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)

Several recent studies with different anesthetic agents have reported increases in plasma norepinephrine concentration during induction. To determine if induction with intravenous injection of thiopental also is associated with initial sympathetic activation, 24 ASA class I patients were assigned randomly to receive one of the following anesthetics: Group I, thiopental 3 mg/kg, iv, followed by inhalation of 100% oxygen and a continuous intravenous infusion of thiopental 0.2-0.3 mg X kg-1 X min-1; Group II, thiopental 3 mg/kg followed by inhalation of halothane (1.5% end-tidal concentration) in oxygen; and Group III, thiopental 3 mg/kg followed by inhalation of 70% nitrous oxide in oxygen. After thiopental injection, ventilation was controlled to maintain PCO2 near control levels. In Group I, plasma norepinephrine concentration decreased with continued administration of thiopental. This decrease became statistically significant (P less than 0.05) 10 min after injection. Plasma epinephrine concentration did not change. For Groups II and III, both plasma norepinephrine and epinephrine concentration did not change. For Groups II and III, the stability of the catecholamine concentrations during induction may have been caused by the circumvention of the second stage of anesthesia, equal depression of both inhibitory and excitatory synapses, or the combined effects of the agents. Regardless of the cause, the use of a modest induction dose of thiopental appears to allow the induction of anesthesia without sympathetic activation. When it is important to prevent sympathetic activation, administering a modest dose of thiopental before the inhalation of halothane or nitrous oxide may be preferable to inducing anesthesia with inhalation agents or narcotics alone.
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PMID:Effect of thiopental induction on sympathetic activity. 685 7

ICI 35868 was used to induce anesthesia in 39 ASA I patients (9 male and 30 female, aged 17-64 years), scheduled to undergo minor surgical procedures. The first 6 patients were given 1.0 mg/kg, the next 22 1.5 mg/kg and the final 11 2.0 mg/kg ICI 35868 I.V. over 30 seconds, without premedication. Anesthesia was successfully induced in 100% of patients at 2.0 mg/kg, 81% at 1.5 mg/kg and 50% at 1.0 mg/kg. Pain at the injection site occurred in 23% of patients. There were no signs of venous damage postoperatively. A small transient fall in blood pressure and some respiratory depression were seen immediately after induction; transient apnoea occurred in 27% of patients given 1.5 mg/kg and 55% given 2.0 mg/kg. Other side effects were minor and of low incidence. Three minutes after induction of anesthesia, when assessments were complete, 23 patients were given a further dose of a conventional induction agent, as they were beginning to awaken, and anesthesia was maintained in all patients by inhalational techniques. There were no untoward events during maintenance of or on recover from anesthesia.
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PMID:Use of ICI 35868 as an anesthetic induction agent. 697 55

Twenty unpremedicated patients (ASA grade I) were assigned randomly to receive thiopentone in 50-mg increments every 15 s until loss of lash reflex (group I) or as a 4-mg kg-1 bolus (group II). Arterial pressure, heart rate, systolic time intervals and end-tidal carbon dioxide were measured in the control state and then every 30 s. The mean dose of thiopentone in group I was 5.58 +/- 1.24 (SD) mg kg-1 which was significantly larger than in group II (P less than 0.001). Both groups exhibited similar decreases in arterial pressure and increases in heart rates. The degree of cardiac depression revealed from measurement of the systolic time intervals, indexed for heart rate, was equal in the two groups.
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PMID:Comparison of the cardiovascular effects of bolus v. incremental administration of thiopentone. 738 6

Presentation of drugs most worthy of interest in autumn 1995. Among these, the ACE inhibitors, the HMGCOA inhibitors, the Proton Pump inhibitors, the serotoninergics used against depression and migraine, the endobronchial corticoids and finally the ASA. Review of their successes, failures and uncertainties.
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PMID:[Leading drugs in 1995: success, failures and uncertainties]. 748 Dec 49

