PURPOSE: To describe the relative effects of graded central nervous system (CNS) depression, using increasing propofol infusion rates, on neurovegetative brainstem-mediated circulatory control mechanisms and higher cortical activity in healthy humans. METHODS: Propofol was administered using an infusion scheme designed to achieve three target blood concentrations in ten healthy volunteers. ...

The cardiac response to intravenous adenosine 112 micrograms kg-1 was studied in 16 patients scheduled for coronary artery bypass surgery before and during anaesthesia with 1% end-tidal isoflurane and fentanyl 10 micrograms kg-1. Mean time from injection to onset of adenosine-induced PR prolongation was significantly greater during anaesthesia (12.8 (SD ...

BACKGROUND AND OBJECTIVES: Intrathecal fentanyl with bupivacaine provides rapid labor analgesia of limited duration. We investigated the effect of initiating an epidural infusion of 0.1% ropivacaine with fentanyl 2 microg/mL and epinephrine 1:400,000 (REF) on the duration of analgesia and incidence of side effects after intrathecal injection in the combined ...

We compared the effects of the lightwand technique on hemodynamic responses, time-to-intubation, number of attempts, and complications during tracheal intubation with those of direct-vision laryngoscopy in normotensive (LN and TN group; n = 20, respectively) and hypertensive (LH and TH group; n = 20, respectively) patients. Lightwand or laryngoscopic oral ...

PURPOSE: The aim of this study was to compare the efficacy of nicardipine and lidocaine in attenuation of cardiovascular responses to endotracheal intubation. METHODS: In a randomized, double-blind, controlled trial, 60 unpremedicated (ASA I) patients undergoing elective surgery were given either 30 microg.kg(-1) nicardipine or 1.5 mg.kg(-1) lidocaine intravenously 2 ...

PURPOSE: The aim of this study was to evaluate the effects of propofol and alfentanil on the increase in intraocular pressure (IOP) due to succinylcholine and intubation, in comparison with thiopental sodium and vecuronium bromide. METHODS: Forty patients aged 20-50 years, scheduled for elective surgery requiring endotracheal intubation, were assigned ...

Physiological homeostatic mechanisms and interventions by anaesthetists attempt to moderate excessive change in many biological variables during anaesthesia. These mechanisms may have fast or slow response times. This study describes how mean arterial blood pressure changes with time and how the change is dependent upon the pre-existing blood pressure. The ...

BACKGROUND: Propofol has been advocated for sedation in intensive care because of superior recovery characteristics. We hypothesised that the use of two totally different sedation methods after coronary artery bypass grafting should result in differences not only in extubation time, but also in breathing pattern and gas exchange during weaning ...

Background. Laryngoscopy and endotracheal intabation my produce adverse homodynamic effects such as hypertension and tachycardia. Magnesium has direct vasodilating properties on coronary arteries and inhibits catecholamine release, that attenuating the homodynamic effects during endotracheal intubations. Methods. This randomized, double blind study compared the effects of magnesium sulphate with lidocaine for ...

This study was designed to determine the efficacy of oral etilefrine in preventing hypotension induced by spinal anaesthesia. Forty patients, ASA grade I or II, aged 23-60 years, scheduled for orthopaedic surgery involving the lower extremity under spinal anaesthesia were studied. The patients were randomly allocated to one of two ...

We have investigated the effects of xenon on regional cerebral blood flow (rCBF) and autoregulation in pigs sedated with propofol 4 mg kg-1 h-1. Balloon-tipped catheters were placed into the descending aorta and inferior vena cava of 15 Göttingen Minipigs for manipulation of arterial pressure and blood sampling. rCBF was ...

This study assessed the safety of sevoflurane anaesthesia using two Komesaroff vaporizers inside the circle with both spontaneous and controlled ventilation. Sevoflurane concentrations were continuously monitored using a mass spectrometer and the anaesthetic depth was easily controlled. Involuntary movements occurred in eight patients and breath-holding occurred in five patients after ...

