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  • 1
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 44 (1989), S. 0 
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Four groups of 20 patients each received either vecuronium or atracurium together with either glycopyrronium or saline, and underwent anaesthesia free of vagolytic drugs, and surgery devoid of vagal activity. Determinations of plasma histamine concentrations were made to examine the possible correlation between these levels and changes in heart rate and blood pressure as well as a possible relationship with skin reactions after the administration of the relaxants. Patients who received vecuronium without the anticholinergic drug, glycopyrronium, showed a greater tendency towards bradycardia (though not statistically significant) than those given atracurium. More cutaneous reactions were observed with patients who received atracurium than in those with vecuronium, but there was no correlation with plasma histamine concentrations of either relaxant group. There was no correlation either between histamine concentrations and heart rate or blood pressure associated with atracurium. The incidence of bradycardia with either relaxant is low if the anaesthetic technique and the surgery are devoid of vagal activity.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 39 (1984), S. 0 
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Thymol may accumulate in halothane vaporizers and influence their accuracy. We determined the thymol concentration in residual liquid halothane of 28 vaporizers in regular use. Two halothane samples were brownish, probably due to a long exposure to light and irregular drainage. Irregularly drained vaporizers contained higher thymol concentrations than those drained weekly (p 〈 0.05). The highest individual thymol concentration was 19 times that found in fresh halothane. Halothane vapour concentration deviated most from setting in Fluotec Mark II vaporizers, but this did not correlate with thymol concentrations in halothane liquid. The need for weekly drainage and regular service of halothane vaporizers is stressed.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 51 (1996), S. 0 
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The knee-chest position for lumbar spine surgery is favoured because decreased filling of the epidural veins is associated with reduced peroperative bleeding. However, the position may be unfavourable from a circulatory point of view. In the present study, non-invasive assessment of circulation in the lower limbs was performed in 21 unanaesthetised, healthy volunteers who were placed in the surgical knee-chest position. Measurements included blood flow velocity (colour Doppler ultrasonography), oscillotonometric arterial blood pressure from upper and lower limbs and pulse oximetry from a toe. There was a statistically significant reduction in the posterior tibial artery flow velocity, maximally 31.6%, when the subject was moved from the prone to the knee-chest position. An enlargement of the trunk-femoral angle at the hip did not improve arterial flow. In 10 of the 21 volunteers, no flow in the posterior tibial vein was detected in the knee-chest position. In spite of the deteriorated blood flow, pulse oximetry indicated sufficient capillary flow in the very periphery of the lower limb. The change from prone to knee-chest position resulted in an increase in arterial blood pressure of the upper limb; the increase in diastolic arterial pressure was statistically significant (p 〈 0.001). It is concluded that the surgical knee-chest position involves deterioration of both the arterial and venous flow of the lower limbs. This should be considered in patients undergoing surgery in this position and, in particular, in those at risk of developing cardiovascular complications.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 48 (1993), S. 0 
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: In a double-blind, randomised study of patients scheduled for minor hand surgery 0.5% 2-chloroprocaine (n = 30) and 0.5% prilocaine (n = 30) in a volume of 40 ml were compared for intravenous regional anaesthesia. The onset of sensory and motor block and recovery of sensory block were determined, and the occurrence of side-effects was noted. Twenty-four patients in the 2-chloroprocaine group and 17 in the prilocaine group developed complete sensory block by 15 min after injection (p 〈 0.05). Complete recovery of sensation was faster after prilocaine (7.1 min) than 2-chloroprocaine (9.8 min) (p〈0.01). Venous irritation and/or urticaria after tourniquet release was observed on 10 occasions in those receiving 2-chloroprocaine and twice in those receiving prilocaine. An increase in heart rate of 〉 20% above control values occurred in three patients, all of whom had been given 2-chloroprocaine. Clinically, local anaesthetic properties of 0.5% 2-chloroprocaine and prilocaine were similar, but there were more side-effects with the former drug.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 39 (1984), S. 0 
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The antipyrine (phenazone) half-life was determined in 20 surgical patients to discover whether there are changes in hepatic metabolic rate during or immediately after anasthesia compared with the pre-anasthetic rate. Nine patients received enflurane (mean duration 8.6, SD 2.0 hours) and six patients had a balanced anasthetic without enflurane (duration 4.4, SD 3.3 hours). A further five patients received a spinal anasthetic with bupivacaine. The changes in antipyrine half-life were inconsistent, and there was no evidence of competitive metabolic inhibition, by general anasthesia. Antipyrine half-lives did not correlate with serum fluoride levels or urinary fluoride excretion in the case of enflurane. The mean serum inorganic fluoride concentrution rose to 29 μmol/litre, and two patients had potentially nephrotoxic concentrations (64 and 50 μmol/litre) after 8 hours of exposure to enflurane though without any evident harmful effects.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 47 (1992), S. 0 
