food 3 hours before anaesthesia (BA) (treatment 3D), canned food (half daily rate) 3 hours BA (treatment 3C), 0% fat cow milk 3 hours BA (treatment 3M), dry food 10 hours BA (treatment 10D), canned food 10 hours BA (treatment 10C), low fat canned food 10 hours BA (treatment 10F) and low protein canned food 10 hours BA (treatment 10P). All animals were pre-medicated with propionyl promazine and anaesthesia was induced with thiopental sodium and maintained with halothane. GC was aspirated using an orogastric catheter and its volume and pH were measured. Treatment 10F had significantly lower GC pH than all the 3-hour treatments. Treatments 10D and 10P had significantly lower pH than treatments 3D and 3C. Treatment 3M had significantly lower pH than the other 3-hour treatments. Treatment 3D had significantly greater gastric volume than treatments 3M, 10C, 10F and 10P. Canned food at half the daily rate administered 3 hours before anaesthesia did not increase significantly the GC volume compared to the other types of food used. The GC pH was also high. This type of food fed 3 hours before induction of anaesthesia may be of benefit in reduction of the incidence of gastro-oesophageal reflux during anaesthesia in dogs.

  14. Comparison of an infrared anaesthetic agent analyser (Datex-Ohmeda) with refractometry for measurement of isoflurane, sevoflurane and desflurane concentrations.

    Science.gov (United States)

    Rudolff, Andrea S; Moens, Yves P S; Driessen, Bernd; Ambrisko, Tamas D

    2014-07-01

    To assess agreement between infrared (IR) analysers and a refractometer for measurements of isoflurane, sevoflurane and desflurane concentrations and to demonstrate the effect of customized calibration of IR analysers. In vitro experiment. Six IR anaesthetic monitors (Datex-Ohmeda) and a single portable refractometer (Riken). Both devices were calibrated following the manufacturer's recommendations. Gas samples were collected at common gas outlets of anaesthesia machines. A range of agent concentrations was produced by stepwise changes in dial settings: isoflurane (0-5% in 0.5% increments), sevoflurane (0-8% in 1% increments), or desflurane (0-18% in 2% increments). Oxygen flow was 2 L minute(-1) . The orders of testing IR analysers, agents and dial settings were randomized. Duplicate measurements were performed at each setting. The entire procedure was repeated 24 hours later. Bland-Altman analysis was performed. Measurements on day-1 were used to yield calibration equations (IR measurements as dependent and refractometry measurements as independent variables), which were used to modify the IR measurements on day-2. Bias ± limits of agreement for isoflurane, sevoflurane and desflurane were 0.2 ± 0.3, 0.1 ± 0.4 and 0.7 ± 0.9 volume%, respectively. There were significant linear relationships between differences and means for all agents. The IR analysers became less accurate at higher gas concentrations. After customized calibration, the bias became almost zero and the limits of agreement became narrower. If similar IR analysers are used in research studies, they need to be calibrated against a reference method using the agent in question at multiple calibration points overlapping the range of interest. © 2013 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesia and Analgesia.

  15. The effect of pre-emptive gabapentin on anaesthetic and analgesic requirements in patients undergoing rhinoplasty: A prospective randomised study

    Directory of Open Access Journals (Sweden)

    Eman Ramadan Salama

    2018-01-01

    Full Text Available Background and Aims: Hypotensive anaesthesia is necessary in rhinoplasty for better visualisation of surgical field and reduction of surgery time. Gabapentin is a new generation anticonvulsant with anti-hyperalgesic and anti-nociceptive properties. We aimed to investigate the effect of pre-operative administration of oral gabapentin (1200 mg on anaesthetic requirements and post-operative analgesic consumption and its role in hypotensive anaesthesia for rhinoplasty. Methods: Seventy adult patients undergoing rhinoplasty, were randomly allocated to two groups. Group I (G I (n = 35 received gabapentin 1.2 g and Group II (G II (n = 35 received oral placebo capsules 2 h before surgery. General anaesthesia was maintained with sevoflurane in oxygen-nitrous oxide to maintain bispectral index value between 40 and 60, and remifentanil infusion to keep mean arterial pressure (MAP at 55–60 mmHg. End-tidal sevoflurane concentration, intra-operative remifentanil consumption and time to intended MAP were recorded. Visual analogue scale (VAS scores, post-operative analgesic requirements and side effects for the first 24 h were recorded. Results: G I required significantly lower intra-operative remifentanil (G I = 0.8 ± 0.26 mg and G II = 1.7 ± 0.42 mg; P = 0.001 and end-tidal sevoflurane concentration, with reduced doses of post-operative tramadol and diclofenac sodium. Time to the intended MAP was significantly less in G I than G II (59.1 ± 12.3 vs. 73.6 ± 16.4, respectively, with P = 0.001. Conclusion: Pre-operative oral gabapentin significantly reduced intra-operative remifentanil and sevoflurane requirements during hypotensive anaesthesia along with decreased post-operative analgesic requirement.

  16. An analysis of surgical and anaesthetic factors affecting skin graft viability in patients admitted to a Burns Intensive Care Unit.

    Science.gov (United States)

    Isitt, Catherine E; McCloskey, Kayleigh A; Caballo, Alvaro; Sharma, Pranev; Williams, Andrew; Leon-Villapalos, Jorge; Vizcaychipi, Marcela P

    2016-01-01

    Skin graft failure is a recognised complication in the treatment of major burns. Little research to date has analysed the impact of the complex physiological management of burns patients on the success of skin grafting. We analysed surgical and anaesthetic variables to identify factors contributing to graft failure. Inclusion criteria were admission to our Burns Intensive Care Unit (BICU) between January 2009 and October 2013 with a major burn. After exclusion for death before hospital discharge or prior skin graft at a different hospital, 35 patients remained and were divided into those with successful autografts (n=16) and those with a failed autograft (n=19). For the purposes of this study, we defined poor autograft viability as requiring at least one additional skin graft to the same site. Logistic regression of variables was performed using SPSS (Version 22.0 IBMTM). Age, Sex, %Total Burn Surface Area or Belgian Outcome Burns Injury score did not significantly differ between groups. No differences were found in any surgical factor at logistic regression (graft site, harvest site, infection etc.). When all operations were analysed, the use of colloids was found to be significantly associated with graft failure (p=0.035, CI 95%) and this remained significant when only split thickness skin grafts (STSGs) and debridement operations were included (p=0.034, CI 95%). No differences were found in crystalloid use, intraoperative temperature, pre-operative haemoglobin and blood products or vasopressor use. This analysis highlights an independent association between colloids and graft failure which has not been previously documented.

  17. Inhibition of protein kinase A activity depresses phrenic drive and glycinergic signalling, but not rhythmogenesis in anaesthetized rat.

    Science.gov (United States)

    Burke, P G R; Sousa, L O; Tallapragada, V J; Goodchild, A K

    2013-07-01

    The cAMP-protein kinase A (PKA) pathway plays a critical role in regulating neuronal activity. Yet, how PKA signalling shapes the population activity of neurons that regulate respiratory rhythm and motor patterns in vivo is poorly defined. We determined the respiratory effects of focally inhibiting endogenous PKA activity in defined classes of respiratory neurons in the ventrolateral medulla and spinal cord by microinjection of the membrane-permeable PKA inhibitor Rp-adenosine 3',5'-cyclic monophosphothioate (Rp-cAMPS) in urethane-anaesthetized adult Sprague Dawley rats. Phrenic nerve activity, end-tidal CO2 and arterial pressure were recorded. Rp-cAMPS in the preBötzinger complex (preBötC) caused powerful, dose-dependent depression of phrenic burst amplitude and inspiratory period. Rp-cAMPS powerfully depressed burst amplitude in the phrenic premotor nucleus, but had no effect at the phrenic motor nucleus, suggesting a lack of persistent PKA activity here. Surprisingly, inhibition of PKA activity in the preBötC increased phrenic burst frequency, whereas in the Bötzinger complex phrenic frequency decreased. Pretreating the preBötC with strychnine, but not bicuculline, blocked the Rp-cAMPS-evoked increase in frequency, but not the depression of phrenic burst amplitude. We conclude that endogenous PKA activity in excitatory inspiratory preBötzinger neurons and phrenic premotor neurons, but not motor neurons, regulates network inspiratory drive currents that underpin the intensity of phrenic nerve discharge. We show that inhibition of PKA activity reduces tonic glycinergic transmission that normally restrains the frequency of rhythmic respiratory activity. Finally, we suggest that the maintenance of the respiratory rhythm in vivo is not dependent on endogenous cAMP-PKA signalling. © 2013 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

  18. Análise ultra-estrutural do miocárdio usando solução cardioplégica cristalóide com e sem procaína em pacientes submetidos à troca valvar aórtica Ultrastructural study of the myocardium using cardioplegic crystalloid solution with and without procaine in patients undergoing aortic valve replacement

    Directory of Open Access Journals (Sweden)

    Luiz Henrique Dussin

    2008-09-01

    Full Text Available OBJETIVO: Avaliar as alterações ultra-estruturais de dois tipos de cardioplegia (com e sem procaína em corações de pacientes submetidos a troca valvar aórtica eletiva. MÉTODOS: Foram estudados 18 pacientes submetidos a circulação extracorpórea para troca valvular aórtica eletiva, no Hospital de Clínicas de Porto Alegre num período de 10 meses. Cada paciente foi distribuído aleatoriamente em dois grupos: grupo A - oito pacientes que receberam solução cardioplégica sem procaína; grupo B - Dez pacientes que receberam solução cardioplégica com procaína. Em ambos os grupos, o saco pericárdico foi irrigado com solução salina hipotérmica. As biópsias miocárdicas foram realizadas em três momentos: I - antes da parada isquêmica, II- no final do período isquêmico e III-15 minutos após a reperfusão. RESULTADOS: A avaliação ultra-estrutural comparando os grupos nos três momentos não demonstrou diferenças significativas, sendo a média dos escores no grupo A, nos momentos I, II, e III, de 0,1 ± 0,2; 0,4 ± 0,3 e 0,4 ± 0,4. No grupo B, a médio dos escores foi 0,2 ± 0,2; 0,4 ± 0,3 e 0,7 ± 0,2, respectivamente, nos momentos I, II, e III. A curva de CK-MB foi similar entre os dois grupos. O retorno espontâneo do ritmo cardíaco, pós-despinçamento, ocorreu em 70% dos pacientes no grupo B e, em 12,5% no grupo A (p=0,024. CONCLUSÃO: As duas soluções testadas protegeram o miocárdio de forma eficaz e não foi possível demonstrar, em nível ultra-estrutural, a superioridade da solução contendo procaína. Constatou-se que o retorno ao ritmo espontâneo do coração após o despinçamento aórtico foi significativamente maior no grupo que utilizou procaína adicionada à solução.OBJECTIVE: The aim of this study was to assess whether the presence of procaine in crystalloid cardioplegic solution increases myocardial protection at the ultra structural level. METHODS: Eighteen patients that underwent aortic valve

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  20. Does the volume of supplemental intraligamentary injections affect the anaesthetic success rate after a failed primary inferior alveolar nerve block? A randomized-double blind clinical trial.

    Science.gov (United States)

    Aggarwal, V; Singla, M; Miglani, S; Kohli, S; Sharma, V; Bhasin, S S

    2018-01-01

    To investigate the efficacy of 0.2 mL vs. 0.6 mL of 2% lidocaine when given as a supplementary intraligamentary injection after a failed inferior alveolar nerve block (IANB). Ninety-seven adult patients with symptomatic irreversible pulpits received an IANB and root canal treatment was initiated. Pain during treatment was recorded using a visual analogue scale (Heft-Parker VAS). Patients with unsuccessful anaesthesia (n = 78) randomly received intraligamentary injection of either 0.2 mL or 0.6 mL of 2% lidocaine with 1 : 80 000 epinephrine. Root canal treatment was reinitiated. Success after primary injection or supplementary injection was defined as no or mild pain (HP VAS score ≤54 mm) during access preparation and root canal instrumentation. Heart rate was monitored using a finger pulse oximeter. The anaesthetic success rates were analysed with Pearson chi-square test at 5% significance levels. The heart rate changes were analysed using t-tests. The intraligamentary injections with 0.2 mL solution gave an anaesthetic success rate of 64%, whilst the 0.6 mL was successful in 84% of cases with failed primary IANB. (χ 2  = 4.3, P = 0.03). There was no significant effect of the volume of intraligamentary injection on the change in heart rate. Increasing the volume of intraligamentary injection improved the success rates after a failed primary anaesthetic injection. © 2017 International Endodontic Journal. Published by John Wiley & Sons Ltd.

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

    International Nuclear Information System (INIS)

    Watanabe, Yoshimasa; Itoh, Takeo; Shiraishi, Hiroaki; Maeno, Yoshitaka; Arima, Yosuke; Torikoshi, Aiko; Namera, Akira; Makita, Ryosuke; Yoshizumi, Masao; Nagao, Masataka

    2013-01-01

    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

  2. Size-relative Effectiveness of Clove Oil as an Anaesthetic for Rainbow Trout (Oncorhynchus mykiss Walbaum, 1792 and Goldfish (Carassius auratus Linnaeus, 1758

    Directory of Open Access Journals (Sweden)

    Costas Perdikaris

    2010-01-01

    Full Text Available The purpose of this work was to investigate the size-relative effectiveness of clove oil as an anaesthetic for rainbow trout and goldfish. In total, 128 rainbow trout (Oncorhynchus mykiss (two groups of 20-23 and 30-33 cm mean fork length and 160 goldfish (Carassius auratus (four size groups of 1.5-2.5, 5-7, 11-15 and 20-25 cm were anaesthetized at different clove oil concentrations of 50, 100, 150 mg·l-1 for trouts and 75, 100, 150 mg·l-1 for goldfish. Rainbow trout exhibited total loss of balance and no response to external stimuli with shorter induction time as dosage increased (120.5 s, 64.4 s and 44.3 s, respectively. Goldfish exhibited total loss of balance and no response to external stimuli after induction time that varied with dosage used and body size of fish. The small fish (1.5-7 cm exhibited shorter induction time which ranged from 84.28 s at 75 mg·l-1 clove oil to 41.14 s at 150 mg·l-1 clove oil. The larger fish had a longer induction time inversely related to the dosage. Recovery time was longer than induction time in both species. Both species recovered within 6 min after anaesthesia at 150 mg·l-1 clove oil. Clove oil did not produce marked changes (P compared to the control. However, marked changes (P P > 0.05. For both fish species, clove oil was effective, producing minimum stress and zero mortalities, and can be recommended as an effective anaesthetic.

  3. Minimising post-operative risk using a Post-Anaesthetic Care Tool (PACT): protocol for a prospective observational study and cost-effectiveness analysis.

    Science.gov (United States)

    Street, Maryann; Phillips, Nicole M; Kent, Bridie; Colgan, Stephen; Mohebbi, Mohammadreza

    2015-06-01

    While the risk of adverse events following surgery has been identified, the impact of nursing care on early detection of these events is not well established. A systematic review of the evidence and an expert consensus study in post-anaesthetic care identified essential criteria for nursing assessment of patient readiness for discharge from the post-anaesthetic care unit (PACU). These criteria were included in a new nursing assessment tool, the Post-Anaesthetic Care Tool (PACT), and incorporated into the post-anaesthetic documentation at a large health service. The aim of this study is to test the clinical reliability of the PACT and evaluate whether the use of PACT will (1) enhance the recognition and response to patients at risk of deterioration in PACU; (2) improve documentation for handover from PACU nurse to ward nurse; (3) result in improved patient outcomes and (4) reduce healthcare costs. A prospective, non-randomised, pre-implementation and post-implementation design comparing: (1) patients (n=750) who have surgery prior to the implementation of the PACT and (2) patients (n=750) who have surgery after PACT. The study will examine the use of the tool through the observation of patient care and nursing handover. Patient outcomes and cost-effectiveness will be determined from health service data and medical record audit. Descriptive statistics will be used to describe the sample and compare the two patient groups (pre-intervention and post-intervention). Differences in patient outcomes between the two groups will be compared using the Cochran-Mantel-Haenszel test and regression analyses and reported as ORs with the corresponding 95% CIs. This study will test the clinical reliability and cost-effectiveness of the PACT. It is hypothesised that the PACT will enable nurses to recognise and respond to patients at risk of deterioration, improve handover to ward nurses, improve patient outcomes, and reduce healthcare costs. Published by the BMJ Publishing Group

  4. 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

    injections through an intraarticular catheter in eight-hour intervals. 19 patients received ropivacaine and 14 received saline. The intervention period was 48 hours and the observation period was 5 days. In both groups there were no restrictions on the total daily dose of rescue analgesics. Pain was assessed...... 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...

