Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 74-year-old woman developed severe cardiovascular depression during percutaneous transtracheal high frequency jet ventilation for laser surgery of the epiglottis. This was found to be caused by acute airway obstruction secondary to severe laryngospasm. We recommend profound neuromuscular blockade during percutaneous transtracheal jet ventilation, in order to prevent this complication.
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PMID:Laryngospasm during transtracheal high frequency jet ventilation. 832 17

Using a fibreoptic laryngoscope, we have recorded on video tape the movements of the vocal cords after induction of anaesthesia with either propofol or thiopentone. The angle formed by the vocal cords decreased after induction of anaesthesia in both groups. This reduction in angle was significantly greater in the thiopentone group. The vocal cords closed completely in four patients in the thiopentone group and one patient in the propofol group. This difference may be explained by greater depression of laryngeal reflexes by propofol and this may account for the lower incidence of laryngospasm after induction of anaesthesia with propofol in comparison with thiopentone.
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PMID:Movements of the vocal cords on induction of anaesthesia with thiopentone or propofol. 129 54

The authors sought to define a dose of oral ketamine that would facilitate induction of anesthesia without causing significant side effects. Forty-five children (ASA Physical Status 1 and 2; aged 1-7 yr) were assigned randomly in a prospective, double-blind fashion to three separate groups that received either 3 mg/kg, 6 mg/kg, or no ketamine mixed in 0.2 ml/kg cola-flavored soft drink. They also were evaluated preoperatively and postoperatively for acceptance of oral ketamine as a premedicant, reaction to separation from parents, emotional state, and emergence phenomena. The authors detected no episodes of respiratory depression, tachycardia, or arterial hemoglobin desaturation before, during, or after surgery. The 6 mg/kg dose was well accepted; provided uniform, predictable sedation within 20-25 min; and allowed calm separation from parents and good induction conditions. The 3 mg/kg dose did not always cause sedation and calm separation from parents. Neither dose of ketamine increased the incidence of laryngospasm, prolonged recovery times, or caused emergence phenomena. The authors conclude that an oral dose of 6 mg/kg ketamine is easily administered and well accepted in young children and provides predictable, satisfactory premedication without significant side effects.
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PMID:Oral ketamine preanesthetic medication in children. 151 2

Methohexital is an ultrashort-acting barbiturate widely used in dentistry because of its rapid onset, predictable effects, and short duration of action. Like other barbiturates, methohexital exerts its effects through the gamma-aminobutyric acid (GABA) receptor complex. By binding to its own receptor on the complex, methohexital augments the inhibitory effect of GABA on neurons and additionally can exert a similar effect independent of GABA. After intravenous injection, maximal brain concentrations are achieved within 30 sec and then quickly fall as the drug is redistributed to other tissues, yielding a duration of action after a single dose of 4 to 7 min. Hepatic metabolism accounts for elimination of the drug. Methohexital at conventional doses in healthy individuals is a mild respiratory depressant with modest cardiovascular effects. Adverse effects, however, can include apnea, cardiovascular depression, laryngospasm, hiccough, and allergic-like reactions. Although more recently introduced drugs, such as midazolam, etomidate, and propofol, have specific advantages, methohexital remains a drug of choice for dental outpatient anesthesia because of its low cost, rapid onset, short duration, lack of secretory or emetic properties, and proven history.
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PMID:Methohexital: a practical review for outpatient dental anesthesia. 184 56

During inhalation induction of the pediatric patient, laryngospasm can develop before intravenous access has been established. The intramuscular administration of succinylcholine is commonly used in such instances. This study was designed to determine if the injection of succinylcholine by an extraoral submental approach would be an acceptable method of terminating laryngospasm when compared to conventional intramuscular sites. Following induction with halothane and nitrous oxide in oxygen, a total of fifteen ASA 1 children were given 3.0 mg/kg intramuscular succinylcholine either intralingually by a submental approach, or using the upper leg musculature in order to electromyographically measure the time to maximum (or 90 percent depression from baseline) twitch depression. The intralingual submental injection had a mean twitch depression of 265 +/- 62.5 seconds compared to the quadriceps femoris at 295 +/- 42.6 seconds. A group with digital massage of the intralingual injection site produced a mean depression time of 133 +/- 11.9 seconds and was also the only group providing 100% success rate in reaching the desired twitch depression level. This may suggest that the operator should consider digital massage to produce a more predictable and desirable result.
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PMID:Submental administration of succinylcholine in children. 209 11