PURPOSE: Meperidine has local anesthetic properties and, therefore, when given epidurally it has the potential to cause hemodynamic changes. Our objective was to study the hemodynamic effects of an analgesic dose of epidural meperidine (50 mg) in 34 ASA 1-2 term parturients scheduled for elective Cesarean section under epidural anesthesia. ...

AIMS: To determine the effects of premedication with thiopental on heart rate, blood pressure, and oxygen saturation during semi-elective nasotracheal intubation in neonates. METHODS: A randomised, placebo controlled, non-blinded study design was used to study 30 neonates (mean birthweight 3.27 kg) requiring semi-elective nasotracheal intubation. The babies were randomly allocated ...

BACKGROUND: Spinal anesthesia for surgical repair of hip fracture in the elderly is associated with a high incidence of hypotension. The synergism between intrathecal opioids and local anesthetics may make it possible to achieve reliable spinal anesthesia with minimal hypotension using a minidose of local anesthetic. METHODS: Twenty patients aged ...

The effects of propofol on mean arterial pressure, heart rate and Adelta and C somatosympathetic reflexes, recorded in renal nerves, evoked by repeated individual supramaximal electrical stimuli applied to radial nerves, were observed in anaesthetized, paralysed and artificially ventilated dogs. Propofol was infused at rates from 0.4 to 2.0 mg ...

OBJECTIVE: The aim of this study was to utilize an anesthesia information management system (AIMS) in investigating the effects of hypnotic agents used to induce anesthesia on blood pressure, heart rate and arterial oxygen saturation. The characteristics of these agents, known from previous studies, were compared to the effects documented ...

We have compared three bolus and infusion regimens of remifentanil on the cardiovascular response to laryngoscopy and orotracheal intubation in three groups of 20 ASA I-II female patients, in a randomized, double-blind study. Patients in group 1 received glycopyrolate 200 micrograms i.v. followed by a bolus dose of remifentanil 1 ...

The aim of the study was to assess the usefulness of methohexitone and propofol in total intravenous anaesthesia applied during planned knee joint arthroscopy in day-case surgery. Studies comprised 186 patients divided into 2 groups depending on the anaesthetic used (methohexitone n = 112 or propofol n = 74). ECG, ...

In this study, we compared the effect of prophylactic administration of warm and cold saline against spinal anaesthesia induced hypotension in parturients undergoing elective caesarean section. One hundred and thirteen parturients with singleton pregnancies received an i.v. infusion of isotonic saline 20 mL x kg(- 1)during the 15 min before ...

In order to examine whether changes in the bispectral index (BIS) may be an adequate monitor for the analgesic component of anesthesia, we evaluated the effect of remifentanil on the BIS change and hemodynamic responses to laryngoscopy and tracheal intubation. Fifty ASA physical status I patients were randomly assigned, in ...

Laryngoscopy and tracheal intubation, or insertion of a laryngeal mask airway may lead to an arousal response on the electroencephalogram. We studied whether more intense stimulation (laryngoscopy and tracheal intubation) causes a greater arousal response than less intense stimulation (laryngeal mask airway insertion). Thirty-four patients (ASA I-II) were anaesthetised with ...

Anaesthesia of 2 five-year-old female African elephants (Loxodonta africana) was required for dental surgery. The animals were each premedicated with 120 mg of azaperone 60 min before transportation to the hospital. Before offloading, 1 mg etorphine was administered intramuscularly (i.m.) to each elephant to facilitate walking them to the equine ...

BACKGROUND AND OBJECTIVES: Little is known about the effect of adding epinephrine to local anesthetic solutions on the intensity of sensory block during epidural anesthesia. This study examined development of sensory block during lumbar epidural anesthesia using a cutaneous current perception threshold (CPT) quantitative sensory testing device. METHODS: Twenty ASA ...

PURPOSE: To determine if preoperative intravenous dextrose affects the incidence and ease of treatment of spinal-induced hypotension in parturients having elective Cesarean section under spinal anesthesia. METHODS: In this prospective, double-blind study, following informed consent, 119 ASA I, II parturients for elective Cesarean section were randomized to receive intravenously either ...