  5. Differences between state entropy and bispectral index during analysis of identical electroencephalogram signals: a comparison with two randomised anaesthetic techniques.

    Science.gov (United States)

    Pilge, Stefanie; Kreuzer, Matthias; Karatchiviev, Veliko; Kochs, Eberhard F; Malcharek, Michael; Schneider, Gerhard

    2015-05-01

    It is claimed that bispectral index (BIS) and state entropy reflect an identical clinical spectrum, the hypnotic component of anaesthesia. So far, it is not known to what extent different devices display similar index values while processing identical electroencephalogram (EEG) signals. To compare BIS and state entropy during analysis of identical EEG data. Inspection of raw EEG input to detect potential causes of erroneous index calculation. Offline re-analysis of EEG data from a randomised, single-centre controlled trial using the Entropy Module and an Aspect A-2000 monitor. Klinikum rechts der Isar, Technische Universität München, Munich. Forty adult patients undergoing elective surgery under general anaesthesia. Blocked randomisation of 20 patients per anaesthetic group (sevoflurane/remifentanil or propofol/remifentanil). Isolated forearm technique for differentiation between consciousness and unconsciousness. Prediction probability (PK) of state entropy to discriminate consciousness from unconsciousness. Correlation and agreement between state entropy and BIS from deep to light hypnosis. Analysis of raw EEG compared with index values that are in conflict with clinical examination, with frequency measures (frequency bands/Spectral Edge Frequency 95) and visual inspection for physiological EEG patterns (e.g. beta or delta arousal), pathophysiological features such as high-frequency signals (electromyogram/high-frequency EEG or eye fluttering/saccades), different types of electro-oculogram or epileptiform EEG and technical artefacts. PK of state entropy was 0.80 and of BIS 0.84; correlation coefficient of state entropy with BIS 0.78. Nine percent BIS and 14% state entropy values disagreed with clinical examination. Highest incidence of disagreement occurred after state transitions, in particular for state entropy after loss of consciousness during sevoflurane anaesthesia. EEG sequences which led to false 'conscious' index values often showed high

  6. Local food:

    DEFF Research Database (Denmark)

    Sundbo, Donna Isabella Caroline

    2013-01-01

    are identified and then categorised according to whether they pertain to the food product itself or the production methods and facilities and whether they describe physical or social properties of local food. From this a model with four categories is developed. It is found that properties of the product are more......Recently there has been more focus on food in general and local food in particular. But what is local food? And what are the perceptions of this concept according to theory and to providers and consumers of local food? This article first summarises and compares three different theoretical...... perspectives on local food, namely experience economy, local food systems and what is termed pro-industrialism. These have differing and sometimes opposite conceptualisations and aims for the concept of local food. Using the perspective of experience economy as theoretical background, the concept of local food...

  7. Cost analysis of injection laryngoplasty performed under local anaesthesia versus general anaesthesia: an Australian perspective.

    Science.gov (United States)

    Chandran, D; Woods, C M; Schar, M; Ma, N; Ooi, E H; Athanasiadis, T

    2018-02-01

    To conduct a cost analysis of injection laryngoplasty performed in the operating theatre under local anaesthesia and general anaesthesia. The retrospective study included patients who had undergone injection laryngoplasty as day cases between July 2013 and March 2016. Cost data were obtained, along with patient demographics, anaesthetic details, type of injectant, American Society of Anesthesiologists score, length of stay, total operating theatre time and surgeon procedure time. A total of 20 cases (general anaesthesia = 6, local anaesthesia = 14) were included in the cost analysis. The mean total cost under general anaesthesia (AU$2865.96 ± 756.29) was significantly higher than that under local anaesthesia (AU$1731.61 ± 290.29) (p costs. Procedures performed under local anaesthesia in the operating theatre are associated with shorter operating theatre time and length of stay in the hospital, and provide significant cost savings. Further savings could be achieved if local anaesthesia procedures were performed in the office setting.

  8. Local Content

    CSIR Research Space (South Africa)

    Gibberd, Jeremy

    2016-10-01

    Full Text Available Local content refers to materials and products made in a country as opposed those that are imported. There is an increasing interest in the concept of local content as a means of supporting local economies and providing jobs (Belderbos & Sleuwaegen...

  9. Assessment of Common Anaesthetic and Clinical Indices of Multimodal Therapy of Propofol, Xylazine, and Ketamine in Total Intravenous Anaesthesia in West African Dwarf Goat

    Directory of Open Access Journals (Sweden)

    Ukwueze Celestine Okwudili

    2014-01-01

    Full Text Available The assessment of anaesthetic and clinical indices of multimodal therapy of propofol, xylazine, and ketamine was done in West African Dwarf (WAD goat. Sixteen healthy male WAD goats were assigned into four treatment groups, namely, control (group A (ketamine 5 mg/kg + xylazine 0.05 mg/kg, group B (propofol 5 mg/kg + xylazine 0.05 mg/kg, group C (propofol 5 mg/kg + ketamine 5 mg/kg, and group D (propofol 2.5 mg/kg + ketamine 2.5 mg/kg + xylazine 0.05 mg/kg. All drugs were administered intravenously. The multimodal therapy decreased significantly (P<0.05 the heart rate in groups A, B, and D. Also respiratory rate significantly (P<0.05 decreased in groups A, B, and D but significantly (P<0.05 increased at 20 min after induction in group C. However, temperature significantly (P<0.05 decreased in groups A, B, and C. The induction was good and smooth in groups B and D. Surgical anaesthetic time was longer in groups B and D and shorter in group C. The quality of recovery was good in groups B and D. Side effects such as salivation and apnoea were observed in all groups. In conclusion, the multimodal therapy could be used successfully. However, group D could be the best combination considering the parameters measured.

  10. 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].

  11. Data fabrication and other reasons for non-random sampling in 5087 randomised, controlled trials in anaesthetic and general medical journals.

    Science.gov (United States)

    Carlisle, J B

    2017-08-01

    Randomised, controlled trials have been retracted after publication because of data fabrication and inadequate ethical approval. Fabricated data have included baseline variables, for instance, age, height or weight. Statistical tests can determine the probability of the distribution of means, given their standard deviation and the number of participants in each group. Randomised, controlled trials have been retracted after the data distributions have been calculated as improbable. Most retracted trials have been written by anaesthetists and published by specialist anaesthetic journals. I wanted to explore whether the distribution of baseline data in trials was consistent with the expected distribution. I wanted to determine whether trials retracted after publication had distributions different to trials that have not been retracted. I wanted to determine whether data distributions in trials published in specialist anaesthetic journals have been different to distributions in non-specialist medical journals. I analysed the distribution of 72,261 means of 29,789 variables in 5087 randomised, controlled trials published in eight journals between January 2000 and December 2015: Anaesthesia (399); Anesthesia and Analgesia (1288); Anesthesiology (541); British Journal of Anaesthesia (618); Canadian Journal of Anesthesia (384); European Journal of Anaesthesiology (404); Journal of the American Medical Association (518) and New England Journal of Medicine (935). I chose these journals as I had electronic access to the full text. Trial p values were distorted by an excess of baseline means that were similar and an excess that were dissimilar: 763/5015 (15.2%) trials that had not been retracted from publication had p values that were within 0.05 of 0 or 1 (expected 10%), that is, a 5.2% excess, p = 1.2 × 10 -7 . The p values of 31/72 (43%) trials that had been retracted after publication were within 0.05 of 0 or 1, a rate different to that for unretracted trials, p = 1.03

  12. 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.

  13. Tuberous sclerosis Anaesthetic considerations

    African Journals Online (AJOL)

    QuickSilver

    Communication with the patient may be difficult since mental retardation is common (about ... This visual impairment may be caused by retinal astrocytomas or choroid hamartomas which .... Affected first degree relative. Cardiac rhabdomyoma.

  14. The safe spinal anaesthetic

    African Journals Online (AJOL)

    Mariane Senekal did her undergraduate training at Stellenbosch University and her postgraduate anaesthesia training at the University of the Free ... effects and complications are recognised .... and a functional decrease in the effective.

  15. 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...

  16. Effect of high-volume systematic local infiltration analgesia in Caesarean section

    DEFF Research Database (Denmark)

    Larsen, Klaus Richter; Kristensen, B B; Rasmussen, M A

    2015-01-01

    BACKGROUND: Pain after Caesarean section is often treated with opioids with a risk of side effects. Wound infiltration with local anaesthetics is effective and has few side effects, but volume vs. dose concentration has not been examined. METHODS: Ninety patients scheduled for elective Caesarean...... found concerning time spent in the PACU, to first mobilisation or in number of women with nausea/vomiting (P ≥ 0.05). No complications related to ropivacaine were observed. CONCLUSIONS: Systematic infiltration with a high concentration, low volume compared with low concentration, high volume showed...

  17. 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......-articular catheters with 20 ml ropivacaine 0.5% given at 6 h and again at 24 h, postoperatively. Analgesic efficacy was assessed for 3 h after each injection, using a visual analogue score, where 0 = no pain and 100 = worst pain. There was no statistically significant difference between groups. Maximum pain relief...

  18. Local anesthetic effects of bupivacaine loaded lipid-polymer hybrid nanoparticles: In vitro and in vivo evaluation.

    Science.gov (United States)

    Ma, Pengju; Li, Ting; Xing, Huaixin; Wang, Suzhen; Sun, Yingui; Sheng, Xiugui; Wang, Kaiguo

    2017-05-01

    There is a compelling need for prolonged local anesthetic that would be used for analgesia with a single administration. However, due to the low molecular weight of local anesthetics (LA) (lidocaine, bupivacaine, procaine, dibucaine, etc), they present fast systemic absorption. The aim of the present study was to develop and evaluate bupivacaine lipid-polymer hybrid nanoparticles (BVC LPNs), and compared with BVC loaded PLGA nanoparticles (BVC NPs). Their morphology, particle size, zeta potential and drug loading capacity were evaluated. In vitro release study, stability and cytotoxicity were studied. In vivo evaluation of anesthetic effects was performed on animal models. A facile nanoprecipitation and self-assembly method was optimized to obtain BVC LPNs, composed of PLGA, lecithin and DSPE-PEG 2000 , of ∼175nm particle size. Compared to BVC NPs, BVC LPNs exhibited prolonged in vitro release in phosphate-buffered saline (pH=7.4). Further, BVC LPNs displayed enhanced in vitro stability in 10% FBS and lower cytotoxicity (the concentration of BVC ranging from 1.0μM to 20μM). In addition, BVC LPNs exhibited significantly prolonged analgesic duration. These results demonstrate that the LPNs could function as promising drug delivery system for overcoming the drawbacks of poor stability and rapid drug leakage, and prolonging the anesthetic effect with slight toxicity. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  19. Effects of topical anaesthetic and buccal meloxicam on average daily gain, behaviour and inflammation of unweaned beef calves following surgical castration.

    Science.gov (United States)

    Van der Saag, D; Lomax, S; Windsor, P A; Taylor, C; Thomson, P; Hall, E; White, P J

    2018-02-26

    Although the pain caused by castration of calves is a significant animal welfare issue for the beef industry, analgesia is not always used for this procedure, largely because of practical limitations associated with injectable forms of pain relief. Novel analgesic formulations have now been developed for livestock to allow topical and buccal administration, offering practical options to improve cattle welfare if shown to be effective. To assess the effects of topical anaesthetic (TA) and buccal meloxicam (BM) on average daily gain (ADG), behaviour and inflammation following surgical castration of beef calves, a total of 50 unweaned bull calves were randomly allocated to: (1) sham castration (SHAM, n=10); (2) surgical castration (C, n=10); (3) surgical castration with pre-operative buccal meloxicam (CBM, n=10); (4) surgical castration with post-operative topical anaesthetic (CTA, n=10); and (5) surgical castration with pre-operative buccal meloxicam and post-operative topical anaesthetic (CBMTA, n=10). Calves were recorded on video for 5 h following treatment and the frequency and duration of specific behaviours displayed by each animal was later observed for 5 min every hour (total of 25 min). Average daily gain was calculated 1, 2 and 6 days following treatment. Scrotal diameter measurements and photographs of wounds were collected from all castrated calves 1, 2 and 6 days following treatment to evaluate inflammation and wound healing. Infrared photographs were used to identify maximum scrotal temperature. Digital photographs were used to visually score wounds on a numerical rating scale of 1 to 5, with signs of inflammation increasing and signs of healing decreasing with progressive scores. Sham castration calves displayed significantly less, and C calves displayed significantly more foot stamps than all other calves (P=0.005). Observations on the duration of time that calves displayed a hypometric 'stiff gait' locomotion, indicated that SHAM calves tended to

  20. 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...

  1. Localized superconductors

    International Nuclear Information System (INIS)

    Ma, M.; Lee, P.A.

    1985-01-01

    We study the effects of Anderson localization on superconductivity by using a Bardeen-Cooper-Schrieffer (BCS)-type trial wave function which pairs electrons in exact time-reversed eigenstates of the single-particle Hamiltonian. Within this approximation, and neglecting localization effects on the effective Coulomb repulsion and the electron-phonon coupling, we find that superconductivity persists below the mobility edge. In fact, Anderson's theorem is valid in the localized phase as long as rhoΔ 0 L/sup d/ > 1 (rho is the density of states averaged over +- Δ 0 of the Fermi energy, Δ 0 the BCS gap parameter, and L the localization length). Hence the gap order parameter Δ(r) remains uniform in space at the BCS value Δ 0 . The superfluid density and response to electromagnetic perturbations, however, show marked differences from the ''dirty superconductor'' regime. For rhoΔ 0 L/sup d/ < 1, Δ(r) fluctuates spatially and eventually drops to zero. In the limit when states are site localized, the system crosses over into the ''Anderson negative-U glass.'' Considerations beyond the trial wave-function approximation will speed up the destruction of superconductivity. The superconductor formed from localized states has the property that its quasiparticle excitations are also localized. Such excitations can be probed by observing the normal current in a tunneling junction

  2. Anaesthetic efficacy of supplemental lingual infiltration of mandibular molars after inferior alveolar nerve block plus buccal infiltration in patients with irreversible pulpitis.

    Science.gov (United States)

    Dou, L; Luo, J; Yang, D

    2013-07-01

    To investigate the effect of supplemental lingual infiltration (LI) of mandibular molars following an inferior alveolar nerve block (IANB) plus buccal infiltration (BI) in patients with irreversible pulpitis. Eighty adult patients diagnosed with irreversible pulpitis participated in this prospective study. All patients received standard IANB via injection of 4 mL of 2% lidocaine with 1 : 100,000 epinephrine. Ten minutes after the IANB, patients with numbness of the lower lip were randomly divided into two groups. In the BI group, 40 patients received supplemental BI of 0.9 mL of 4% articaine with 1 : 100,000 epinephrine. In the buccal plus lingual infiltration (BLI) group, 40 patients received supplemental BI of 0.9 mL of 4% articaine with 1 : 100,000 epinephrine and, subsequently, LIs with the same anaesthetic solution and dose. Endodontic access cavity preparation began 15 min after the IANB. Pain during treatment was recorded using a Heft-Parker visual analogue scale. Success was defined when pain was 'none' or 'mild' on endodontic access and initial instrumentation. The pain was estimated and statistically analysed by the chi-squared test (α = 0.05). The success rates for the BI and BLI groups were 70% and 62.5%, respectively. No statistical difference was found between the two groups (P = 0.478). Supplemental LIs are not recommended for administration in mandibular molars with irreversible pulpitis, because they do not improve the anaesthetic success after IANB plus BI. © 2012 International Endodontic Journal. Published by John Wiley & Sons Ltd.