Ketamine produces rapid and consistent pediatric sedation with a predictable onset and recovery time. A wide margin of safety is afforded without the respiratory and cardiovascular depression commonly seen with alternative agents. The efficacy of ketamine is well established in anesthesia and dentistry and has extensive applications in other specialties. Ketamine sedation facilitates superior technical and cosmetic results while minimizing emotional trauma to distraught children. The much-feared complications of aspiration and laryngospasm are extremely rare when ketamine is used with proper precautions. Ketamine deserves increased use in the ED, and we advocate additional clinical investigation in this setting.
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PMID:Ketamine sedation for pediatric procedures: Part 2, Review and implications. 220 90

The effects of ketamine administered per nasus (PN) or per rectum (PR) as pre-anesthetic medication for day surgery was studied in 70 ASA class I children with age ranging from 6 months to 6 years. Before study they were divided into 3 groups. Group A (n = 25) received no premedicant, while group B (n = 25) and group C (n = 20) received ketamine 6 mg/kg PR and 3 mg/kg PN as premedicant respectively. It was demonstrated that patients in group B and group C accepted the facemask during induction of anesthesia more willingly and peacefully than those in group A. In group B and group C there was accompaniment of analgesic effect seen postoperatively. The incidence of adverse reactions (nausea, vomiting, laryngospasm, salivation, respiratory depression) was low following the use of PR or PN ketamine although the children in these two groups emerged more belatedly from anesthesia and stayed in the post-anesthetic recovery room (PARR) for a longer time than in group A.
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PMID:Rectal ketamine versus intranasal ketamine as premedicant in children. 221 4

The in situ isolated rodent larynx preparation can be utilized for the detection of peripheral opiate receptor antagonists. Measurements of peripheral opioid-induced laryngospasm and central opioid-induced respiratory depression can be made in each preparation. Fentanyl citrate was used to stimulate both peripheral and central opiate receptors and [D-Ala2-Met5] enkephalinamide was used to stimulate only peripheral opiate receptors. Compounds that inhibit both laryngeal and respiratory effects of fentanyl, e.g., naloxone HCl, can be considered both central and peripheral opiate receptor antagonists. Compounds that inhibit only the peripheral laryngeal effects of fentanyl, e.g., naltrexone methylbromide, can be considered peripheral opiate receptor antagonists. The description of this preparation provides a simple and sensitive anesthetized animal model for the detection and characterization of compounds acting at peripheral and/or central opiate receptors.
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PMID:The in situ isolated larynx for evaluating peripheral opiate receptor antagonists. 303 83

The use of di-isopropyl phenol (Diprivan) for induction of anaesthesia was assessed in doses ranging from 1 to 3 mg kg-1. With less than 1.75mg kg-1 not all patients were anaesthetized; 2.0 mg kg-1 appeared to be a satisfactory induction dose. Involuntary muscle movement, cough and hiccup at induction were rare with any dose studied. However, the frequency of hypotension and respiratory depression were related to the dose given. Pain on injection was uncommon when the drug was given into an antecubital vein, but occurred in 39% of patients when injected to the back of the hand or wrist. Recovery was rapid, and characterized by lack of emetic sequelae. Di-isopropyl phenol 1.5 - 2.0 mg kg-1 given rapidly during reactive hyperaemia can produce anaesthesia in one arm-brain circulation time. A reaction involving flush, hypotension, cough, laryngospasm and bronchospasm occurred in one patient receiving 2.5 mg kg-1 given over 20 s.
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PMID:Use of di-isopropyl phenol as main agent for short procedures. 697 90

The changes in laryngeal resistance (LR) during respiratory arrest produced by withdrawal of hypoxia stimulation and administration of various respiratory depressants were studied in 14 spontaneously breathing, anesthetized cats (11 cats with alpha-chloralose and three cats with halothane). Withdrawal of hypoxia stimulation caused a transient respiratory arrest with no central inspiratory activity, during which a considerable increase in LR was observed to a level higher than the fixed resistance after muscle paralysis [LR(fix)]. Intravenous injection of thiopentone, ketamine, and lidocaine all caused a transient respiratory arrest. However, the effects on the laryngeal function and the central inspiratory activity were different for each agent. Both thiopentone and ketamine induced an inspiratory apneusis pattern in phrenic nerve discharge, and lidocaine caused a silence of phrenic nerve activity. Thiopentone relaxed the larynx, and LR during thiopentone-induced respiratory arrest was almost equal to LR(fix). Ketamine maintained a dilatation of the larynx, and LR during ketamine-induced respiratory arrest was lower than LR(fix). Lidocaine caused a constriction of the larynx and LR greatly increased, leading frequently to laryngospasm. These results indicate that hypoxia withdrawal, thiopentone, ketamine, and lidocaine all cause different effects on the central inspiratory activity, and that the central respiratory depression produced by these methods is not accompanied by a uniform depression of laryngeal function.
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PMID:Different laryngeal responses during respiratory arrest produced by hypoxia withdrawal, thiopentone, ketamine, and lidocaine in cats. 706 36


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