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Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Periduralaneaesthesia by the cervical route (C6-C7 or C7-D1) or by the upper lumbar route with an ascending catheter, permit thoracic surgery in all its applications. The reduction in operative bleeding is an appreciable advantage of the method, and automatic nervous stability is remarkable. On the other hand, keeping the patient in the waking state is a definite disadvantage, especially in removal of one lung. As far as the anaesthetist is concerned he will be faced with difficulties of ventilation and bronchial aspiration. On the other hand, combined with slight general anaesthesia and tracheal intubation, peridural anaesthesia is definitely of interest. Furthermore, during the post-operative period, it is precious permitting a cough without pain and, in this respect, the comparison with anaesthesia of the inter-costal nerves, is worth discussins, each technique having special advantages.
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PMID:[Role of peridural anesthesia in thoracic surgery]. 1 23

An up-to-eight-hour lasting anterograde amnesia is achieved by "Rohypnol" i.v. causing no excitation before local anesthesia is given (prolongation by analgetics, anesthetics, neuroleptics). The cardiovascular functions remain stable with spontaneous breathing and preservation of the swallow and coughing reflexes. During the operation the patient is responsive and cooperative. The patient answers all questions, moves his body into any wanted position and when ordered he performs Valsalva's manoeuver without any remembrane. If not spoken to and having no pain he falls asleep right away. Postoperative vomiting is reduced. The patient feels relaxed after waking up. No complications have been noticed during more than 500 operations. The later questioning of all patients showed only 4 patients (with unsufficient preoperative sedation) who could remember part of the terminal phase of the operation.
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PMID:[Prolongated amnesia after "rohypnol" i.v. before local anesthesia and responsiveness during operation (author's transl)]. 1 38

The authors induced experimental hydrothorax in cats by injecting dextran into the pleural cavity under brief N2O anaesthesia. They examined the parameters of cough -- elicited by mechanical stimulation of the airway mucosa -- and blood gas and pH values under normal conditions and after the injection of 50, 100, 200 and 250 ml dextran. The tests were always performed 30 min after terminating anaesthesia, i.e. in conscious animals. The free fluid in the thorax was found, in conscious cats, to reduce the inspiratory values of cough, but to have no effect on cough expiration. This is in agreement with previous findings showing that the intensity of a cough expiration does not always depend on the intensity of the preceding cough inspiration. According to this finding, the decrease in the expiratory values of cough observed during experimental pleurisy cannot be due to the actual exudate. In cats, experimental hydrothorax in doses of 200 and 250 ml leads to respiratory insufficiency. The authors further found that, for the study of interoception in the airways of conscious cats, which requires experimental induction of pathological conditions under brief anaesthesia, nitrous oxide is a convenient anesthetic.
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PMID:Effect of experimental hydrothorax on the cough reflex in conscious cats. 4 93

In 16 baboons, reproducible bronchograms could be achieved by inhalation of 400--800 mg of powdered calcium ioglycamic acid. Anesthesia, tracheal intubation, or premedication were not necessary. In patients and volunteers, the inhalation of the contrast medium dust caused strong cough. Local anesthesia allowed inhalation for about 10 minutes, which resulted in successful demonstration of the pharynx, larynx, and trachea with bifurcation. Lobular and segmental bronchi were demonstrated only after a longer inhalation time. The contrast medium was completely eliminated and did not cause any recognizable adverse reaction. Nonspecific inflammatory reaction of the bronchial mucosa was seen microscopically in baboons.
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PMID:Inhalation bronchography using powdered calcium ioglycamic acid. 10 59

An eight-year-old male Yorkshire terrier which had had a cough for two years was presented and a diagnosis of tracheal collapse was made after examination with a bronchoscope. It was decided to try to correct the tracheal defect by plication. Two weeks after the operation the dog was examined under general anaesthesia. Although traction had exposed a part of the thoracic trachea it was not sufficient in this case to achieve a complete repair. In view of a grave prognosis, the dog was destroyed.
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PMID:A case of tracheal collapse in the dog. 32 44

The effect of intravenous lidocaine in the treatment of persistent cough occurring after diagnostic bronchoscopies performed under general anaesthesia was investigated in a controlled clinical trial. The study comprised 28 adults patients, all of whom had regained consciousness after anaesthesia. Fifteen patients were treated with lidocaine (1.05 mg/kg body weight) and 13 patients with placebo (saline). In each patient the intravenously injected dose was repeated once after 5 min. In 11 of the 15 patients (73%) who received lidocaine coughing ceased, while it continued in all 13 patients in the placebo group. The difference is highly significant (P less than 0.001). None of the patients developed side effects such as hypotension, arrhythmias, central nervous system symptoms or respiratory depression after injection of lidocaine. It is therefore concluded that intravenous lidocaine in man is a safe and useful cough-suppressant.
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PMID:Intravenous lidocaine as a suppressant of persistent cough caused by bronchoscopy. 35 7