  3. Ensuring availability of in date and fit for purpose emergency guidelines in all anaesthetic areas throughout the South East Scotland deanery.

    Science.gov (United States)

    Hindle, Elise

    2016-01-01

    Our aim was to institute a system whereby emergency anaesthetic guidelines are available in >90% of appropriate clinical areas throughout each of the acute hospital sites in three health board administrative regions, and whereby >90% of available guidelines are deemed to be in date and fit for purpose. Our objective was to achieve these targets within 6 months. Using quality improvement methodology, we inventoried available emergency anaesthetic guidelines in 132 locations throughout seven acute care hospitals. Five guidelines were then randomly selected per site per month and assessed for three process markers: was the guideline available in all appropriate areas, was it in-date (i.e. within date of review as specified on guideline or on consultation with author) and was it fit for purpose. Fitness for purpose was assessed by asking a junior colleague to simulate the emergency in a table top exercise using the guideline to aid management. This project was also used as a surveillance system to highlight outdated, unfit or missing guidance. Interventions included iterative revision of the master guideline lists, removal of outdated or unfit guidelines and creation or updating of guideline folders. 30 guidelines were assessed pre-intervention and 203 post-intervention. 52% of guidelines were available in appropriate areas pre-intervention rising to 76% post intervention, 67% of guidelines were in date pre-intervention rising to 82% post-intervention and 87% of guidelines were deemed fit for purpose pre-intervention rising to 92% post-intervention. We have demonstrated that regular review of emergency guidelines to maintain their currency is achievable and also demonstrated the feasibility of recruiting over 20 trainees across a training deanery to complete a QI project. We believe that organisations should maximise the resource of highly motivated trainees to achieve their QI goals.

  4. Reduced anaesthetic requirements and postoperative analgesics in patients undergoing laparoscopic cholecystectomy: premedication with intravenous paracetamol versus ketorolac, a double blind and randomised clinical trial.

    Science.gov (United States)

    Medina-Vera, A J; Novoa, L M

    2017-02-01

    To compare the effects of premedication with intravenous paracetamol versus ketorolac, in decreasing intraoperative anaesthetic and postoperative opioid analgesics requirements in patients undergoing laparoscopic cholecystectomy. An experimental, prospective, comparative, double blind, and randomised clinical trial was conducted to determine intraoperative opioid requirements, and pain and analgesic requirements in the postoperative period in 100 healthy patients undergoing laparoscopic cholecystectomy. They were randomised into 2 groups: Group 1: pre-medicated with paracetamol 1g, and Group 2: with ketorolac 30mg (both administered intravenously 30minutes prior to surgery). There were no statistically significant differences between groups as regards intraoperative remifentanil use (Group 1: 0.0739±0.016μg/kg/min, Group 2: 0.0741±0.018μg/kg/min). The number of patients in Group 2 that had values of VAS>4 points (22.4%) was lower than in Group 1 (28.6%), but with no statistically significant difference. Of the patients who needed postoperative opioid rescue, most required a single rescue and application of analgesics during hospitalisation, that prevailed between 3 and 12hours, without any significant differences between groups. No adverse effects were observed in the study sample. Paracetamol 1g IV given preoperatively decreased anaesthetic requirements and the need for postoperative analgesics similar to the preoperative administration of ketorolac 30mg IV. Copyright © 2016 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. Behavioural Effects of the Commonly Used Fish Anaesthetic Tricaine Methanesulfonate (MS-222) on Zebrafish (Danio rerio) and Its Relevance for the Acetic Acid Pain Test

    Science.gov (United States)

    Nordgreen, Janicke; Tahamtani, Fernanda M.; Janczak, Andrew M.; Horsberg, Tor Einar

    2014-01-01

    The pros and cons of using anaesthesia when handling fish in connection with experiments are debated. A widely adopted practice is to wait thirty minutes after anaesthesia before behavioural observations are initiated, but information about immediate effects of a treatment is then lost. This is pertinent for responses to acute stressors, such as acid injection in the acetic acid pain test. However, omission of anaesthetics in order to obtain data on immediate responses will compromise the welfare of fish and contribute to experimental noise due to stress. We therefore tested the effect of tricaine methanesulfonate on the behaviour of zebrafish. We predicted that tricaine (MS 222) would decrease swimming velocity and that the control fish would show an increased level of anxiety- and stress-related behaviours compared to the tricaine group. Following acclimatization to the test tank, baseline behaviour was recorded before immersion in either tricaine (168 mg l−1, treatment group, N = 8) or tank water (control group, N = 7). Latencies to lose equilibrium and to lose response to touch were registered. The fish was then returned to the test tank, and the latency to regain equilibrium was registered in anaesthetized fish. When equilibrium was regained, and at five, thirty and sixty minutes after the fish had been returned to the test tank, behaviour was recorded. The tricaine fish showed the following responses (mean ± sd): latency to lose equilibrium 22.6 s±3.9; latency to lose response to touch 101.9 s±26.8; latency to regain equilibrium 92.0 s±54.4. Contrary to our predictions, neither treatment caused a change in any of the behaviours registered. This indicates that tricaine has no effect on several commonly used behavioural parameters, and that it may be unnecessary to postpone behavioural observations to 30 min after anaesthesia. PMID:24658262

  6. Localized Scleroderma

    Science.gov (United States)

    ... How Is Localized Scleroderma Diagnosed? Doctors who are familiar with scleroderma, or who are experts at examining ... systemic treatment with a medication or other treatment interventions (for example, ultraviolet light), are reserved for more ...

  7. [Necrosis in fingers and toes following local anaesthesia with adrenaline--an urban legend?].

    Science.gov (United States)

    Finsen, Vilhjalmur

    2013-09-17

    It is often maintained that a local anaesthetic (usually lidocaine) with adrenaline must not be used in fingers and toes because it may cause necrosis due to vascular spasm in end arteries. This review article is an attempt to find evidence to support this warning. Relevant literature was found by means of searches in PubMed limited downwards to 1946 and in EMBASE from 1980 to 2012, and in reference lists. Five review articles on finger necrosis following local anaesthesia concluded that lidocaine with adrenaline does not entail a risk of ischaemic injury. One article found 48 reported cases of finger necrosis in the period 1880 to 2000. Most were from the first half of the 1900s, and none involved lidocaine. Gangrene of part of the finger tip has subsequently been described in one patient with Raynaud's syndrome. No cases of necrosis have been described in a large number of reported accidents in which EpiPen injections contained the same quantity of adrenaline as is found in 60 ml lidocaine with adrenaline. Over a quarter of a million reports have been made of operations on feet, hands, fingers and toes anaesthetised with lidocaine with adrenaline without resulting necrosis. There are no grounds for the warning against using lidocaine with adrenaline in fingers and toes. This anaesthetic offers considerable practical advantages. Care should be taken with infected fingers or fingers with poor circulation.

  8. [Comparison of the systems used for providing local anesthesia in dentistry--the Wand (Milestone Scientific) and Injex (Rosch)].

    Science.gov (United States)

    Zarzecka, Joanna; Gończowski, Krzysztof; Kesek, Barbara; Darczuk, Dagmara; Zapała, Jan

    2006-01-01

    Local anesthesia is one of the basic and the most often executed interventions in dentistry. This procedure is very stressful for the patients because it is combined with pain. The new systems for delivering local anesthesia in dentistry have revolutionized the technique considerably by its simplify as well as reduction in pain. this study presents the comparison between the local anesthesia delivery systems used in dentistry--The Wand and Injex, taking into consideration pain intensity during performing anesthesia and the intensification of fear before executed anesthesia with the given system. the Visual Analogue Scale (VAS), verbal scale and questionnaires were used to evaluate pain and fear. On the basis of our investigations it can be concluded that there were statistically important differences between men and women in fear intensity combined with the anesthesia procedure--men were less afraid than women. The patients who were anaesthetized with system The WAND declared less fear before similar anesthesia in future. The average value of intensity of pain analyzed with both verbal and visual scales during anaesthetizing with the system Injex (independently from sex) was statistically significantly higher than for system The WAND--respectively 0.57 and 8.55 for The WAND, 2.02 and 32.18 for Injex (p = 0.001). on the basis of the results of this study it can be concluded that the less stressful and painful local anesthesia delivery system is the WAND.

  9. Safety and efficacy of alternative antibiotic regimens compared with 7 day injectable procaine benzylpenicillin and gentamicin for outpatient treatment of neonates and young infants with clinical signs of severe infection when referral is not possible: a randomised, open-label, equivalence trial.

    Science.gov (United States)

    Baqui, Abdullah H; Saha, Samir K; Ahmed, A S M Nawshad Uddin; Shahidullah, Mohammad; Quasem, Iftekhar; Roth, Daniel E; Samsuzzaman, A K M; Ahmed, Wazir; Tabib, S M Shahnawaz Bin; Mitra, Dipak K; Begum, Nazma; Islam, Maksuda; Mahmud, Arif; Rahman, Mohammad Hefzur; Moin, Mamun Ibne; Mullany, Luke C; Cousens, Simon; El Arifeen, Shams; Wall, Stephen; Brandes, Neal; Santosham, Mathuram; Black, Robert E

    2015-05-01

    Severe infections remain one of the main causes of neonatal deaths worldwide. Possible severe infection is diagnosed in young infants (aged 0-59 days) according to the presence of one or more clinical signs. The recommended treatment is hospital admission with 7-10 days of injectable antibiotic therapy. In low-income and middle-income countries, barriers to hospital care lead to delayed, inadequate, or no treatment for many young infants. We aimed to identify effective alternative antibiotic regimens to expand treatment options for situations where hospital admission is not possible. We did this randomised, open-label, equivalence trial in four urban hospitals and one rural field site in Bangladesh to determine whether two alternative antibiotic regimens with reduced numbers of injectable antibiotics combined with oral antibiotics had similar efficacy and safety to the standard regimen, which was also used as outpatient treatment. We randomly assigned infants who showed at least one clinical sign of severe, but not critical, infection (except fast breathing alone), whose parents refused hospital admission, to one of the three treatment regimens. We stratified randomisation by study site and age (treatment was intramuscular procaine benzylpenicillin and gentamicin once per day for 7 days (group A). The alternative regimens were intramuscular gentamicin once per day and oral amoxicillin twice per day for 7 days (group B) or intramuscular procaine benzylpenicillin and gentamicin once per day for 2 days, then oral amoxicillin twice per day for 5 days (group C). The primary outcome was treatment failure within 7 days after enrolment. Assessors of treatment failure were masked to treatment allocation. Primary analysis was per protocol. We used a prespecified similarity margin of 5% to assess equivalence between regimens. This study is registered with ClinicalTrials.gov, number NCT00844337. Between July 1, 2009, and June 30, 2013, we recruited 2490 young infants into the

  10. Successful fetoscopic laser coagulation for twin-to-twin transfusion syndrome under local anaesthesia.

    LENUS (Irish Health Repository)

    Cooley, S

    2011-06-01

    A review of the efficacy and outcome of fifteen fetoscopic laser ablations under local anaesthesia for twin to twin transfusion syndrome (TTTS) in the National Maternity Hospital Dublin was undertaken. The mean gestation at laser was 19.7 weeks (range 16-25 weeks) with a mean gestation at delivery of 29.1 weeks (range 20-35 weeks). The overall liveborn birth rate was 79% (22 infants) and one pregnancy was still ongoing. There were four neonatal deaths secondary to complications of prematurity. The surviving eighteen infants (64%) undergo regular paediatric review. The procedure was performed successfully in all cases with local anaesthesia. In no case was there maternal discomfort that warranted the procedure to be abandoned and good visual access of the vascular anastamoses was obtained in all cases. Local anaesthesia therefore offers a safe effective anaesthetic option for fetoscopic laser coagulation in monochorionic pregnancies complicated by TTTS.

  11. Locals Collection

    Directory of Open Access Journals (Sweden)

    Stephen Hastings-King

    2010-03-01

    Full Text Available A locals collection is a set of parameters that are used to delimit data-mining operations. This piece uses a collection of locals from around Essex Massachusetts to shape and delimit an interrogation of post-reality in contemporary America. It explores the notion of crisis, the possibility of a crisis of empire that may or may not emerge in a media-space that does not allow crisis of empire to be mentioned and relations this maybe-crisis to the various levels of economic dysfunction that have become evident since late 2008. But mostly this piece explores ways in which particular stories about particular people do and do not link/link to these larger-scale narratives. This is the first of a potential series of locals collections that will mine the American post-real.

  12. Local equilibrium

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    1984-12-15

    From 3-6 September the First International Workshop on Local Equilibrium in Strong Interaction Physics took place in Bad-Honnef at the Physics Centre of the German Physical Society. A number of talks covered the experimental and theoretical investigation of the 'hotspots' effect, both in high energy particle physics and in intermediate energy nuclear physics.

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

    Directory of Open Access Journals (Sweden)

    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

  14. Net Locality

    DEFF Research Database (Denmark)

    de Souza e Silva, Adriana Araujo; Gordon, Eric

    Provides an introduction to the new theory of Net Locality and the profound effect on individuals and societies when everything is located or locatable. Describes net locality as an emerging form of location awareness central to all aspects of digital media, from mobile phones, to Google Maps......, to location-based social networks and games, such as Foursquare and facebook. Warns of the threats these technologies, such as data surveillance, present to our sense of privacy, while also outlining the opportunities for pro-social developments. Provides a theory of the web in the context of the history...... of emerging technologies, from GeoCities to GPS, Wi-Fi, Wiki Me, and Google Android....

  15. Local supertwistors

    International Nuclear Information System (INIS)

    Merkulov, S.A.

    1987-01-01

    Geometry of local supertwistors is investigated. It is proved that the Yang-Mills equations for the introduced ansatz for supertwistor connection are equivalent to free bach equations, describing the dynamics of N=1 conformal supergravity. Analogous interpretation of the dynamics of N=1 conformal supergravity coupled to a vector superfield is proposed. It is proved that any complex conformally right or left flat superspace automatically satisfies the Bach equations

  16. Effect of fentanyl target-controlled infusions on isoflurane minimum anaesthetic concentration and cardiovascular function in red-tailed hawks (Buteo jamaicensis).