Lumbar epidural analgesia was administered to 60 ASA class 1 & 2 patients with 3 ml test dose of 1.5% lidocaine and bolus of 20 ml of 0.5% lidocaine containing 0.5 microgram/kg sufentanil. Bilateral decreased lumbar cold perception was accepted as evidence of analgesia despite persisting pinprick sensation in thoracic dermatomes. Oxygen saturation (SpO2), respiratory rate, cardiovascular parameters and leg muscle strength were monitored throughout and until 1 hour afterwards. Midazolam provided light sedation and atropine bradycardia control. Verbal communication was maintained. ESWL could start within 6-10 minutes of bolus, with analgesia adequate in 86% of patients, the rest being "rescued" with 5-10 ml 0.5% lidocaine or analgesic doses (20-30 mg IV) of ketamine. Leg weakness developed in 14%, with 1 patient fully paralyzed. All resolved within 1 hour. Topical urethral analgesia was used in males where cystoscopy preceded ESWL. Phenylephrine was required once for nild systolic hypotension, otherwise blood pressures were stable. Two of 4 patients experiencing pruritus needed naloxone relief. Itching appeared in skin recovering from sensory block while visceral analgesia persists. Excessive respiratory depression was not seen.
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PMID:Low dose epidural lidocaine/sufentanil is effective for outpatient lithotripsy. 756 23

The effect of preoperative sublingual buprenorphine (B) on postoperative pain (VAS), the need for postoperative opioid injections and on time to discharge, was evaluated in a prospective randomised double-blind study. Forty ASA I-II patients scheduled for arthroscopy of the knee received premedication with 0.4 mg buprenorphine (group B) and 42 patients were given placebo (group P). Postoperatively, pethidine was given to patients with pain. Three of the 40 patients in group B vs 11 of the 42 in group P received pethidine (P < 0.05). In group B, however, 13 of the 40 patients complained of nausea, prolonging median time to discharge from 155 to 255 minutes (P < 0.05). In group P, 3 of the 42 patients were nauseated, P < 0.01, compared with group B. Time to discharge did not differ between the groups in patients without nausea. The median respiratory rate was significantly lower in group B, but no patient required ventilatory support. In conclusion, premedication with sublingual buprenorphine cannot be recommended for this procedure. It reduces the need for postoperative injections of pethidine but increases the incidence of postoperative nausea which prolongs the recovery time. Careful monitoring is also mandatory because of the possibility of respiratory depression.
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PMID:Premedication with sublingual buprenorphine for out-patient arthroscopy: reduced need for postoperative pethidine but higher incidence of nausea. 757 13

The effects of general anaesthesia and surgical trauma on neutrophil function were studied in 60 female ASA 1 and 2 patients undergoing anaesthesia for gynaecological surgery. Patients were divided into three groups depending on the degree of trauma and duration of surgery. Group 1 (n = 15) were patients for dilatation and curettage (minor surgical trauma) and were given 2% halothane. Group 2 (n = 30) had laparoscopic surgery (moderate surgical trauma) and received either 0.5% halothane or 1% enflurane. Group 3 (n = 15) were those having hysterectomy (major surgical trauma) and received 0.5% halothane for a longer duration. Venous samples were taken 30 min before anaesthesia (control value), 10 min after induction of anaesthesia, 10 min after the start of surgery, 30 min after the end of anaesthesia and 24 h later. Phagocytic index, nitroblue tetrazolium reduction test, total leucocyte count, and differential leucocyte counts were performed on each sample. Data were analysed by paired t-test to compare findings in the same patient and by unpaired t-test for differences between groups. Anaesthesia with halothane 0.5% to 2% caused a dose-related depressant effect on leucocyte function which reversed. Enflurane 1% on the other hand caused significantly greater depression of leucocyte function compared with 0.5% halothane which persisted during the recovery period and recovered on the first postoperative day. Total leucocyte counts also showed a fivefold increase in the major surgery groups.
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PMID:Effect of general anaesthesia and surgery on neutrophil function. 757 65