Airway reflexes are difficult to study in conscious animals because associated changes in ventilation alter intrathoracic airway dimensions. By studying an isolated segment of extrathoracic trachea, we have overcome this problem. In each of 2 dogs, we created surgically an isolated tracheal segment just below the larynx, sealed at one end and tapered at the other to a 3-mm opening via a skin fistula. A chronic tracheostomy was also created near the thoracic outlet. We monitored intraluminal pressure (Pseg) of the isolated segment to reflect changes in smooth muscle tone. During anesthesia, with pentobarbital, gentle mechanical stimulation of the carina, deflation of the lungs, and asphyxia for one min increased Pseg (+9 to +/- 16 cm H2O). Lung inflation and alveolar hyperventilation decreased Pseg (-9 to -16 cm H2O). Five breaths of 2 per cent histamine aerosol increased Pseg (+5 cm H2O) when resting tone was normal. We also coated lumen of the isolated segment with tantalum powder and documented roentgenologically changes in the size of the segment that reflected changes in smooth muscle tone; constriction and dilation in response to asphyxia and lung inflation, respectively, were demonstrated directly by this technique. In conscious dogs, lung inflation decreased Pseg, and carinal stimulation increased Pseg. Instillation of lidocaine hydrochloride (Xylocaine) into the isolated tracheal segment blocked cough caused by mechanical stimulation of the segment, but carinal stimulation still caused constriction of the segment under these conditions which indicated that afferent, but not effrent parasympathetic innervation of the segment had been blocked selectively. Conversely, instillation of atropine sulfate into the isolated tracheal segment blocked constriction of the segment caused by carinal stimulation, but mechanical stimulation of the segment still caused cough under these conditions, which indicated that efferent, but not afferent parasympathetic innervation of the segment had been blocked selectively. We conclude that an innervated extrathoracic tracheal segment constricts and dilates via cholinergic pathways and is suitable for the study of airway reflexes in conscious dogs.
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PMID:A chronic isolated tracheal segment to study airway reflexes in conscious dogs. 46 75

To relieve postoperative pain along a lumbar incision in 9 patients the intercostal nerves were blocked with catheters for continuous epidural anesthesia. The catheters were inserted near the intercostal nerves, above and beneath the incision, just before the wound was closed and 0.25% bupivacaine hydrochloride solution was infused periodically through the catheters. With this technique 5 of 9 patients had a satisfactory analgesic effect and could breathe deeply or cough without pain. The other 4 patients did not have satisfactory results and this was believed to be owing to inadequate insertion of the catheters. None of the patients had any complications. The technique is simple and can produce an analgesic effect repeatedly without causing pain for the patient.
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PMID:Continuous intercostal nerve block for pain relief after lumbar incision. 48 Apr 94

Our data in 74 patients demonstrate that procaine hydrochloride is a safe anesthetic adjuvant in doses of 1 mg/kg/min even when total doses are 5 to 7 g. Blood pressure, heart rate, electrocardiographic variables, and blood gases were not adversely affected. Patients had no nausea or untoward postanesthesia symptoms. Emergence from anesthesia was rapid, within less than 15 minutes in all patients, and most were fully awake before leaving the operating room. In two patients in whom blood levels were studied the drug disappeared within 40 minutes. Procaine is inexpensive, $1.16 for 10 g, and it is not a known liver or kidney toxin. Until studies on cardiovascular dynamics and analgesic effects as in whom a low plasma cholinesterase activity is present or suspected. The clinical appraisal in 56 patients indicates its usefulness in suppressing premature venticular contractions and cough reflexes during endoscopic procedures in the respiratory tract. Procaine can be used to advantage in supplementing general anesthesia in outpatient surgery because of its brief action. For these reasons, the drug merits further study.
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PMID:Reappraisal of intravenous procaine as a short-acting anesthetic adjuvant. 50 95

Procaine suppresses the cough reflex, decreases laryngeal irritability, and has general anesthetic properties. For these reasons, 14 pediatric patients undergoing CO2 laser resection of laryngeal papillomas were studied in which an intravenous infusion of procaine (1 mg/kg/min) was added to N2O-O2 halothane/enflurane general anesthesia immediately following endotracheal intubation. These patients were compared to nine patients receiving the same anesthesia without procaine. The mean age of both groups was 11 years. There was no difference between the groups in duration of anesthesia or surgery. Emergence, however, averaged 15 minutes in study patients compared to 36 minutes in the control group (p less than 0.01). There was no difference in anesthetic concentrations required to maintain satisfactory operative conditions in the two groups. Muscle relaxants were required intraoperatively in seven control patients but in none of the study patients. The surgeon ranked the operative conditions excellent in all study patients but poor in seven of the nine control patients. Five of the latter required postoperative treatment of laryngeal complications, including reintubation in three. Only one of the study patients had postoperative stridor. No evidence of procaine toxicity was noted in the study patients with total doses ranging from 500--3600 mg. Intravenous procaine is useful in pediatric patients having endoscopic laryngeal operations.
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PMID:Intravenous procaine as a supplement to general anesthesia for carbon dioxide laser resection for carbon dioxide laser resection of laryngeal papillomas in children. 57 34


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