    Science.gov (United States)

    Pavez, Juan C; Hawkins, Michelle G; Pascoe, Peter J; Knych, Heather K DiMaio; Kass, Philip H

    2011-07-01

    To determine the impact of three different target plasma concentrations of fentanyl on the minimum anaesthetic concentration (MAC) for isoflurane in the red-tailed hawk and the effects on the haemodynamic profile. Experimental study. Six healthy adult red-tailed hawks (Buteo jamaicensis) of unknown sex with body weights (mean ± SD) of 1.21 ± 0.15 kg. This study was undertaken in two phases. In the first phase anaesthesia was induced with isoflurane in oxygen via facemask and maintained with isoflurane delivered in oxygen via a Bain circuit. Following instrumentation baseline determination of the MAC for isoflurane was made for each animal using the bracketing method and a supramaximal electrical stimulus. End-tidal isoflurane concentration (E'Iso) was then set at 0.75 × MAC and after an appropriate equilibration period a bolus of fentanyl (20 μg kg(-1)) was administered intravenously (IV) in order to determine the pharmacokinetics of fentanyl in the isoflurane-anaesthetized red-tailed hawk. During the second phase anaesthesia was induced in a similar manner and E'Iso was set at 0.75 × MAC for each individual. Fentanyl was infused IV to achieve target plasma concentrations between 8 and 32 ng mL(-1). At each fentanyl plasma concentration, the MAC for isoflurane and cardiovascular variables were determined. Data were analyzed by use of repeated-measures anova. Mean ± SD fentanyl plasma concentrations and isoflurane MACs were 0 ± 0, 8.51 ± 4, 14.85 ± 4.82 and 29.25 ± 11.52 ng mL(-1), and 2.05 ± 0.45%, 1.42 ± 0.53%, 1.14 ± 0.31% and 0.93 ± 0.32% for the target concentrations of 0, 8, 16 and 32 ng mL(-1), respectively. At these concentrations fentanyl significantly (p = 0.0016) decreased isoflurane MAC by 31%, 44% and 55%, respectively. Dose had no significant effect on heart rate, systolic, diastolic or mean arterial blood pressure. Fentanyl produced a dose-related decrease of isoflurane MAC with minimal effects on measured cardiovascular parameters in

  17. Local supertwistors

    International Nuclear Information System (INIS)

    Merkulov, S.A.

    1987-01-01

    The geometry of local supertwistors is investigated. An ansatz on the form of the supertwistor superconnection is introduced. Because of this restriction on the form of such a superconnection the Yang-Mills equations for the superconnection turn out to be equivalent to the free Bach equations describing the dynamics of simple conformal supergravity. It is shown that the equations of motion of conformal supergravity interacting with a vector superfield admit an analogous interpretation. It is proved that an arbitrary conformally right-flat or left-flat superspace is automatically a solution of the Bach equations

  18. 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.

  19. Anaesthetic, procedure and complications management of serial whole-lung lavage in an obese patient with pulmonary alveolar proteinosis: case report.

    Science.gov (United States)

    Rebelo, Helena Marta; Guedes, Luisa; Veiga, Dalila; Fiuza, Antonio C; Abelha, Fernando

    2012-01-01

    The first case of Pulmonary Alveolar Proteinosis (PAP) was described by Rose in 1958, but it is still a rare disorder. PAP is characterized by deposition of lipoproteinaceous material secondary to abnormal processing of surfactant by macrophages. Patients may suffer from progressive dyspnea and cough that at times is accompanied by worsening hypoxia and its course can vary from progressive deterioration to spontaneous improvement. Many therapies have been used to treat PAP including antibiotics, postural drainage, and intermittent positive pressure breathing with aerosolized Acetylcysteine, heparin and saline. At present, the mainstay of treatment is whole lung lavage (WLL). Although generally well tolerated, WLL can be associated with some complications. We report a case of severe PAP through the anaesthetic, procedure and complications management of pulmonary alveolar proteinosis in one patient who has undergone multiple, alternating, single-lung lavages over the past seven years, the last three in our hospital, with improvements in her symptoms following each therapy. Copyright © 2012 Elsevier Editora Ltda. All rights reserved.

  20. Neurons of the A5 region are required for the tachycardia evoked by electrical stimulation of the hypothalamic defence area in anaesthetized rats.

    Science.gov (United States)

    López-González, M V; Díaz-Casares, A; Peinado-Aragonés, C A; Lara, J P; Barbancho, M A; Dawid-Milner, M S

    2013-08-01

    In order to assess the possible interactions between the pontine A5 region and the hypothalamic defence area (HDA), we have examined the pattern of double staining for c-Fos protein immunoreactivity (c-Fos-ir) and tyrosine hydroxylase, throughout the rostrocaudal extent of the A5 region in spontaneously breathing anaesthetized male Sprague-Dawley rats during electrical stimulation of the HDA. Activation of the HDA elicited a selective increase in c-Fos-ir with an ipsilateral predominance in catecholaminergic and non-catecholaminergic A5 somata (P HDA. Cardiorespiratory changes were analysed in response to electrical stimulation of the HDA before and after ipsilateral microinjection of muscimol within the A5 region. Stimulation of the HDA evoked an inspiratory facilitatory response, consisting of an increase in respiratory rate (P HDA stimulation were reduced (P HDA and the A5 region, extracellular recordings of putative A5 neurones were obtained during HDA stimulation. Seventy-five A5 cells were recorded, 35 of which were affected by the HDA (47%). These results indicate that neurones of the A5 region participate in the cardiovascular response evoked from the HDA. The possible mechanisms involved in these interactions are discussed.

  1. Spontaneous abortions and malformations in the offspring of nurses exposed to anaesthetic gases, cytostatic drugs, and other potential hazards in hospitals, based on registered information of outcome

    Energy Technology Data Exchange (ETDEWEB)

    Hemminki, K; Kyyroenen, P L; Lindbohm, M L

    1985-06-01

    Nurses working in selected departments of general hospitals in Finland were collected from a central register on health personnel in Finland. Using the Hospital Discharge Register and the Register of Congenital Malformations, case nurses were selected who had had a spontaneous abortion (N = 217) or a malformed child (N = 46) between the years 1973 and 1979. Controls consisted of three nurses who had had a normal birth; the control nurses were matched for age and hospital of employment. Information on exposure in the first trimester of pregnancy was sought through the head nurses of the hospitals. No significant increase in risk of spontaneous abortion or of malformation was observed after exposure to anaesthetic gases (odds ratio for spontaneous abortion 1.2), sterilizing gases and soaps, or x-rays. Handling of cytostatic drugs did not affect the frequency of spontaneous abortion but was associated with malformations in the offspring. The odds ratio, based on eight cases, was 4.7 (p = 0.02) when the logistic model was adopted. The results suggest that the exposures investigated, other than cytostatic drugs, do not cause a strong reproductive risk. Further studies are needed, particularly on cytostatic drugs.

  2. A comparison of the 'cost per child treated' at a primary care-based sedation referral service, compared to a general anaesthetic in hospital.

    Science.gov (United States)

    Jameson, K; Averley, P A; Shackley, P; Steele, J

    2007-09-22

    To compare the cost-effectiveness of dental sedation techniques used in the treatment of children, focusing on hospital-based dental general anaesthetic (DGA) and advanced conscious sedation in a controlled primary care environment. Data on fees, costs and treatment pathways were obtained from a primary care clinic specialising in advanced sedation techniques. For the hospital-based DGA cohort, data were gathered from hospital trusts in the same area. Comparison was via an average cost per child treated and subsequent sensitivity analysis. Analysing records spanning one year, the average cost per child treated via advanced conscious sedation was pound245.47. As some treatments fail (3.5% of cases attempted), and the technique is not deemed suitable for all patients (4-5%), DGA is still required and has been factored into this cost. DGA has an average cost per case treated of pound359.91, 46.6% more expensive than advanced conscious sedation. These cost savings were robust to plausible variation in all parameters. The costs of advanced conscious sedation techniques, applied in a controlled primary care environment, are substantially lower than the equivalent costs of hospital-based DGA, informing the debate about the optimum way of managing this patient group.

  3. [Is therapy with local infiltrations feasible in primary care consultations?].

    Science.gov (United States)

    Magaña Loarte, J E; Pérez Franco, J; Sánchez Sánchez, G

    1999-01-01

    To study the feasibility of local infiltration in primary care consultations. Before-and-after intervention study. Two clinics at an urban health centre. Patients diagnosed with pathology of tender areas and treated with corticosteroid infiltration between May 1997 and May 1998. Corticoid infiltration plus local anaesthetic. Weekly check-up. Analysis of the variables: sex, age, diagnosis, time elapsed between indication and start of treatment, subjective assessment of pain before and after treatment (VRS scale), number of infiltrations per patient, side-effects. Evaluation of overall and individual effectiveness. 41 patients were infiltrated. Average age was 58. Most common pathologies were: rotary joint tendinitis (48.7%), anserine bursitis (24.4%), plantar fasciitis (7.3%). Average number of infiltrations per pathology: 1.3. Mean waiting time: 3.5 days. Comparison of pain by means of VRS (range 0-5) before and after treatment used the Wilcoxon test, with a statistically significant difference and p < 0.001 (z = -5.5109). For 35 patients (85.4%), pain was solved very well (values 0 and 1 on the VRS). For 3 patients (7.3%), improvement was moderate; and for 3 (7.3%) there was no improvement. 1. Treatment with local infiltration of corticosteroids is effective in dealing with pain, and is an alternative to treatment with NSAIDs. 2. It is feasible in primary care, and there are many advantages if the general practitioner employs this therapeutic technique.

  4. 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

  5. New procedure to synthesize silver nanoparticles and their interaction with local anesthetics

    Directory of Open Access Journals (Sweden)

    Mocanu A

    2013-10-01

    Full Text Available Aurora Mocanu,1 Roxana Diana Pasca,1 Gheorghe Tomoaia,2 Corina Garbo,1 Petre T Frangopol,1 Ossi Horovitz,1 Maria Tomoaia-Cotisel11Chemical Engineering Department, Babes-Bolyai University, 2Orthopedic Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, RomaniaAbstract: Silver nanoparticles (AgNPs were prepared in aqueous colloid dispersions by the reduction of Ag+ with glucose in alkaline medium. Tetraethyl orthosilicate and l-asparagine were added as stabilizers of NPs. The AgNPs were characterized, and their interaction with three local anesthetics (procaine, dibucaine, or tetracaine was investigated. Optical spectra show the characteristic absorption band of AgNPs, due to surface plasmon resonance. Modifications in the position and shape of this band reflect the self-assembly of metal NPs mediated by anesthetic molecules and the progress in time of the aggregation process. Zeta-potential measuring was applied in order to characterize the electrostatic stability of the NPs. The size and shape of the AgNPs, as well as the features of the assemblies formed by their association in the presence of anesthetics, were evidenced by transmission electron microscopy images. Atomic force microscopy images showed the characteristics of the films of AgNPs deposited on glass support. The effect of the anesthetics could be described in terms of electrostatic forces between the negatively charged AgNPs and the anesthetic molecules, existing also in their cationic form at the working pH. But also hydrophobic and hydrogen bonding interactions between the coated nanoparticles and anesthetics molecular species should be considered.Keywords: self-assembled nanostructures, UV-vis spectra, TEM, AFM, zeta potential

  6. Local Sustainability

    International Nuclear Information System (INIS)

    Carrizosa Umana, Julio

    1998-01-01

    The current polemic about the possibilities of sustainable development has led to a renovated interest for the topic of the sustainability of the communities and the local sustainability. In front of the global sustainability whose conditions have been exposed by systemic ecologists and for macro economists, the sustainability of specific places arises in the planet whose conditions are object of study of the ecology of landscapes, of the ecological economy, of the cultural anthropology, of the environmental sociology and naturally, of the integral environmentalism. In this discussion the Colombian case charges unusual interest to be one of the few countries of Latin America, where a very dense net of municipalities exists, each one with its urban helmet and with a position and some functions defined by the political constitution of the nation. This net of municipalities and of urban helmets it also constitutes net of alternative to the current macro-cephalic situation. As well as Bogota grew, in a hundred years, of less than a hundred thousand inhabitants to six million inhabitants, each one of these municipalities contains a potential of growth that depends on the characteristics of its ecological, social, economic and politic sustainability

  7. Quantum Locality?

    Science.gov (United States)

    Stapp, Henry P.

    2012-05-01

    , in response to Griffiths' challenge, why a putative proof of locality that he has described is flawed.

  8. Effects of a topical anaesthetic formulation and systemic carprofen, given singly or in combination, on the cortisol and behavioural responses of Merino lambs to castration.

    Science.gov (United States)

    Paull, D R; Lee, C; Colditz, I G; Fisher, A D

    2009-06-01

    To determine the effectiveness of a topical anaesthetic formulation (Tri-Solfen) with or without the administration of a non-steroidal anti-inflammatory drug (carprofen) on the pain and distress response associated with ring or surgical castration of ram lambs. Merino ram lambs (n = 78) were allocated to 10 treatment groups: 4 groups of knife-castrated lambs and 4 groups of ring-castrated lambs received carprofen (4 mg/kg SC) and Tri-Solfen; 2 control groups (sham) received carprofen at 0 or 4 mg/kg SC. Measurements included plasma cortisol and haptoglobin concentrations, haematology, and behaviour, including posture. Knife-castrated lambs had higher peak cortisol and integrated cortisol responses for the first 6 h after treatment and greater concentration s of circulating acute phase proteins than ring-castrated lambs, both of which were significantly different from the sham controls. Tri-Solfen applied to the knife castration wound significantly reduced both the peak plasma cortisol concentration and the integrated cortisol response for the first 6 h and improved lying behaviour in the first 12 h. Carprofen reduced the cortisol response to knife castration at 30 min, but elevated the cortisol responses at 24 and 48 h. Carprofen nearly halved the number of acute pain behaviours associated with ring castration. There were no significant additive or synergistic effects from combining the analgesic treatments. Tri-Solfen applied to the tail wound provided no detectible benefits during ring castration + tail docking. The physiological and behavioural responses suggest that ring castration has less impact on the lamb than knife castration. The specific analgesic treatments can provide modest amelioration of the pain and discomfort associated with castration. Alternative doses or application methods may enhance their efficacy.

  9. The effect of site (deltoid or gluteus muscle of intramuscular administration of anaesthetic drugs on the course of immobilisation in macaque monkeys (Macaca mulatta

    Directory of Open Access Journals (Sweden)

    Ladislav Hess

    2012-01-01

    Full Text Available The aim of this work was to study the effect of site of intramuscular administration of anaesthetic drugs on the course of immobilisation in macaque monkeys (Macaca mulatta. Twenty macaque monkeys were given medetomidine (25 µg·kg-1 and ketamine (3 mg·kg-1 intramuscularly to the deltoid (n = 10 animals or gluteus (n = 10 animals muscles. Behavioural changes, loss of aggressiveness, immobilisation time and cardiorespiratory changes were recorded. The effect of drugs was reversed after 20 min by i.m. administration of atipamezole at the dose of 250 µg·kg-1. Highly significant differences (P < 0.001 were found between groups with gluteal or deltoid administration of drugs on the onset of immobilisation effect (71.3 s and 108.3 s, respectively, and immobilisation time (152.7 s and 254.4 s, respectively. In the gluteus muscle group, the grasp reflex was still present at the beginning of immobilisation and slowly wore off in 15–45 s. The same was valid for muscle tone. There were no differences in cardiorespiratory parameters in any of the groups. Animals of both groups recovered in 3–6 min after atipamezole administration. Administration of drugs to the deltoid muscle resulted in a more rapid onset and increased effect of immobilisation than administration to the gluteus muscle. Both in veterinary and human medicine, injection to the deltoid muscle may be more convenient in all cases, when rapid and more prominent effect is desirable as in premedication before surgery or in emergency medicine. The study is the first to compare the effect of administering drugs to different muscles and the results may improve the practice of intramuscular injections in animals and in humans.

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Detomidine and the combination of detomidine and MK-467, a peripheral alpha-2 adrenoceptor antagonist, as premedication in horses anaesthetized with isoflurane.

