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  • 1
    Electronic Resource
    Electronic Resource
    Dose-response relationship and time course of action of Org 9426 (1991)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 46 (1991), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The dose-response relationship of Org 9426, its time course of action and the reversibility of the residual block by neostigmine have been investigated in 100 patients undergoing various anaesthetic techniques. The dose-response was measured immediately following induction of anaesthesia. Doses of Org 9426, required for 50% and 90% depression of the twitch height, were 202 and 328 μg.kg−1, respectively. The clinical duration of the maintenance doses, 150 μg.kg−1, ranged from 9.5 to 13.4 min and from 12.8 to 18.9 min for the first and fifth maintenance doses, respectively. Spontaneous recovery indices (25%-75%) were between 9.5 and 16.7 min; neostigmine methylsulphate administered at 25% recovery of the twitch height promptly reversed the residual block. No side effects were observed. The extent of the influence of the anaesthetic on the time course of Org 9426 appears to be fractional considering the variation of the time course within the separate groups.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1991.tb09843.x
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  • 2
    Electronic Resource
    Electronic Resource
    Alfentanil infusion in the elderly (1988)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 43 (1988), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The use of a computer-assisted infusion of alfentanil, combined with 66% nitrous oxide in oxygen, for induction and maintenance of anaesthesia was evaluated in IS elderly patients. The target alfentanil concentration for induction was varied between 300 and 475 ng/ml, to be achieved in 2 minutes. During maintenance, the alfentanil concentration was increased or decreased according to each patient's responses. Arterial blood samples were taken for measurement of alfentanil concentration. There were high incidences of muscle rigidity, bradycardia and hypotension during induction. Hypotension was dose- and concentration-dependent. Signs of light anaesthesia during maintenance were controlled rapidly by increasing the target plasma concentration. Nine patients required naloxone at the end of surgery. Ventilatory depression recurred in three of these. The use of published alfentanil pharmacokinetic data from elderly patients to predict plasma concentrations during prolonged infusion resulted in significant prediction errors, notably in the higher concentration range.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1988.tb05598.x
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  • 3
    Electronic Resource
    Electronic Resource
    The accuracy of trained nurses in pre-operative health assessment: results of the OPEN study (2004)
    Oxford, UK : Blackwell Science Ltd
    Anaesthesia 59 (2004), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: We quantified the accuracy of trained nurses to correctly assess the pre-operative health status of surgical patients as compared to anaesthetists. The study included 4540 adult surgical patients. Patients' health status was first assessed by the nurse and subsequently by the anaesthetist. Both needed to answer the question: ‘is this patient ready for surgery without additional work-up, Yes/No?’ (primary outcome). The secondary outcome was the time required to complete the assessment. Anaesthetists and nurses were blinded for each other's results. The anaesthetists' result was the reference standard. In 87% of the patients, the classifications by nurses and anaesthetists were similar. The sensitivity of the nurses' assessment was 83% (95% CI: 79–87%) and the specificity 87% (95% CI: 86–88%). In 1.3% (95% CI: 1.0–1.6%) of patients, nurses classified patients as ‘ready’ whereas anaesthetists did not. Nurses required 1.85 (95% CI: 1.80–1.90) times longer than anaesthetists. By allowing nurses to serve as a diagnostic filter to identify the subgroup of patients who may safely undergo surgery without further diagnostic workup or optimisation, anaesthetists can focus on patients who require additional attention before surgery.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.2004.03858.x
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  • 4
    Electronic Resource
    Electronic Resource
    Non-drug related asystole associated with anaesthetic induction (1991)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 46 (1991), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: A patient is presented where routine venepuncture associated with anaesthetic induction resulted in bradycardia and asystole. The case highlights the need for special caution with, and ECG monitoring throughout induction for, patients with a history of syncope. It also demonstrates the need for caution when attributing cardiovascular events during induction to the effect of the induction agents used.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1991.tb09313.x
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  • 5
    Electronic Resource
    Electronic Resource
    Alfentanil requirement in Crohn's disease (1989)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 44 (1989), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The dose requirement of alfentanil as a supplement to nitrous oxide anaesthesia was studied in 13 patients with Crohn's disease and seven control patients all of whom underwent laparotomy. Alfentanil was administered as a variable rate infusion with supplemental bolus injections titrated to the patient's needs. The alfentanil requirement was independent of the duration of surgery and was significantly higher in patients with Crohn's disease than in control patients. The results indicate that Crohn's disease alters the dose requirement of alfentanil.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1989.tb11224.x