A novel positioning technique was tested to see whether the unpredictability of block height and haemodynamic instability during spinal anaesthesia for caesarean section could be reduced. In this 'Oxford' position, the woman is placed left lateral with an inflated bag under the shoulder and pillows supporting the head. Following spinal ...

We have examined the effect of remifentanil on the haemodynamic response to emergence from anaesthesia and tracheal extubation in 40 ASA I-II female patients undergoing diagnostic laparoscopy, in a randomized, double-blind study. All patients received a standard general anaesthetic comprising propofol, vecuronium and 1% isoflurane with 66% nitrous oxide in ...

PURPOSE: Hypertensive patients exhibit exaggerated cardiovascular responses to tracheal extubation. This study was undertaken to compare the efficacy of combined diltiazem and lidocaine with each drug alone in suppressing the hemodynamic changes during tracheal extubation. METHODS: Sixty hypertensive patients (ASA II), defined as systolic blood pressure > 160 mmHg and/or ...

OBJECTIVE: To determine effects of i.v. administered yohimbine on perineal analgesia, cardiovascular and respiratory activity, and head and pelvic limb position in healthy mares following epidural administration of detomidine hydrochloride solution. ANIMALS: 8 healthy mares. PROCEDURE: Each mare received detomidine hydrochloride (0.06 mg/kg of body weight), administered in the caudal ...

We studied 160 patients undergoing elective Caesarean section under spinal anaesthesia who received a preloading volume of 15 ml kg-1 of 10% pentastarch in 0.9% saline, or Hartmann's solution, in a prospective, randomized, double-blind study. We compared the incidence of spinal-induced hypotension in each group. Hypotension was defined as a ...

The aim of the study was to investigate the effect of epidural analgesia on blood pressure, duration of the second stage and mode of delivery. In a prospective controlled study carried out in a district general hospital, 122 parturients made up the study population; 81 had epidural blocks and 41 ...

The bispectral index, a value derived from the electroencephalogram, has been proposed as a measure of anaesthetic effect. The aim of the present study was to evaluate the bispectral index during midazolam-fentanyl anaesthesia for cardiac surgery for its possible role as a predictor of increases in systolic blood pressure during ...

STUDY OBJECTIVE: To investigate changes in respiratory pattern and arterial blood gases during sedation with propofol or midazolam in spinal anesthesia. DESIGN: Randomized, placebo-controlled study. SETTING: Operating room of a university-affiliated hospital. PATIENTS: 40 ASA physical status I and II patients who required spinal anesthesia. INTERVENTIONS: Spinal anesthesia with tetracaine ...

Changes in basic haemodynamic variables following a sudden increase in the concentration of inspired desflurane administered during anaesthesia were compared in 30 female smokers and 30 nonsmokers. Smokers had significantly greater percentage increases in heart rate (p = 0.02), systolic and diastolic blood pressure (p < 0.005 and = 0.01, ...

BACKGROUND: Poor or no clinical signs of psychological distress are usually observed in patients affected by severe or profound mental retardation (MR). The aim of this study was to use clinical and hormonal parameters in order to compare the amount of stress in patients affected by different degrees of MR ...

The induction and intubation characteristics of sevoflurane were studied prospectively in 23 children, aged 3 months to 6 years (mean 24 +/- 20.25), undergoing repair of congenital cardiac defects. After premedication with syrup chloral hydrate (75mg/kg orally), anaesthesia was induced with 8% sevoflurane and 50% nitrous oxide in oxygen. Nasal ...

Cardiac arrhythmia can be a serious complication during general anaesthesia of patients suffering from cardiac arrhythmias and using antiarrhythmic drugs. The aim of the present experiments was to establish the way in which lidocaine and verapamil influence haemodynamic parameters of rabbits after midazolam anaesthesia. The experiments were performed on rabbits. ...

BACKGROUND: Effective treatment and prevention of hyperthermia and shivering-like tremor during labor is hindered by a poor understanding of their causes. The authors sought to identify the incidence of nonthermoregulatory shivering-like tremor and the factors associated with this activity. METHODS: The authors studied women in spontaneous full-term labor who chose ...