    Science.gov (United States)

    Pakkanen, Soile Ae; Raekallio, Marja R; Mykkänen, Anna K; Salla, Kati M; de Vries, Annemarie; Vuorilehto, Lauri; Scheinin, Mika; Vainio, Outi M

    2015-09-01

    To investigate MK-467 as part of premedication in horses anaesthetized with isoflurane. Experimental, crossover study with a 14 day wash-out period. Seven healthy horses. The horses received either detomidine (20 μg kg(-1) IV) and butorphanol (20 μg kg(-1) IV) alone (DET) or with MK-467 (200 μg kg(-1) IV; DET + MK) as premedication. Anaesthesia was induced with ketamine (2.2 mg kg(-1) ) and midazolam (0.06 mg kg(-1) ) IV and maintained with isoflurane. Heart rate (HR), mean arterial pressure (MAP), end-tidal isoflurane concentration, end-tidal carbon dioxide tension, central venous pressure, fraction of inspired oxygen (FiO2 ) and cardiac output were recorded. Blood samples were taken for blood gas analysis and to determine plasma drug concentrations. The cardiac index (CI), systemic vascular resistance (SVR), ratio of arterial oxygen tension to inspired oxygen (Pa O2 /FiO2 ) and tissue oxygen delivery (DO2 ) were calculated. Repeated measures anova was applied for HR, CI, MAP, SVR, lactate and blood gas variables. The Student's t-test was used for pairwise comparisons of drug concentrations, induction times and the amount of dobutamine administered. Significance was set at p detomidine concentrations were reduced in the group receiving MK-467. After DET+MK, the area under the plasma concentration time curve of butorphanol was smaller. MK-467 enhances cardiac function and tissue oxygen delivery in horses sedated with detomidine before isoflurane anaesthesia. This finding could improve patient safety in the perioperative period. The dosage of MK-467 needs to be investigated to minimise the effect of MK-467 on MAP. © 2014 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesia and Analgesia.

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

    Directory of Open Access Journals (Sweden)

    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.

  13. 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.

  14. Local Foods, Local Places Summary Reports

    Science.gov (United States)

    These reports summarize community projects done with Local Foods, Local Places assistance, including farmers markets, cooperatives, community gardens, and other food-related enterprises that can boost local economies and drive revitalization.

  15. Quantum Locality?

    Energy Technology Data Exchange (ETDEWEB)

    Stapp, Henry

    2011-11-10

    vagaries that he cites do not upset the proof in question. It is show here in detail why the precise statement of this theorem justifies the specified application of CQT. It is also shown, in response to his challenge, why a putative proof of locality that he has proposed is not valid.

  16. Effect of oral premedication on the anaesthetic efficacy of inferior alveolar nerve block in patients with irreversible pulpitis - A systematic review and network meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Pulikkotil, S J; Nagendrababu, V; Veettil, S K; Jinatongthai, P; Setzer, F C

    2018-02-26

    This systematic review (SR; PROSPERO database: CRD42017075160) and network meta-analysis (NMA) identified the most effective oral premedication for anaesthetic success of inferior alveolar nerve blocks (IANB) in cases of irreversible pulpitis. Medline and Ebscohost databases were searched up until 10/2017. Randomized controlled trials (RCT) studying the effect of oral premedication, alone or in combination, on the success of IANB for cases of irreversible pulpitis, compared to placebo or other oral premedications, were included. Quality of the included studies was appraised by the revised Cochrane risk of bias tool for randomized trials. Pairwise analysis, NMA and quality of evidence assessment using GRADE criteria were performed. Nineteen studies (n = 1654 participants) were included. NMA demonstrated that compared to placebo, dexamethasone was most effective in increasing anaesthetic success (RR, 2.92 [95% CI 1.74,4.91]; SUCRA = 0.96), followed by NSAIDs (RR, 1.92 [95% CI 1.63,2.27], SUCRA = 0.738) and Tramadol (RR, 2.03 [95% CI 1.18,3.49], SUCRA = 0.737). Premedication with acetaminophen added to NSAIDs demonstrated similar efficacy as NSAIDs alone (RR, 1.06 [95% CI 0.79,1.43]). Sensitivity analyses proved the superiority of dexamethasone or NSAIDs over any other premedications. Subgroup analyses of specific dosages in comparison with placebo demonstrated that dexamethasone 0.5 mg was most effective, followed by ketorolac 10 mg, piroxicam 20 mg, ibuprofen 400 mg + acetaminophen 500 mg and Tramadol 50 mg. Ibuprofen 400 mg, 600 mg and 800 mg had a significantly improved IANB success, while Ibuprofen 300 mg had no effect. Oral premedication with dexamethasone, NSAIDs or Tramadol significantly increased anaesthetic success. More trials are needed to evaluate the premedication effects of dexamethasone or Tramadol for improved anaesthetic success of IANB when treating irreversible pulpitis. © 2018 International Endodontic Journal. Published by John

  17. Impact of four different recumbencies on the distribution of ventilation in conscious or anaesthetized spontaneously breathing beagle dogs: An electrical impedance tomography study.

    Directory of Open Access Journals (Sweden)

    Tamas D Ambrisko

    Full Text Available The aim was to examine the effects of recumbency and anaesthesia on distribution of ventilation in beagle dogs using Electrical Impedance Tomography (EIT. Nine healthy beagle dogs, aging 3.7±1.7 (mean±SD years and weighing 16.3±1.6 kg, received a series of treatments in a fixed order on a single occasion. Conscious dogs were positioned in right lateral recumbency (RLR and equipped with 32 EIT electrodes around the thorax. Following five minutes of equilibration, two minutes of EIT recordings were made in each recumbency in the following order: RLR, dorsal (DR, left (LLR and sternal (SR. The dogs were then positioned in RLR, premedicated (medetomidine 0.01, midazolam 0.1, butorphanol 0.1 mg kg-1 iv and pre-oxygenated. Fifteen minutes later anaesthesia was induced with 1 mg kg-1 propofol iv and maintained with propofol infusion (0.1-0.2 mg kg-1 minute-1 iv. After induction, the animals were intubated and allowed to breathe spontaneously (FIO2 = 1. Recordings of EIT were performed again in four recumbencies similarly to conscious state. Centre of ventilation (COV and global inhomogeneity (GI index were calculated from the functional EIT images. Repeated-measures ANOVA and Bonferroni tests were used for statistical analysis (p < 0.05. None of the variables changed in the conscious state. During anaesthesia left-to-right COV increased from 46.8±2.8% in DR to 49.8±2.9% in SR indicating a right shift, and ventral-to-dorsal COV increased from 49.8±1.7% in DR to 51.8±1.1% in LLR indicating a dorsal shift in distribution of ventilation. Recumbency affected distribution of ventilation in anaesthetized but not in conscious dogs. This can be related to loss of respiratory muscle tone (e.g. diaphragm and changes in thoracic shape. Changing position of thoraco-abdominal organs under the EIT belt should be considered as alternative explanation of these findings.

  18. 21 CFR 526.1696a - Penicillin G procaine.

    Science.gov (United States)

    2010-04-01

    ... treatment of mastitis caused by Streptococcus agalactiae, S. dysgalactiae, and S. uberus in lactating cows... of mastitis caused by Streptococcus agalactiae in dry cows. (3) Limitations. Discard all milk for 72... and 061623 in § 510.600(c) of this chapter. (d) Conditions of use in lactating cows—(1) Amount. Infuse...

  19. Colostomy in neonates under local anaesthesia: indications, technique and outcome.

    Science.gov (United States)

    Lukong, Christopher Suiye; Jabo, Basheer Abdullahi; Mfuh, Anita Yafeh

    2012-01-01

    Colostomy is a resuscitative procedure in paediatric surgical practice. In critical patients, mortality may be high, if general anaesthesia is used. Local anaesthesia may be an alternative in this group of neonates. The aim of this article was to evaluate the indications, the technique and outcome of colostomy in neonates under local anaesthesia. A prospective analysis of 38 neonates who had colostomy under local anaesthesia, from July 2008 to September 2011, in our centre. There were 34 boys and 4 girls. The median age was 4 days (range 2-11 days),and all presented in a critical state. The indication for colostomy was anorectal malformation 37 (97.4%) and colonic atresia 1 (2.6%). COLOSTOMY: sigmoid 7 (18.4%), descending 29 (76.3%), transverse 2 (5.3%). The median duration of the procedure was 45 minutes (range 30-60 minutes). The hospital stay was 7-15 days (median 7 days) and cost of treatment 7000-7500 Naira (median 7500 Naira = $50). There were 5 (13.2%) early complications, namely, skin excoriation 2, superficial site infection 2, and bowel evisceration 1; mortality was 2 (5.3%). The late complications were stomal stenosis 1 (2.6%), colostomy diarrhoea 2 (5.3%), and parastomal hernia 2 (5.3%). 25 (65.7%) had colostomy takedown and 13 (34%) were yet to have colostomy takedown. Follow-up was for 1-2 years. None of the patients had a permanent colostomy. Colostomy in neonates under local anaesthesia is feasible, safe and cost-effective. The outcome is good and may be used when neonatal anaesthetic expertise and intensive care facilities are lacking.

  20. Comparison of the anaesthetic efficacy of epinephrine concentrations (1 : 80 000 and 1 : 200 000) in 2% lidocaine for inferior alveolar nerve block in patients with symptomatic irreversible pulpitis: a randomized, double-blind clinical trial.

    Science.gov (United States)

    Aggarwal, V; Singla, M; Miglani, S; Kohli, S

    2014-04-01

    The aim of this randomized controlled, double-blind trial was to comparatively evaluate the anaesthetic efficacy and injection pain of 1.8 mL of 2% lidocaine with different concentrations of epinephrine (1 : 80 000 and 1 : 200 000) in patients with symptomatic irreversible pulpitis. Sixty-two adult volunteers, actively experiencing pain, were randomly allocated into 2 groups and received 1.8 mL of 2% lidocaine with either 1 : 80 000 or 1 : 200 000 epinephrine concentration. Endodontic access preparation was initiated 15 min after the initial IANB. Pain during treatment was recorded using the Heft-Parker visual analogue scale (HP VAS). The primary outcome measure, and the definition of 'success', was the ability to undertake pulp access and canal instrumentation with no or mild pain (HP VAS score <55 mm). Secondary outcome measure was the pain experienced during LA solution deposition. Statistical analysis was performed using Mann-Whitney U-test and chi-square test. The anaesthetic success rates of 2% lidocaine solutions containing 1 : 80 000 and 1 : 200 000 epinephrine concentrations were 20% and 28%, respectively. The difference was not statistically significant. There was also no significant difference in the pain experienced during deposition of the solutions. Two percent lidocaine solution used for IANB achieved similar success rates when used with 1 : 80 000 or 1 : 200 000 epinephrine concentration. © 2013 International Endodontic Journal. Published by John Wiley & Sons Ltd.

  1. Anaesthetic Monitoring - the Pulse Oximeter

    African Journals Online (AJOL)

    peg, which is conveniently clipped to the thumb or finger and connected to a compact battery and mains operated display unit. The finger probe is set to detect the two different wavelengths of reflected light in capillary blood and the display shows the amount of oxy-Hb compared with the sum of the oxy- and de-oxy-Hb ...

  2. The 'simple' general dental anaesthetic

    African Journals Online (AJOL)

    Dental anaesthesia should not be underestimated. Eddie Oosthuizen .... dental surgeon has limited training in airway management. ... primary teeth to hours for extensive dental conservation .... options after the extraction of permanent teeth ...

  3. Anaesthetic management of paediatric adenotonsillectomy

    African Journals Online (AJOL)

    From a risk-benefit perspective, tonsillectomy is an elective ... Potential problems with adenotonsillectomy can be minimised by .... For many children, pain and functional limitation ... pain after tonsillectomy, and time to resumption of oral intake.

  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 sev...

  5. Mucopolysaccharidoses -An Adventurous Anaesthetic Encounter

    Directory of Open Access Journals (Sweden)

    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.

  6. Caesarean section and anaesthetic mortality

    African Journals Online (AJOL)

    Southern African Journal of Anaesthesia and Analgesia is co-published by Medpharm Publications, NISC (Pty) Ltd and Cogent, Taylor & Francis Group. LETTER TO THE EDITOR. Caesarean section and ... births there are 3.1 maternal deaths,2 13 neonatal deaths, 28 infantile deaths and 40 deaths under the age of 5 ...

  7. Analgesic effects of ultrasound-guided transverse abdominis plane block using different volumes and concentrations of local analgesics after laparoscopic cholecystectomy.

    Science.gov (United States)

    Şahin, Ayça Sultan; Ay, Necmiye; Şahbaz, Nuri Alper; Akay, Mehlika Kocabaş; Demiraran, Yavuz; Derbent, Abdurrahim

    2017-02-01

    Objective To evaluate the effects of an ultrasound-guided transverse abdominis plane (US-TAP) block used for postoperative pain relief by comparing the efficacy of two different volumes/concentrations of the local anaesthetic bupivacaine in patients undergoing laparoscopic cholecystectomies. Methods This randomized study enrolled patients undergoing laparoscopic cholecystectomies. They were randomized to two groups: group A received a 20 ml US-TAP block (50 mg bupivacaine +10 ml saline solution) and group B received a 30 ml US-TAP block (50 mg bupivacaine + 20 ml saline solution). The intraoperative consumption of remifentanil, the requirement for postoperative rescue analgesics, patient satisfaction scores, postoperative complications, and postoperative pain as measured by a visual analogue scale at 20 min, 12 h, and 24 h were recorded. Results A total of 60 patients enrolled in the study. There were no differences between the two groups with respect to demographic characteristics, duration of anaesthesia and patient satisfaction scores. The intraoperative consumption of remifentanil, postoperative VAS scores (20 min, 12 h and 24 h) and the requirement for postoperative analgesics were all significantly lower in group B who received a larger volume but a lower concentration of local anaesthetic solution compared with group A. Conclusion A US-TAP block can form part of a balanced postoperative analgesic regimen following laparoscopic cholecystectomy.

  8. Local Stereo Matching Using Adaptive Local Segmentation

    NARCIS (Netherlands)

    Damjanovic, S.; van der Heijden, Ferdinand; Spreeuwers, Lieuwe Jan

    We propose a new dense local stereo matching framework for gray-level images based on an adaptive local segmentation using a dynamic threshold. We define a new validity domain of the fronto-parallel assumption based on the local intensity variations in the 4-neighborhood of the matching pixel. The

  9. Locally Finite Root Supersystems

    OpenAIRE

    Yousofzadeh, Malihe

    2013-01-01

    We introduce the notion of locally finite root supersystems as a generalization of both locally finite root systems and generalized root systems. We classify irreducible locally finite root supersystems.

  10. Decreased spinal synaptic inputs to phrenic motor neurons elicit localized inactivity-induced phrenic motor facilitation

    OpenAIRE

    Streeter, K.A.; Baker-Herman, T.L.

    2014-01-01

    Phrenic motor neurons receive rhythmic synaptic inputs throughout life. Since even brief disruption in phrenic neural activity is detrimental to life, on-going neural activity may play a key role in shaping phrenic motor output. To test the hypothesis that spinal mechanisms sense and respond to reduced phrenic activity, anesthetized, ventilated rats received micro-injections of procaine in the C2 ventrolateral funiculus (VLF) to transiently (~30 min) block axon conduction in bulbospinal axons...

  11. Local duality for 2-dimensional local ring

    Indian Academy of Sciences (India)

    dimensional complete local ring whose residue field is an n-dimensional local field in the sense of. Kato–Parshin. Our results generalize the Saito works in the case n = 0 and are applied to study the Bloch–Ogus complex for such rings in various cases.

  12. Local food and tourism

    DEFF Research Database (Denmark)

    Boesen, Morten; Sundbo, Donna; Sundbo, Jon

    2017-01-01

    This article investigates the question: Why local food networks succeed or fail in collaborating with local tourism actors to create more tourism based on local food? The article focuses on entrepreneurial local food networks and their collaboration with local tourism actors. Emphasis...... is on the actions and attitude logics of local food networks and tourism actors, and whether their respective logics fit as a factor to explain why or why not development of local food concepts lead to increased local tourism. Six local food networks and their collaboration with local tourism actors are studied...... by using observation supplemented with other qualitative methods. Analysis of these networks reveals that successful collaboration is characterised by the food networks and tourism actors having at least one logic in common. The fitting logics that lead to success are primarily celebrity and civic logics...