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Ten healthy male volunteers received intravenous regional anaesthesia of the upper limb on two separate occasions using 40 ml of 0.5% prilocaine or 40 ml plain 0.5% chloroprocaine by random allocation. Using a double-blind method, the onset and recovery of sensory block was tested (pinprick) in the four main nerve areas. The onset and recovery of motor block was measured by squeezing a rubber balloon connected to a manometer. The symptoms after deflation of the tourniquet were recorded. Seven volunteers in both groups developed total anaesthesia in 20 min. Complete motor block occurred in 12.3 min with prilocaine and 11.3 min with chloroprocaine. Sensation recovered in all areas in 7.6 min with prilocaine and 10.0 min with chloroprocaine (ns). Motor function recovered in 8.4 and 12.0 min respectively (p 〈 0.01). Six volunteers in the chloroprocaine group showed signs of venous irritation and/or antecubital urticaria in the test arm for 30–45 min after the deflation. Four volunteers in the chloroprocaine group had increased in heart rate (〉20%) and one of them short periods ofjunctional rhythm during the first 2 min after tourniquet deflation. Mild, short-lived Cns side effects occurred in both groups.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The effect of the addition of 0.1 mg or 0.2 mgfentanyl to 40 ml 0.5% prilocaine in intravenous regional anaesthesia of the arm was investigated in 37 patients in a randomised, double-blind study. The characteristics of the sensory and motor block were studied. There was no difference in the speed of onset of analgesia in the groups (mean latency approximately 4 min in each group). However, significantly more patients in thefentanylO.2 mg group (7/12) had complete anaesthesia at 15 min than in the fentanyl 0.1 mg group (1/13) and the control group (2/12) (p 〈 0.05). There were no differences in the incidence of tourniquet pain immediately before cuff deflation (tourniquet time 45–87 min). After cuff deflation, in those patients who complained of wound pain within 30 min, on average the pain appeared later in the fentanyl 0.2 mg group (six patients, mean 14.3 min) than in the control group (eight patients, mean 9.4 min) (ns). In the fentanyl groups, the incidence of central nervous system side effects was greater than in the control group (fentanyl 0.1 mg 7/13 patients, fentanyl 0.2 mg 6/12 patients, control 1/12 patients) (p 〈 0.05). The plasma concentrations of prilocaine after cuff deflation were higher, in a dose-dependent fashion, in the fentanyl groups than in the control group, but the concentrations of prilocaine and fentanyl did not correlate with the symptoms. Postoperative nausea occurred only in the patients who had received fentanyl.
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 44 (1989), S. 0 
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The effects of different techniques of exsanguination of the upper arm during intravenous regional anaesthesia on prilocaine plasma concentrations, quality of anaesthesia, toxic symptoms after dejation of the tourniquet and injection pressure of the anaesthetic were studied in 10 healthy male volunteers. The nondominant arm was exsanguinated using either Esmarch's bandage or elevation of the arm for 2 minutes plus arterial occlusion by compression of the brachial artery. The injection pressure after the prilocaine dose (3 mg/kg) was signijcantly higher in the elevation group (maximally 98 mmHg). There were no statistically signijcant differences in the onset of, or recovery from, anaesthesia between the groups. Various mild toxic symptoms, were experienced in the central nervous system after dejation of the tourniquet. However, there was no correlation between the two techniques and the degree of severity of the toxic symptoms. The highest single venous plasma concentration (total) of prilocaine was 2.3 pgcglml measured from the contralateral cubital vein (elevation group, 2 minutes). The differences in prilocaine concentrations between the groups were not statistically significant.
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 43 (1988), S. 0 
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Propofol and methohexitone given in equipatent doses were compared for anaesthesia for thermocoagulation of trigeminal rootlets. Thirty-eight patients received two to six injections of the induction agents in one therapy session. The increase in arterial blood pressure during coagulation was significantly lower in the propofol group. Respiratory problems were encountered more often in those who received methohexitone (7/19 patients) than propofol (2/19 patients). There was a small but significant increase in blood propofol concentrations as well as in methohexitone plasma concentrations after repeated injections. Individual wake-up times increased to a statistically significant extent in relation to the number of doses of the induction agent but the increases were clinically unimportant (maximal mean change approximately 2 minutes). There were no differences in wake-up times between the two anaesthetic groups.
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 42 (1987), S. 0 
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: A perivascular catheter technique (PVT) and a nerve stimulator technique (NST) for axillary brachial plexus block were compared in terms of quality: complete, incomplete or failed blocks. In a randomised series, 30 PVT blocks and 30 NST blocks were performed by three staff anaesthetists. In the NST group, surgical anaesthesia was always achieved, whereas in the PVT group, four blocks required supplementation with general anaesthesia. In both groups eight patients needed supplementation with addilioncd conduction blocks of 1–3 peripheral nerves. It is concluded that a nerve stimulator technique may increase the success rate of axillary brachial plexus block to some extent.
    Type of Medium: Electronic Resource
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