In this double-blinded, randomized study, we examined the hemodynamic effects of lumbar epidural injection of alkalinized lidocaine with phenylephrine in 81 patients undergoing inguinal herniorrhaphy. Patients assigned to four equal groups received 20 mL of alkalinized lidocaine (17 mL of 2% lidocaine + 3 mL of 7% sodium bicarbonate) with ...

OBJECTIVE: To evaluate the changes in hemodynamic variables and intraocular pressure (IOP) after tracheal intubation using either lightwand or direct-vision laryngoscopy techniques. DESIGN: Prospective, randomized study. SETTING: Inpatient anesthesia at a University Anesthesia Department. PATIENTS: 50 normotensive, ASA physical status I and II patients, without ocular or cardiovascular diseases, and ...

We have compared the effect of rocuronium and succinylcholine on intraocular pressure (IOP) during rapid sequence induction of anaesthesia using propofol and fentanyl, in a randomized double-blind study. We studied 30 adult patients, allocated to one of two groups. Anaesthesia was induced with fentanyl 2 micrograms kg-1 and propofol until ...

OBJECTIVE: To evaluate epicutaneous application of 5% lidocaine-prilocaine and 30% lidocaine cream anesthetics for neonatal circumcision. METHODS: The efficacy of 5% lidocaine-prilocaine and 30% lidocaine creams was compared in a randomized, double-blind, placebo-controlled trial. Sixty-one neonates were randomly assigned to one of three groups: 5% prilocaine-lidocaine (n = 20), 30% ...

This study compared the haemodynamic effects of subarachnoid block with plain bupivacaine 0.5% (dextrose-free), heavy bupivacaine 0.5% (in dextrose 8%) and a mixture of these two solutions, i.e. bupivacaine 0.5% in dextrose 4%. Thirty-six male patients, aged 55-89 years, undergoing transurethral surgery were recruited. Invasive systolic arterial and central venous ...

Rapid i.v. induction of general anaesthesia is indicated in infants at risk of vomiting or regurgitation to reduce the risk of aspiration of gastric contents. Propofol is an alternative to thiopental in infants, and we have compared cardiovascular changes when propofol or thiopental was used for induction of anaesthesia in ...

OBJECTIVE: To assess the hemodynamic effects of propofol and the counteracting effect of calcium chloride (CaCl2) in patients undergoing coronary artery bypass grafting (CABG). DESIGN: Prospective, randomized study. SETTING: University hospital, department of cardiac surgery. PARTICIPANTS: Fifty-eight patients undergoing elective CABG, divided into group A (n = 29) and group ...

PURPOSE: The administration of desflurane to humans can lead to substantial activation of the neurohumoral axis. Propofol can inhibit the sympathetic response to stress. This study compared the neurocirculatory effects of induction of anesthesia with propofol with those of etomidate on desflurane-mediated sympathetic activation. METHODS: After informed consent, awake baseline ...

Injection of lidocaine into the subcutaneous tissues by the tumescent technique results in a delayed absorption of the local anesthetic and has allowed clinicians to exceed the maximum recommended dose of lidocaine without reported complications. However, little knowledge exists about the mechanisms that permit such high doses of lidocaine to ...

Expert and aggressive pre-operative preparation of the woman with severe pre-eclampsia will ultimately determine her intraoperative outcome. Such considerations as the effect of endotracheal manipulation on intracranial pressure, of thrombocytopenia on the potential to produce a compressive epidural haematoma following epidural or combined spinal-epidural neuraxial block and of adequacy of ...

We have determined if tracheal intubation causes an increase in neuropeptide Y (NPY), a marker of major adrenergic activation, and investigated if rectal premedication with clonidine 2.5 micrograms kg-1 might be capable of attenuating the stress response to tracheal intubation compared with midazolam 300 micrograms kg-1, in 20 paediatric patients ...

Propofol may cause profound bradycardia and asystole, which are mediated indirectly via cardiac innervation but could involve direct effects on the sino-atrial (SA) node and the conducting system of the heart. To test the hypothesis that propofol may also activate Bezold-Jarisch reflexes to cause bradycardia, 5-hydroxytryptamine (5-HT), veratridine and propofol ...