  13. Defining local food

    DEFF Research Database (Denmark)

    Eriksen, Safania Normann

    2013-01-01

    Despite evolving local food research, there is no consistent definition of “local food.” Various understandings are utilized, which have resulted in a diverse landscape of meaning. The main purpose of this paper is to examine how researchers within the local food systems literature define local...... food, and how these definitions can be used as a starting point to identify a new taxonomy of local food based on three domains of proximity....

  14. Local perturbations perturb—exponentially–locally

    International Nuclear Information System (INIS)

    De Roeck, W.; Schütz, M.

    2015-01-01

    We elaborate on the principle that for gapped quantum spin systems with local interaction, “local perturbations [in the Hamiltonian] perturb locally [the groundstate].” This principle was established by Bachmann et al. [Commun. Math. Phys. 309, 835–871 (2012)], relying on the “spectral flow technique” or “quasi-adiabatic continuation” [M. B. Hastings, Phys. Rev. B 69, 104431 (2004)] to obtain locality estimates with sub-exponential decay in the distance to the spatial support of the perturbation. We use ideas of Hamza et al. [J. Math. Phys. 50, 095213 (2009)] to obtain similarly a transformation between gapped eigenvectors and their perturbations that is local with exponential decay. This allows to improve locality bounds on the effect of perturbations on the low lying states in certain gapped models with a unique “bulk ground state” or “topological quantum order.” We also give some estimate on the exponential decay of correlations in models with impurities where some relevant correlations decay faster than one would naively infer from the global gap of the system, as one also expects in disordered systems with a localized groundstate

  15. New model. Local financing for local energy

    International Nuclear Information System (INIS)

    Detroy, Florent

    2015-01-01

    While evoking the case of the VMH Energies company in the Poitou-Charentes region, and indicating the difference between France and Germany in terms of wind and photovoltaic energy production potential, of number of existing local companies, and of citizen-based funding, this article shows that renewable energies could put the energy production financing in France into question again, with a more important participation of local communities and of their inhabitants. The author describes how the law on energy transition makes this possible, notably with the strengthening of citizen participation. The author evokes some French local experiments and the case of Germany where this participation is already very much developed

  16. Locally analytic vectors in representations of locally

    CERN Document Server

    Emerton, Matthew J

    2017-01-01

    The goal of this memoir is to provide the foundations for the locally analytic representation theory that is required in three of the author's other papers on this topic. In the course of writing those papers the author found it useful to adopt a particular point of view on locally analytic representation theory: namely, regarding a locally analytic representation as being the inductive limit of its subspaces of analytic vectors (of various "radii of analyticity"). The author uses the analysis of these subspaces as one of the basic tools in his study of such representations. Thus in this memoir he presents a development of locally analytic representation theory built around this point of view. The author has made a deliberate effort to keep the exposition reasonably self-contained and hopes that this will be of some benefit to the reader.

  17. Active Neural Localization

    OpenAIRE

    Chaplot, Devendra Singh; Parisotto, Emilio; Salakhutdinov, Ruslan

    2018-01-01

    Localization is the problem of estimating the location of an autonomous agent from an observation and a map of the environment. Traditional methods of localization, which filter the belief based on the observations, are sub-optimal in the number of steps required, as they do not decide the actions taken by the agent. We propose "Active Neural Localizer", a fully differentiable neural network that learns to localize accurately and efficiently. The proposed model incorporates ideas of tradition...

  18. Representative of local committee

    International Nuclear Information System (INIS)

    Barcelo, C.

    2007-01-01

    Carlos Barcelo, spoke about the involvement of local companies in the dismantling project. Local companies realised that they could not undertake the whole project, and informed ENRESA of the tasks in which they would be able to co-operate. On the whole, during the course of the 5-year project the local and regional firms were given more work than they had originally expected. Mr. Barcelo praised the good partnership that evolved between the local firms and the implementer. (author)

  19. Local network assessment

    Science.gov (United States)

    Glen, D. V.

    1985-04-01

    Local networks, related standards activities of the Institute of Electrical and Electronics Engineers the American National Standards Institute and other elements are presented. These elements include: (1) technology choices such as topology, transmission media, and access protocols; (2) descriptions of standards for the 802 local area networks (LAN's); high speed local networks (HSLN's) and military specification local networks; and (3) intra- and internetworking using bridges and gateways with protocols Interconnection (OSI) reference model. The convergence of LAN/PBX technology is also described.

  20. Comparison of pain, cortisol levels, and psychological distress in women undergoing surgical termination of pregnancy under local anaesthesia versus intravenous sedation

    Directory of Open Access Journals (Sweden)

    Stein Dan J

    2007-06-01

    Full Text Available Abstract Background The weight of evidence suggests that women who freely choose to terminate a pregnancy are unlikely to experience significant mental health risks, however some studies have documented psychological distress in the form of posttraumatic stress disorder and depression in the aftermath of termination. Choice of anaesthetic has been suggested as a determinant of outcome. This study compared the effects of local anaesthesia and intravenous sedation, administered for elective surgical termination, on outcomes of pain, cortisol, and psychological distress. Methods 155 women were recruited from a private abortion clinic and state hospital (mean age: 25.4 ± 6.1 years and assessed on various symptom domains, using both clinician-administered interviews and self-report measures just prior to termination, immediately post-procedure, and at 1 month and 3 months post-procedure. Morning salivary cortisol assays were collected prior to anaesthesia and termination. Results The group who received local anaesthetic demonstrated higher baseline cortisol levels (mean = 4.7 vs 0.2, more dissociative symptoms immediately post-termination (mean = 14.7 vs 7.3, and higher levels of pain before (mean = 4.9 vs 3.0 and during the procedure (mean = 8.0 vs 4.4. However, in the longer-term (1 and 3 months, there were no significant differences in pain, psychological outcomes (PTSD, depression, self-esteem, state anxiety, or disability between the groups. More than 65% of the variance in PTSD symptoms at 3 months could be explained by baseline PTSD symptom severity and disability, and post-termination dissociative symptoms. Of interest was the finding that pre-procedural cortisol levels were positively correlated with PTSD symptoms at both 1 and 3 months. Conclusion High rates of PTSD characterise women who have undergone surgical abortions (almost one fifth of the sample meet criteria for PTSD, with women who receive local anaesthetic experiencing more

  1. Comparison of the anaesthetic efficacy of different volumes of 4% articaine (1.8 and 3.6 mL) as supplemental buccal infiltration after failed inferior alveolar nerve block.

    Science.gov (United States)

    Singla, M; Subbiya, A; Aggarwal, V; Vivekanandhan, P; Yadav, S; Yadav, H; Venkatesh, A; Geethapriya, N; Sharma, V

    2015-01-01

    To compare the anaesthetic efficacy of different volumes (1.8 mL vs. 3.6 mL) of 4% articaine with 1 : 100 000 epinephrine injected as buccal infiltrations after a failed inferior alveolar nerve block (IANB) in patients with symptomatic irreversible pulpitis. Two hundred and thirty-four adult patients, diagnosed with irreversible pulpitis in a mandibular tooth, participated in this multicentre, randomized double-blinded trial. Patients received IANB with 1.8 mL of 4% articaine with 1 : 100 000 epinephrine. Pain during treatment was recorded using the Heft-Parker visual analogue scale (HP VAS). The primary outcome measure, and the definition of 'success', was the ability to undertake pulp chamber access and canal instrumentation with no or mild pain (HP VAS score <55 mm). Patients who experienced 'moderate-to-severe' pain (HP VAS score ≥ 55 mm) were randomly allocated into two groups and received buccal infiltrations with either 1.8 mL or 3.6 mL of 4% articaine with 1 : 100 000 epinephrine. Root canal treatment was re-initiated after 10 min. Success was again defined as no pain or weak/mild pain during endodontic access preparation and instrumentation. Statistical analysis was performed using Mann-Whitney U and chi-square tests. The initial IANB of 4% articaine gave an overall success rate of 37%. The success rate of supplementary buccal infiltration with 1.8 and 3.6 mL volumes was 62% and 64%, respectively. The difference between the success rates of the two volumes was not statistically significant. Increasing the volume of 4% articaine with 1 : 100 000 epinephrine from 1.8 to 3.6 mL, given as supplementary buccal infiltrations after a failed primary IANB with 1.8 mL of 4% articaine with 1 : 100 000, did not improve the anaesthetic success rates in patients with symptomatic irreversible pulpitis. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

  2. Local quantum thermal susceptibility

    Science.gov (United States)

    de Pasquale, Antonella; Rossini, Davide; Fazio, Rosario; Giovannetti, Vittorio

    2016-09-01

    Thermodynamics relies on the possibility to describe systems composed of a large number of constituents in terms of few macroscopic variables. Its foundations are rooted into the paradigm of statistical mechanics, where thermal properties originate from averaging procedures which smoothen out local details. While undoubtedly successful, elegant and formally correct, this approach carries over an operational problem, namely determining the precision at which such variables are inferred, when technical/practical limitations restrict our capabilities to local probing. Here we introduce the local quantum thermal susceptibility, a quantifier for the best achievable accuracy for temperature estimation via local measurements. Our method relies on basic concepts of quantum estimation theory, providing an operative strategy to address the local thermal response of arbitrary quantum systems at equilibrium. At low temperatures, it highlights the local distinguishability of the ground state from the excited sub-manifolds, thus providing a method to locate quantum phase transitions.

  3. Local quantum thermal susceptibility

    Science.gov (United States)

    De Pasquale, Antonella; Rossini, Davide; Fazio, Rosario; Giovannetti, Vittorio

    2016-01-01

    Thermodynamics relies on the possibility to describe systems composed of a large number of constituents in terms of few macroscopic variables. Its foundations are rooted into the paradigm of statistical mechanics, where thermal properties originate from averaging procedures which smoothen out local details. While undoubtedly successful, elegant and formally correct, this approach carries over an operational problem, namely determining the precision at which such variables are inferred, when technical/practical limitations restrict our capabilities to local probing. Here we introduce the local quantum thermal susceptibility, a quantifier for the best achievable accuracy for temperature estimation via local measurements. Our method relies on basic concepts of quantum estimation theory, providing an operative strategy to address the local thermal response of arbitrary quantum systems at equilibrium. At low temperatures, it highlights the local distinguishability of the ground state from the excited sub-manifolds, thus providing a method to locate quantum phase transitions. PMID:27681458

  4. Local Worlds of Activation

    DEFF Research Database (Denmark)

    Jacobsson, Kerstin; Hollertz, Katarina; Garsten, Christina

    2017-01-01

    arrangements and the role of private services and actors in service delivery differed significantly too, ranging from strictly market-based forms of governance to classical public administration. The article moreover shows how the different activation approaches were reflected in the radically different usages...... from local politics, established local traditions, patterns of networking and modes of collaborating, as the notion of ‘local words of activation’ intends to capture....

  5. Quantification of local mobilities

    DEFF Research Database (Denmark)

    Zhang, Y. B.

    2018-01-01

    A new method for quantification of mobilities of local recrystallization boundary segments is presented. The quantification is based on microstructures characterized using electron microscopy and on determination of migration velocities and driving forces for local boundary segments. Pure aluminium...... is investigated and the results show that even for a single recrystallization boundary, different boundary segments migrate differently, and the differences can be understood based on variations in mobilities and local deformed microstructures. The present work has important implications for understanding...

  6. Local Social Networks

    DEFF Research Database (Denmark)

    Sapuppo, Antonio; Sørensen, Lene Tolstrup

    2011-01-01

    Online social networks have become essential for many users in their daily communication. Through a combination of the online social networks with opportunistic networks, a new concept arises: Local Social Networks. The target of local social networks is to promote social networking benefits...... in physical environment in order to leverage personal affinities in the users' surroundings. The purpose of this paper is to present and discuss the concept of local social networks as a new social communication system. Particularly, the preliminary architecture and the prototype of local social networks...

  7. Local Estuary Programs

    Science.gov (United States)

    This page provides information about Local Individual Estuary Programs including links to their NEP homepages, social media, Comprehensive Conservation and Management Plans, and state of the bay reports.

  8. Local Exhaust Ventilation

    DEFF Research Database (Denmark)

    Madsen, Ulla; Breum, N. O.; Nielsen, Peter V.

    Capture efficiency of a local exhaust system, e.g. a kitchen hood, should include only contaminants being direct captured. In this study basic concepts of local exhaust capture efficiency are given, based on the idea of a control box. A validated numerical model is used for estimation of the capt......Capture efficiency of a local exhaust system, e.g. a kitchen hood, should include only contaminants being direct captured. In this study basic concepts of local exhaust capture efficiency are given, based on the idea of a control box. A validated numerical model is used for estimation...

  9. Ambulatory laparoscopic tubal ligation: A comparison of general anaesthesia with local anaesthesia and sedation

    Directory of Open Access Journals (Sweden)

    Lokesh Gupta

    2011-01-01

    Full Text Available Background: To compare the anaesthetic techniques for laparoscopic tubal ligation using either general anaesthesia with LMA or a combination of local anaesthetic and intravenous sedation, this study was conducted on 60 ASA-1/2 patients in the age group of 20-40 years. Patients & Methods:60 ASA grade I & II female patients undergoing laparoscopic tubal ligation on a day care basis were randomly divided in two groups- group I (GA using LMA, n=30, group II (Local anaesthesia, n=30. Both groups received similar premedication. General anaesthesia in group I was induced with propofol 2-3 mg kg -1 and following LMA insertion, the anaesthesia was maintained with 0.5-1.5% halothane. In group II the incision site was infiltrated with 10 ml of 1.5% lidocaine with adrenaline and patients were sedated with intravenous midazolam 0.07mg kg -1 and ketamine 0.5 mg kg -1 . A rescue dose of 0.15 mg kg -1 of ketamine was given in group II if the patient complained of pain or discomfort during the procedure. Diclofenac sodium 1 mg kg -1 was used for postoperative analgesia in both the groups. All patients were observed in the PACU until they met the discharge criteria. Results:The demographic profile was similar in both the groups. The induction to skin incision time was significantly more in group I (5.13 ±0.93 min vs 3.01 ±1.86 min in group II. The decrease in pulse rate and blood pressure (systolic and diastolic was also significant in group I. The incidence of intraoperative bradycardia was 16.7% and 10% in group I & group II respectively. The changes in SpO 2 during the procedure, recovery time and time to meet discharge criteria were comparable in both the groups. The incidence of PONV was 20% & 3.3% in group I and 10% & 6.6% in group II respectively. All patients in both the groups required postoperative analgesics. Conclusions:Both the techniques were found to be comparable for laparoscopic sterilization, however a longer induction to skin incision time

  10. Locally orderless registration code

    DEFF Research Database (Denmark)

    2012-01-01

    This is code for the TPAMI paper "Locally Orderless Registration". The code requires intel threadding building blocks installed and is provided for 64 bit on mac, linux and windows.......This is code for the TPAMI paper "Locally Orderless Registration". The code requires intel threadding building blocks installed and is provided for 64 bit on mac, linux and windows....

  11. LOCAL ORGANIZING COMMITTEE

    Indian Academy of Sciences (India)

    Prof. B. B. P. Gupta

    INDIAN ACADEMY OF SCIENCES. Bengaluru. 83rd ANNUAL MEETING. 3–5 November 2017, NEHU, Shillong. LOCAL ORGANIZING COMMITTEE. Local Organizing Committee. 1. Prof. S. K. Srivastava. Chairman. Vice-Chancellor, NEHU, Shillong. 2. Prof. B. B. P. Gupta. Organising Secretary. Department of Zoology ...

  12. Transverse Localization of Light

    NARCIS (Netherlands)

    Raedt, Hans De; Lagendijk, Ad; Vries, Pedro de

    1989-01-01

    We study the propagation of light through a semi-infinite medium with transverse disorder (that is, disorder in two directions only). We show that such a system exhibits strong two-dimensional localization by demonstrating that on propagation a beam expands until the transverse localization length

  13. Local instant conservation equations

    International Nuclear Information System (INIS)

    Delaje, Dzh.