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  • 6
    Electronic Resource
    Electronic Resource
    A case of malignant hyperthermia? (1991)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 46 (1991), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: An acute episode of a malignant hyperthermia-like syndrome is described which occurred after suxamethonium and isoflurane anaesthesia in a 41-year-old healthy male patient undergoing a minor elective hand operation. Dantrolene therapy rapidly reversed the life-threatening signs. Laboratory results appeared to confirm the suspicion of malignant hyperthermia. However, the in vitro contracture test, which was carried out according to the standards of the European Malignant Hyperthermia Group, was equivocal.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1991.tb09854.x
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  • 7
    Electronic Resource
    Electronic Resource
    Cholescintigraphy with99mTc-diethyl-IDA for the detection of rejection of auxiliary liver transplants in pigs (1983)
    Springer
    European journal of nuclear medicine 8 (1983), S. 485-488 
    Details
    ISSN: 1619-7089
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In 15 pigs an auxiliary liver was transplanted and cholescintigraphy with99mTc-diethyl-IDA was performed to study the function of the livers separately. Serial scintigraphy of the recipient and donor liver was performed on days 3, 8 and 18 after transplantation and time-activity curves over 1 h after injection of the radio-tracer were generated for each liver. From these data the time at which the maximal activity was present in the liver (T max) and the time at which during the excretion phase half of this activity was still present in the organ (T 1/2) were determined. Liver biopsy material from the recipient liver and the donor liver was obtained at (approximately) the day of one of the scintigraphic examinations and at autopsy. In all cases no histological abnormalities were found in the recipient liver. In 4 pigs there were no histological signs of rejection of the donor liver, in which cases the values forT max andT 1/2 were normal. In 11 pigs histological signs of rejection were noticed and in all of these casesT 1/2 was significantly prolonged, whereas no changes inT max were observed. Cholescintigraphy revealed an abnormal value forT 1/2 a few days before the biopsy was taken in 10 of these 11 cases. Normal functioning or the prediction of rejection of the auxiliary liver transplant in pigs correlated significantly (P〈0.01) with normal or prolongedT 1/2 values. It is concluded that cholescintigraphy may be helpful in establishing the diagnosis of rejection of liver transplants.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00598906
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  • 8
    Electronic Resource
    Electronic Resource
    Abstracts of Dutch Ph.D. Theses (1985)
    Springer
    Pharmacy world & science 7 (1985), S. 219-224 
    Details
    ISSN: 1573-739X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02307580
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  • 9
    Electronic Resource
    Electronic Resource
    Is unified monitoring improving patient care? (1988)
    Springer
    Journal of clinical monitoring and computing 4 (1988), S. 167-174 
    Details
    ISSN: 1573-2614
    Keywords: Equipment: computers, anesthesia monitoring systems
    Source: Springer Online Journal Archives 1860-2000
    Topics: Computer Science , Medicine
    Notes: Abstract We compared our standard method of data presentation in the operating room (i.e., using “front end” equipment) with a newly developed, computerized monitoring system called the data acquisition and display system. These two systems differed in that data presentation using the standard front-end equipment was scattered and poorly structured, whereas data obtained from the newly developed system were unified and integrated. To effect the comparison, we examined the “controllability” (i.e., the precision of control) by the anesthesiologist of hemodynamic variables: arterial systolic, mean, and diastolic pressures, mean pulmonary artery pressure, mean central venous pressure, and heart rate. Controllability was assumed to be an indictor of the quality of anesthesia. All perioperative data were stored every 15 seconds on a floppy disk, and these data were available for analysis. The controllability was quantified by calculating the surface area of the signal of a variable outside a defined control zone; the smaller this surface area, the greater the controllability. A Mann-Whitney-Wilcoxon statistical test was done to test whether the two different data presentation systems would result in different levels of controllability (the first zero hypothesis). A Kruskal-Wallis test was done to examine the “inter-anesthesiologist variability” between the two systems (the second zero hypothesis). Our data showed great variability. Looking for factors that might explain this, we found that if preoperative systolic blood pressure was greater than 160 mm Hg and diastolic pressure was greater than 95 mm Hg, hemodynamic variables fluctuated more widely. We could show no differences in controllability when the two systems were compard overall. However, we did see a trend toward a difference in controllability among different anesthesiologists using the data acquisition and display system.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01621811
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