Local anaesthetics are ventilatory depressants, but previous investigators have not commented on the effects on ventilatory timing. There is concern about the possible ventilatory depression caused by systemic absorption of local anaesthetics injected extradurally. We have studied ASA grade I patients anaesthetized with a propofol infusion and breathing spontaneously; they were given in random order lignocaine 1.5 mg kg-1 i.v. and an equivalent volume of 0.9% saline. Breathing was analysed using respiratory inductance plethysmography in 30-s periods for 4 min after injection, each period scaled to the 30-s period preceding injection. Lignocaine reduced minute ventilation. The greatest mean reduction in the 4 min was to 85%, occurring 2.5-3 min after injection; the greatest individual reduction was to 60-65%, which occurred by 30-60 s. Lignocaine decreased tidal volume and ventilatory rate by prolonging expiratory time. Lignocaine had no effect on or promoted bimodality of expiratory time. End-tidal carbon dioxide increased by a mean of 0.1%; the largest individual change was 0.3%. This suggests that lignocaine may have reduced the metabolic rate, affecting ventilation indirectly, but we conclude that lignocaine in a normal extradural dose should not be an important ventilatory depressant.
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PMID:Effect of i.v. lignocaine on the breathing of patients anaesthetized with propofol. 757 83

The aim of this prospective study was to evaluate the efficacy of two dosage regimens of (i.m.) morphine calculated from an initial (i.v.) titrated dose in the early postoperative period. Seventy ASA I-III patients who underwent general anaesthesia (GA) (n = 58), regional anaesthesia (RA) (n = 10) or GA+RA (n = 2) for orthopaedic (n = 54), urological (n = 11) or abdominal surgery (n = 5) received i.v. titrated morphine in the post-anaesthesia care unit (PACU). Titration consisted of 3 mg morphine i.v. every ten minutes until patients had a visual analogue pain scale (VAS) < 3, without marked sedation. Seventeen patients did not complain at all or had good analgesia with an initial i.v. dose < or = 6 mg of morphine followed by paracetamol only. Patients who needed more than 6 mg i.v.morphine were randomly assigned to a "high-dose" or a "low-dose" group and received a systematic i.m. morphine regimen calculated from the initial titrated dose. Pain was assessed by VAS before each i.m. injection and the next morning. One patient had respiratory depression and one marked sedation in the PACU. These patients were excluded from the rest of the study. Only 16 patients were excluded from the rest of the study. Only 16 patients had a VAS > 3 at least once during the study period and only three needed rescue analgesia which was available on request. We conclude that a systematic i.m. morphine regimen adapted from an initial i.v. titration in the PACU provides efficacious and relatively inexpensive postoperative analgesia, applicable to a great majority of patients.
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PMID:Can immediate opioid requirements in the post-anaesthesia care unit be used to determine analgesic requirements on the ward? 762 23

We compared the use of methohexital (0.5 mg/kg) with alfentanil (20 micrograms/kg) as a drug for limiting movement and pain during the placement of a retrobulbar block (RBB). Thirty patients (ASA class I-III) were randomly assigned to receive either methohexital or alfentanil (15 patients in each group). All but two patients (87%) treated with alfentanil were awake and responsive to command. All of the patients given methohexital were unresponsive at the time of block placement. However, less movement was observed when patients were treated with alfentanil compared to methohexital (P < 0.0002). None of the patients treated with alfentanil complained of pain during placement of the RBB. No difference was detected in the incidence of respiratory depression. However, one patient who received alfentanil had a prolonged period of apnea (approximately 30 s) with a significant decrease in oxygen saturation. The incidence of nausea and vomiting and the time to discharge from the outpatient department were similar in the two groups. The results of this study suggest that alfentanil may be used as a single drug to limit movement during placement of retrobulbar block for ophthalmic surgery.
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PMID:Comparison of methohexital and alfentanil on movement during placement of retrobulbar nerve block. 865 56


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