    1984-01-01

    Local instant conservation equations for two-phase flow are derived. Derivation of the equation starts from the recording of integral laws of conservation for a fixed reference volume, containing both phases. Transformation of the laws, using the Leibniz rule and Gauss theory permits to obtain the sum of two integrals as to the volume and integral as to the surface. Integrals as to the volume result in local instant differential equations, in particular derivatives for each phase, and integrals as to the surface reflect local instant conditions of a jump on interface surface

  14. Localizing Expression of Ambiguity

    National Research Council Canada - National Science Library

    Bear, John; Hobbs, Sr, Jerry R

    1987-01-01

    In this paper we describe an implemented program for localizing the expression of many types of syntactic ambiguity, in the logical forms of sentences, in a manner convenient for subsequent inferential processing...

  15. RNA Localization in Astrocytes

    DEFF Research Database (Denmark)

    Thomsen, Rune

    2012-01-01

    , regulation of the blood brain barrier and glial scar tissue formation. Despite the involvement in various CNS functions only a limited number of studies have addressed mRNA localization in astrocytes. This PhD project was initially focused on developing and implementing methods that could be used to asses mRNA......Messenger RNA (mRNA) localization is a mechanism by which polarized cells can regulate protein synthesis to specific subcellular compartments in a spatial and temporal manner, and plays a pivotal role in multiple physiological processes from embryonic development to cell differentiation...... localization in astrocyte protrusions, and following look into the subcellular localization pattern of specific mRNA species of both primary astrocytes isolated from cortical hemispheres of newborn mice, and the mouse astrocyte cell line, C8S. The Boyden chamber cell fractionation assay was optimized, in a way...

  16. Nilpotent -local finite groups

    Science.gov (United States)

    Cantarero, José; Scherer, Jérôme; Viruel, Antonio

    2014-10-01

    We provide characterizations of -nilpotency for fusion systems and -local finite groups that are inspired by known result for finite groups. In particular, we generalize criteria by Atiyah, Brunetti, Frobenius, Quillen, Stammbach and Tate.

  17. Stereotype locally convex spaces

    International Nuclear Information System (INIS)

    Akbarov, S S

    2000-01-01

    We give complete proofs of some previously announced results in the theory of stereotype (that is, reflexive in the sense of Pontryagin duality) locally convex spaces. These spaces have important applications in topological algebra and functional analysis

  18. Stereotype locally convex spaces

    Energy Technology Data Exchange (ETDEWEB)

    Akbarov, S S

    2000-08-31

    We give complete proofs of some previously announced results in the theory of stereotype (that is, reflexive in the sense of Pontryagin duality) locally convex spaces. These spaces have important applications in topological algebra and functional analysis.

  19. Stereotype locally convex spaces

    Science.gov (United States)

    Akbarov, S. S.

    2000-08-01

    We give complete proofs of some previously announced results in the theory of stereotype (that is, reflexive in the sense of Pontryagin duality) locally convex spaces. These spaces have important applications in topological algebra and functional analysis.

  20. Focus on Local Reaction.

    Science.gov (United States)

    Howe, Rod

    1999-01-01

    Discusses how the student newspaper "The Lance" (at Westside High School in Omaha, Nebraska) covered the shootings at Columbine High School. Notes that the staff localized the event and brought the student body into the story. (RS)

  1. Local variances in biomonitoring

    International Nuclear Information System (INIS)

    Wolterbeek, H.Th; Verburg, T.G.

    2001-01-01

    The present study was undertaken to explore possibilities to judge survey quality on basis of a limited and restricted number of a-priori observations. Here, quality is defined as the ratio between survey and local variance (signal-to-noise ratio). The results indicate that the presented surveys do not permit such judgement; the discussion also suggests that the 5-fold local sampling strategies do not merit any sound judgement. As it stands, uncertainties in local determinations may largely obscure possibilities to judge survey quality. The results further imply that surveys will benefit from procedures, controls and approaches in sampling and sample handling, to assess both average, variance and the nature of the distribution of elemental concentrations in local sites. This reasoning is compatible with the idea of the site as a basic homogeneous survey unit, which is implicitly and conceptually underlying any survey performed. (author)

  2. EPR and Bell Locality

    OpenAIRE

    Norsen, Travis

    2004-01-01

    A new formulation of the EPR argument is presented, one which uses John Bell's mathematically precise local causality condition in place of the looser locality assumption which was used in the original EPR paper and on which Niels Bohr seems to have based his objection to the EPR argument. The new formulation of EPR bears a striking resemblance to Bell's derivation of his famous inequalities. The relation between these two arguments -- in particular, the role of EPR as part one of Bell's two-...

  3. Local Governance and Corruption

    OpenAIRE

    Marius PROFIROIU; Tudorel ANDREI; Gheorghe POPESCU; Alina PROFIROIU

    2006-01-01

    This paper attempts to examine, from the Romanian perspective, the degree to which decentralization process and improvement of local governance contributes to the reduction of corruption in the short and medium term. Through the methodology that is used the paper is consistent with the international trend that endeavors to analyze the impact of corruption on economic and social processes at the local level. In addition, recent research on corruption issues has focused upon the measurement of ...

  4. Local E11

    International Nuclear Information System (INIS)

    Riccioni, Fabio; West, Peter

    2009-01-01

    We give a method of deriving the field-strengths of all massless and massive maximal supergravity theories in any dimension starting from the Kac-Moody algebra E 11 . Considering the subalgebra of E 11 that acts on the fields in the non-linear realisation as a global symmetry, we show how this is promoted to a gauge symmetry enlarging the algebra by the inclusion of additional generators. We show how this works in eleven dimensions, and we call the resulting enlarged algebra E 11 local . Torus reduction to D dimensions corresponds to taking a subalgebra of E 11 local , called E 11,D local , that encodes the full gauge algebra of the corresponding D-dimensional massless supergravity. We show that each massive maximal supergravity in D dimensions is a non-linear realisation of an algebra E-tilde 11,D local . We show how this works in detail for the case of Scherk-Schwarz reduction of IIB to nine dimensions, and in particular we show how E-tilde 11,9 local arises as a subalgebra of the algebra E 11,10B local associated to the ten-dimensional IIB theory. This subalgebra corresponds to taking a combination of generators which is different to the massless case. We then show that E-tilde 11,D local appears as a deformation of the massless algebra E 11,D local in which the commutation relations between the E 11 and the additional generators are modified. We explicitly illustrate how the deformed algebra is constructed in the case of massive IIA and of gauged five-dimensional supergravity. These results prove the naturalness and power of the method.

  5. Desempleo y justicia local

    Directory of Open Access Journals (Sweden)

    Elster, Jon

    2003-04-01

    Full Text Available In this paper Jon Elster presents a set of criteria of local justice that regulate dismissals. In situations where work is limited and companies adopt means of employment redundancy, the decision of dismissing certain workers —when this one tries not to be arbitrary— can be based on local criteria of fairness like merit, efficiency, age or other analysed in this work. So, after defining the concept of local justice and presenting some examples, the paper focuses on the importance of the work to organize and structure the life of people. Unemployment has serious consequences for the persons who suffer it and the author advises that it is necessary to subordinate dismissals to criteria of local justice.

    En este artículo se presentan una serie de criterios de justicia local para regular los despidos. En situaciones en las que el trabajo es escaso y las empresas adoptan medidas de regulación de empleo, la decisión de despedir a unos trabajadores o a otros se puede basar, cuando se intenta que no sea arbitraria, en criterios locales de equidad como el mérito, la eficacia, la edad u otros que se analizan en este trabajo. Así, tras definir el concepto de justicia local y presentar algunos ejemplos, el artículo se centra en la importancia del trabajo para organizar y estructurar la vida de la gente. Las graves consecuencias que tiene, por ello, el desempleo para quien lo sufre, aconseja que los despidos se sometan a criterios de justicia local.

  6. Oleotourism: Local Actors for Local Tourism Development

    Directory of Open Access Journals (Sweden)

    Marco Tregua

    2018-05-01

    Full Text Available Olive oil consumption has grown substantially in recent years, due in part to the fact that olive oil is healthy. Much of the global olive oil production comes from the rural areas of Jaén in southern Spain. Surrounding this industry, services such as oleotourism are increasing. This paper aims to identify the key elements supporting the development of oleotourism. After a preliminary exploratory analysis of the existing data, a qualitative analysis was performed with actors directly involved in the industry in Jaén. The results helped us define the level of the stakeholders’ involvement and the sustainability, the opportunities, and the constraints affecting oleotourism in this area. The practical implications of this investigation can be useful for governing agencies, local firms, and the tourism industry in support of oleotourism development.

  7. Tackling Health Inequalities Locally

    DEFF Research Database (Denmark)

    Diderichsen, Finn; Scheele, Christian Elling; Little, Ingvild Gundersen

    of this study. It is based on three sources: 1. Interviews with policymakers (administrators and politicians) within healthcare administrations, childhood/education, and labour market administrations from September 2014 to March 2015*. 2. Textual analysis of available policy documents from regions...... of translating small inequalities in wealth into small inequalities in health. Denmark, Norway and Sweden all have legislation that indifferent ways offers local governments key roles in public health. This is partly due to local governments’ responsibility for many policy areas of great relevance to health...... state model, including its health policy, as an area of Nordic collaboration (104). However, realising the principle of health (equity) in all policiesis no simple matter. The national authorities and local government federations in Denmark, Norway and Sweden have therefore initiated various activities...

  8. Local homotopy theory

    CERN Document Server

    Jardine, John F

    2015-01-01

    This monograph on the homotopy theory of topologized diagrams of spaces and spectra gives an expert account of a subject at the foundation of motivic homotopy theory and the theory of topological modular forms in stable homotopy theory. Beginning with an introduction to the homotopy theory of simplicial sets and topos theory, the book covers core topics such as the unstable homotopy theory of simplicial presheaves and sheaves, localized theories, cocycles, descent theory, non-abelian cohomology, stacks, and local stable homotopy theory. A detailed treatment of the formalism of the subject is interwoven with explanations of the motivation, development, and nuances of ideas and results. The coherence of the abstract theory is elucidated through the use of widely applicable tools, such as Barr's theorem on Boolean localization, model structures on the category of simplicial presheaves on a site, and cocycle categories. A wealth of concrete examples convey the vitality and importance of the subject in topology, n...

  9. Localization of relativistic particles

    International Nuclear Information System (INIS)

    Omnes, R.

    1997-01-01

    In order to discuss localization experiments and also to extend the consistent history interpretation of quantum mechanics to relativistic properties, the techniques introduced in a previous paper [J. Math. Phys. 38, 697 (1997)] are applied to the localization of a photon in a given region of space. An essential requirement is to exclude arbitrarily large wavelengths. The method is valid for a particle with any mass and spin. Though there is no proper position operator for a photon, one never needs one in practice. Causality is valid up to exponentially small corrections. copyright 1997 American Institute of Physics

  10. Control of dynamical localization

    International Nuclear Information System (INIS)

    Gong Jiangbin; Woerner, Hans Jakob; Brumer, Paul

    2003-01-01

    Control over the quantum dynamics of chaotic kicked rotor systems is demonstrated. Specifically, control over a number of quantum coherent phenomena is achieved by a simple modification of the kicking field. These include the enhancement of the dynamical localization length, the introduction of classical anomalous diffusion assisted control for systems far from the semiclassical regime, and the observation of a variety of strongly nonexponential line shapes for dynamical localization. The results provide excellent examples of controlled quantum dynamics in a system that is classically chaotic and offer opportunities to explore quantum fluctuations and correlations in quantum chaos

  11. Local versus national

    DEFF Research Database (Denmark)

    Milan, Christian; Nielsen, Mads Pagh; Bojesen, Carsten

    2014-01-01

    of individual energy supply systems based on on-site weather and building conditions, as well as considering the expected energy consumption profile. However, local planning processes are problematic if they do not take regional or national impacts into account. Given the grid connection, the local building...... solution also has an impact on a national scale by exchanging electricity. Therefore it is important to implement respective grid loads into the planning process in order to avoid technology choices, which might counteract grid stability or cost inefficiencies at other sites. The aim of this paper...

  12. Locality and quantum mechanics.

    Science.gov (United States)

    Unruh, W G

    2018-07-13

    It is argued that it is best not to think of quantum mechanics as non-local, but rather that it is non-realistic.This article is part of a discussion meeting issue 'Foundations of quantum mechanics and their impact on contemporary society'. © 2018 The Author(s).

  13. Extent of local participation

    International Nuclear Information System (INIS)

    Albisu, F.

    1977-01-01

    After a brief historical comment on national participation on past nuclear projects, a description is made of the desirable situation to be achieved as regards local content. The reasons, the procedures and the areas for that participation (i.e., the why, how and where) are suggested, as well as the means to promote it. (orig.) [de

  14. Local Area Networks.

    Science.gov (United States)

    Marks, Kenneth E.; Nielsen, Steven

    1991-01-01

    Discusses cabling that is needed in local area networks (LANs). Types of cables that may be selected are described, including twisted pair, coaxial cables (or ethernet), and fiber optics; network topologies, the manner in which the cables are laid out, are considered; and cable installation issues are discussed. (LRW)

  15. Local government in Ethiopia

    African Journals Online (AJOL)

    LAW

    accompanied by the policy and practice of using local authorities for ... labour and revenue in the form of taxation and tribute for the centre. .... Menilik put under his direct administration the regions which resisted his expansionist move.25 This ...

  16. Local control room

    CERN Multimedia

    CERN PhotoLab

    1972-01-01

    Local control room in the ejection building : all electronics pertaining to proton distribution and concomitants such as beam gymnastics and diagnostics at high energies will eventually be gathered here. Shown is the first of two rows of fast ejection electronic racks. It includes only what is necessary for operation.

  17. Test of Einstein locality

    International Nuclear Information System (INIS)

    Roos, Matts

    1980-11-01

    Einstein locality imples that spacelike separated coherent quantum systems do not interfere, and that all interferences must propagate with at most the speed of light. It then follows that the reaction e + e - →K 0 antiK 0 must yield some Ksub(s)Ksuu(s) decays in apparent violation of P and C conservation. (author)

  18. Beyond local climate

    DEFF Research Database (Denmark)

    D'haen, Sarah Ann Lise; Nielsen, Jonas Østergaard; Lambin, Eric F.

    2014-01-01

    At the household level, nonfarm activities are thought to help rural poor households buffer against agricultural risks related to local climate variability by providing them with cash to buy food in the case of harvest shortfalls. Over the recent decades, households in rural Sub-Sahara have been...

  19. Statistics of Local Extremes

    DEFF Research Database (Denmark)

    Larsen, Gunner Chr.; Bierbooms, W.; Hansen, Kurt Schaldemose

    2003-01-01

    . A theoretical expression for the probability density function associated with local extremes of a stochasticprocess is presented. The expression is basically based on the lower four statistical moments and a bandwidth parameter. The theoretical expression is subsequently verified by comparison with simulated...

  20. Local youth policy

    NARCIS (Netherlands)

    R. Gilsing

    1999-01-01

    Original title: Lokaal jeugdbeleid. Local authorities have been given an important role in youth policy in the Netherlands. They are expected to develop preventive youth policy to increase the opportunities of young people and prevent them dropping out from society. At the request of the

  1. Stroke? Localized, otogenic meningitis!

    DEFF Research Database (Denmark)

    Ingolfsdottir, Harpa Maria; Thomasen, Per Caye

    2011-01-01

    We report the case of a patient admitted with aphasia, treated for a stroke. Subsequently, it was revealed that the symptoms were caused by complicated otitis media with localized meningitis. This case draws attention to the possible intracranial spread of infection when neurological symptoms occur...

  2. Local Governance and Corruption

    Directory of Open Access Journals (Sweden)

    Marius PROFIROIU

    2006-06-01

    Full Text Available This paper attempts to examine, from the Romanian perspective, the degree to which decentralization process and improvement of local governance contributes to the reduction of corruption in the short and medium term. Through the methodology that is used the paper is consistent with the international trend that endeavors to analyze the impact of corruption on economic and social processes at the local level. In addition, recent research on corruption issues has focused upon the measurement of the level of corruption level and on its impact on the growing rate of the GDP (Mauro [1995]1, Abed and Davoodi2, Krueger [1974]3, on the impact upon some of the national economical sectors (Tanzi [1998]4, Shang-Jin Wei [2001]5, or on the decentralization processes (Shah [2006]6.

  3. Cerebral localization in antiquity.

    Science.gov (United States)

    Rose, F Clifford

    2009-07-01

    Fragments of neurology can be found in the oldest medical writings in antiquity. Recognizable cerebral localization is seen in Egyptian medical papyri. Most notably, the Edwin Smith papyrus describes hemiplegia after a head injury. Similar echoes can be seen in Homer, the Bible, and the pre-Hippocratic writer Alcmaeon of Croton. While Biblical writers thought that the heart was the seat of the soul, Hippocratic writers located it in the head. Alexandrian anatomists described the nerves, and Galen developed the ventricular theory of cognition whereby mental functions are classified and localized in one of the cerebral ventricles. Medieval scholars, including the early Church Fathers, modified Galenic ventricular theory so as to make it a dynamic model of cognition. Physicians in antiquity subdivided the brain into separate areas and attributed to them different functions, a phenomenon that connects them with modern neurologists.

  4. Are quasars local

    International Nuclear Information System (INIS)

    Terrell, J.

    1974-01-01

    The problems of interpreting quasars as galaxies, at distances of billions of light-years, seem to be increasing with time and with observational knowledge. The incredibly large energy and brightness requirements, the very small size and thus high surface brightness required by their rapid fluctuations in luminosity, the recently-discovered radio-source separation speeds apparently much greater than the speed of light, their general lack of association with distant galaxies, and many other properties are all very difficult to explain on the basis of cosmological distance. The very local quasar model, involving much less massive and bright objects--perhaps similar to Type O stars--emitted at relativistic speeds by the center of our own galaxy, greatly eases these difficulties. Since such ejected objects also seem necessary to explain the similarly strange properties of radio galaxies, the emission of local quasars from some galaxies might be deduced on this basis alone. (6 figures) (U.S.)

  5. Locality of Temperature

    Science.gov (United States)

    Kliesch, M.; Gogolin, C.; Kastoryano, M. J.; Riera, A.; Eisert, J.

    2014-07-01

    This work is concerned with thermal quantum states of Hamiltonians on spin- and fermionic-lattice systems with short-range interactions. We provide results leading to a local definition of temperature, thereby extending the notion of "intensivity of temperature" to interacting quantum models. More precisely, we derive a perturbation formula for thermal states. The influence of the perturbation is exactly given in terms of a generalized covariance. For this covariance, we prove exponential clustering of correlations above a universal critical temperature that upper bounds physical critical temperatures such as the Curie temperature. As a corollary, we obtain that above the critical temperature, thermal states are stable against distant Hamiltonian perturbations. Moreover, our results imply that above the critical temperature, local expectation values can be approximated efficiently in the error and the system size.

  6. Brane-Localized Gravity

    CERN Document Server

    Mannheim, Philip D

    2005-01-01

    This timely and valuable book provides a detailed pedagogical introduction and treatment of the brane-localized gravity program of Randall and Sundrum, in which gravitational signals are able to localize around our four-dimensional world in the event that it is a brane embedded in an infinitely-sized, higher dimensional anti-de Sitter bulk space. A completely self-contained development of the material needed for brane-world studies is provided for both students and workers in the field, with a significant amount of the material being previously unpublished. Particular attention is given to issues not ordinarily treated in the brane-world literature, such as the completeness of tensor gravitational fluctuation modes, the causality of brane-world propagators, and the status of the massless graviton fluctuation mode in brane worlds in which it is not normalizable.

  7. Local area networking handbook

    OpenAIRE

    O'Hara, Patricia A.

    1990-01-01

    Approved for public release; distribution is unlimited. This thesis provides Navy shore based commands with sufficient information on local area networking to (1) decide if they need a LAN, (2) determine what their networking requirements are, and (3) select a LAN that satisfies their requirements. LAN topologies, transmission media, and medium access methods are described. In addition, the OSI reference model for computer networking and the IEEE 802 LAN standards are explained in detail. ...

  8. Rationalising localism and brokerage

    DEFF Research Database (Denmark)

    Kusche, Isabel

    2017-01-01

    . The article employs the notion of global scripts and the concept of domestication of global trends in order to analyse how the question of the appropriate relationship between deputies and voters is informed both by a general trend towards the professionalisation of politicians and a domestic tradition...... of the domestic setting on the other. In this way the article contributes to a better understanding of the entanglement of the global and the local....

  9. Local dependency in networks

    Directory of Open Access Journals (Sweden)

    Kudĕlka Miloš

    2015-06-01

    Full Text Available Many real world data and processes have a network structure and can usefully be represented as graphs. Network analysis focuses on the relations among the nodes exploring the properties of each network. We introduce a method for measuring the strength of the relationship between two nodes of a network and for their ranking. This method is applicable to all kinds of networks, including directed and weighted networks. The approach extracts dependency relations among the network’s nodes from the structure in local surroundings of individual nodes. For the tasks we deal with in this article, the key technical parameter is locality. Since only the surroundings of the examined nodes are used in computations, there is no need to analyze the entire network. This allows the application of our approach in the area of large-scale networks. We present several experiments using small networks as well as large-scale artificial and real world networks. The results of the experiments show high effectiveness due to the locality of our approach and also high quality node ranking comparable to PageRank.

  10. Local orbit feedback

    International Nuclear Information System (INIS)

    Anon.

    1991-01-01

    Critically aligned experiments are sensitive to small changes in the electron beam orbit. At the NSLS storage rings, the electron beam and photon beam motions have been monitored over the past several years. In the survey conducted in 1986 by the NSLS Users Executive Committee, experimenters requested the vertical beam position variation and the vertical angle variation, within a given fill, remain within 10 μm and 10 μr, respectively. This requires improvement in the beam stability by about one order of magnitude. At the NSLS and SSRL storage rings, the beam that is originally centered on the position monitor by a dc orbit correction is observed to have two kinds of motion: a dc drift over a storage period of several hours and a beam bounce about its nominal position. These motions are a result of the equilibrium orbit not being held perfectly stable due to time-varying errors introduced into the magnetic guide field by power supplies, mechanical vibration of the magnets, cooling water temperature variations, etc. The approach to orbit stabilization includes (1) identifying and suppressing as many noise sources on the machine as possible, (2) correcting the beam position globally (see Section 6) by controlling a number of correctors around the circumference of the machine, and (3) correcting the beam position and angle at a given source location by position feedback using local detectors and local orbit bumps. The third approach, called Local Orbit Feedback will be discussed in this section

  11. Local variances in biomonitoring

    International Nuclear Information System (INIS)

    Wolterbeek, H.T.

    1999-01-01

    The present study deals with the (larger-scaled) biomonitoring survey and specifically focuses on the sampling site. In most surveys, the sampling site is simply selected or defined as a spot of (geographical) dimensions which is small relative to the dimensions of the total survey area. Implicitly it is assumed that the sampling site is essentially homogeneous with respect to the investigated variation in survey parameters. As such, the sampling site is mostly regarded as 'the basic unit' of the survey. As a logical consequence, the local (sampling site) variance should also be seen as a basic and important characteristic of the survey. During the study, work is carried out to gain more knowledge of the local variance. Multiple sampling is carried out at a specific site (tree bark, mosses, soils), multi-elemental analyses are carried out by NAA, and local variances are investigated by conventional statistics, factor analytical techniques, and bootstrapping. Consequences of the outcomes are discussed in the context of sampling, sample handling and survey quality. (author)

  12. New Communication Technologies, Local Journalism and the Perception of Locality

    Directory of Open Access Journals (Sweden)

    Ali ÖZCAN

    2016-12-01

    Full Text Available Studies on local journalism as an important element of participatory democracy generally focus on the history of the local press, the financial insufficiencies of local newspapers as well as technical/ technological incompetency that occurs as a result of these factors. This research analyzes local newspapers with a new scientific point of view by focusing on the perception of locality as a mental projection of geographical constraint. Perspectives regarding the transformations on perceptions of locality as a result of the disappearance of time and space constraints due to new communication technologies, and the opportunities that new communication environments offer to local newspapers will be provided. Moreover, the ways in which local newspapers reflect on locality with their printed versions under time and space constraints will be analyzed. The research scope of the study has been limited to 15 newspapers in Konya. Structured interviews and content analysis methods were used for data collection and analysis.

  13. Particle localization detector

    International Nuclear Information System (INIS)

    Allemand, R.

    1976-01-01

    A proportional detector for the localization of particles comprises a leak-tight chamber filled with fluid and fitted with an electrode of a first type consisting of one or more conducting wires and with an electrode of a second type consisting of one or more conducting plates having the shape of a portion of cylindrical surface and a contour which provides a one-to-one correspondence between the position of a point of the wires and the solid angle which subtends the plate at that point, means being provided for collecting the electrical signal which appears on the plates. 12 Claims, 10 Drawing Figures

  14. 'Think globally, act locally'

    DEFF Research Database (Denmark)

    Hoff, Jens Villiam

    2015-01-01

    This chapter argues that citizen participation in environmental and climate policies has moved through four phases from the early 1960s until today. The most recent phase is characterised by a ‘reorientation towards the local’, a move which is increasingly supported by actors at both national...... and international levels. For local governments, the task of initiating or facilitating citizen action concerning climate change mitigation has generated the development of new policy instruments that increasingly target people’s everyday lives, homes and workplaces. Examples of the use of these new policy...

  15. Localization of CANDU technology

    Energy Technology Data Exchange (ETDEWEB)

    Alizadeh, Ala

    2010-09-15

    The CANDU pressurized heavy water reactor's principal design features suit it particularly well for technology transfer and localization. When the first commercial CANDU reactors of 540 MWe entered service in 1971, Canada's population of less than 24 million supported a 'medium' level of industrial development, lacking the heavy industrial capabilities of larger countries like the USA, Japan and Europe. A key motivation for Canada in developing the CANDU design was to ensure that Canada would have the autonomous capacity to build and operate nuclear power reactors without depending on foreign sources for key components or enriched fuel.

  16. Localized Acoustic Surface Modes

    KAUST Repository

    Farhat, Mohamed

    2015-08-04

    We introduce the concept of localized acoustic surface modes (ASMs). We demonstrate that they are induced on a two-dimensional cylindrical rigid surface with subwavelength corrugations under excitation by an incident acoustic plane wave. Our results show that the corrugated rigid surface is acoustically equivalent to a cylindrical scatterer with uniform mass density that can be represented using a Drude-like model. This, indeed, suggests that plasmonic-like acoustic materials can be engineered with potential applications in various areas including sensing, imaging, and cloaking.

  17. Local analytic geometry

    CERN Document Server

    Abhyankar, Shreeram Shankar

    1964-01-01

    This book provides, for use in a graduate course or for self-study by graduate students, a well-motivated treatment of several topics, especially the following: (1) algebraic treatment of several complex variables; (2) geometric approach to algebraic geometry via analytic sets; (3) survey of local algebra; (4) survey of sheaf theory. The book has been written in the spirit of Weierstrass. Power series play the dominant role. The treatment, being algebraic, is not restricted to complex numbers, but remains valid over any complete-valued field. This makes it applicable to situations arising from

  18. Immuno-localization of galanin receptor-1 (GALR1) in rat brain

    International Nuclear Information System (INIS)

    Larm, J.M.; Gundlach, A.L.

    2002-01-01

    Full text: Galanin is expressed in discrete areas throughout the central nervous system and has several putative physiological actions including effects on hormone secretion, reproduction and cognition, via actions at multiple G-protein-coupled receptors. Currently, three galanin receptors - GalR1, -R2, -R3 - have been identified that differ in pharmacology, signalling and distribution. The distribution of [ 125 I]-galanin binding sites presumably represents multiple receptors and so the precise regional and cellular localization of each receptor subtype is unknown. This study examined the distribution in rat brain of GalR1 receptors by immunohistochemistry, using polyclonal antibodies raised against short peptide sequences from the third intracellular loop and the proximal C-terminal. Adult rats were deeply anaesthetized (pentobarbitone 60 mg/kg, ip.) and perfusion-fixed with 4% paraformaldehyde. Specific GalR1 immunoreactivity (IR) was detected in neurons in various brain regions including cells within the olfactory bulb, piriform cortex, dorsomedial thalamus, hypothalamus (PVN, SON, ARC), midbrain/pons (intense staining in ventrolateral/medial PAG) and medulla. The localization pattern was qualitatively similar with both antisera and was consistent with that observed for GalR1 mRNA in normal rat brain. Recent evidence also reveals that GalR1- mRNA and -IR levels are coordinately altered after neuronal stimulation. These studies demonstrate a method for the identification of GalR1-containing cells that should assist in better differentiating the phenotype of galanin-receptive neurons. Copyright (2002) Australian Neuroscience Society

  19. Automatic localization of the da Vinci surgical instrument tips in 3-D transrectal ultrasound.

    Science.gov (United States)

    Mohareri, Omid; Ramezani, Mahdi; Adebar, Troy K; Abolmaesumi, Purang; Salcudean, Septimiu E

    2013-09-01

    Robot-assisted laparoscopic radical prostatectomy (RALRP) using the da Vinci surgical system is the current state-of-the-art treatment option for clinically confined prostate cancer. Given the limited field of view of the surgical site in RALRP, several groups have proposed the integration of transrectal ultrasound (TRUS) imaging in the surgical workflow to assist with accurate resection of the prostate and the sparing of the neurovascular bundles (NVBs). We previously introduced a robotic TRUS manipulator and a method for automatically tracking da Vinci surgical instruments with the TRUS imaging plane, in order to facilitate the integration of intraoperative TRUS in RALRP. Rapid and automatic registration of the kinematic frames of the da Vinci surgical system and the robotic TRUS probe manipulator is a critical component of the instrument tracking system. In this paper, we propose a fully automatic registration technique based on automatic 3-D TRUS localization of robot instrument tips pressed against the air-tissue boundary anterior to the prostate. The detection approach uses a multiscale filtering technique to identify and localize surgical instrument tips in the TRUS volume, and could also be used to detect other surface fiducials in 3-D ultrasound. Experiments have been performed using a tissue phantom and two ex vivo tissue samples to show the feasibility of the proposed methods. Also, an initial in vivo evaluation of the system has been carried out on a live anaesthetized dog with a da Vinci Si surgical system and a target registration error (defined as the root mean square distance of corresponding points after registration) of 2.68 mm has been achieved. Results show this method's accuracy and consistency for automatic registration of TRUS images to the da Vinci surgical system.

  20. Pattern Driven Stress Localization

    Science.gov (United States)

    Croll, Andrew; Crosby, Alfred

    2010-03-01

    The self-assembly of patterns from isotropic initial states is a major driver of modern soft-matter research. This avenue of study is directed by the desire to understand the complex physics of the varied structures found in Nature, and by technological interest in functional materials that may be derived through biomimicry. In this work we show how a simple striped phase can respond with significant complexity to an appropriately chosen perturbation. In particular, we show how a buckled elastic plate transitions into a state of stress localization using a simple, self-assembled variation in surface topography. The collection of topographic boundaries act in concert to change the state from isotropic sinusoidal wrinkles, to sharp folds or creases separated by relatively flat regions. By varying the size of the imposed topographic pattern or the wavelength of the wrinkles, we construct a state diagram of the system. The localized state has implications for both biological systems, and for the control of non-linear pattern formation.