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)

We have determined the relative potency of rocuronium, pancuronium, pipecuronium and vecuronium, and examined the nature of the interaction of rocuronium with the other three steroidal neuromuscular blocking drugs. We studied the dose-response relationships of each drug and their combination with rocuronium in 200 ASA I or II patients during propofol-fentanyl-nitrous oxide-oxygen anaesthesia. Neuromuscular block was recorded as the evoked thenar mechanomyographic response to single twitch stimulation of the ulnar nerve at 10-s intervals. The dose-response curves were determined by probit analysis. Isobolographic and algebraic (fractional) analyses were used to assess the combined effect of equipotent doses of rocuronium and vecuronium, pipecuronium or pancuronium and to define the type of interaction between these drugs. The isobolograms were constructed by plotting single-drug ED50 points on the dose co-ordinates, and a combined ED50 point in the dose field. The calculated doses producing 50% depression (ED50) of the twitch height for rocuronium, pancuronium, pipecuronium and vecuronium were 144.8 (95% confidence intervals 140.4-149.3), 32.4 (31.7-32.9), 27.1 (26.5-27.6) and 23.7 (22.7-24.8) micrograms kg-1, respectively. Corresponding doses producing 95% depression (ED95) of twitch height were, respectively, 322.1 (307.5-337.3), 58.1 (56.2-60.1), 48.7 (46.9-50.5) and 39.9 (38.4-41.4) micrograms kg-1. Based on the estimate of ED50, the relative potency was 1:4.5:5.4:6, respectively. The interaction between rocuronium and vecuronium, pipecuronium or pancuronium was found to be additive.
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PMID:Comparative potency of steroidal neuromuscular blocking drugs and isobolographic analysis of the interaction between rocuronium and other aminosteroids. 766 66

Meperidine 1 mg kg-1 and pentazocine 0.3 mg kg-1 were administered epidurally to investigate their effect on vesical function in twenty American Society of Anesthesiologists Classification I (ASA-1) adult males. Cystometry was performed before and 45 minutes following epidural administration of meperidine and pentazocine. There was no significant change in maximum cystometric capacity, detrusor pressure at which detrusor reflex occurred and in vesical compliance following epidural administration of meperidine in ten patients and also in ten patients who received epidural pentazocine. The mean onset of analgesia after epidural administration of meperidine was 8 minutes which lasted for more than 360 minutes whereas mean onset of analgesia after epidural administration of pentazocine was 4 minutes which lasted for more than 360 minutes. There was no significant change in heart rate, blood pressure and respiratory rate after epidural administration of either meperidine or pentazocine. None of the subjects in either of the groups experienced any difficulty in passing urine, frequency or urgency of micturition. Side-effects like nausea, vomiting, pruritus and respiratory depression were not observed. It is concluded that epidural administration of meperidine 1 mg kg-1 or pentazocine 0.3 mg kg-1 produces significant analgesia of faster onset without altering vesical function as documented, both subjectively by voiding symptoms and objectively by cystometry.
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PMID:Analgesic and urodynamic effects of epidural meperidine and pentazocine--a comparative study. 771 90

The aim of this study was to investigate pain perception during thiopentone or propofol infusions for sedation. Thirty ASA 1 or 2 patients received a two step infusion of either thiopentone (step 1: 1.25 mg.kg-1 followed by 2.5 mg.kg-1.h-1; step 2: 1.25 mg.kg-1 and 12.5 mg.kg-1.h-1; n = 15) or propofol (step 1: 0.5 mg.kg-1, 1 mg.kg-1.h-1; step 2: 0.5 mg.kg-1, 5 mg.kg-1.h-1; n = 15) for sedation. At control and 10 min after the start of each infusion dosage, reaction times and thermal pain detection thresholds were determined. We found no clinically or statistically significant depression of thermal pain detection thresholds during propofol or thiopentone infusions and these are, therefore, unlikely to be associated with clinically relevant hyperalgesia.
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PMID:Sedation with intravenous infusions of propofol or thiopentone. Effects on pain perception. 771 87

We carried out a controlled, randomized, double-blind study to examine the effects of intravenous fentanyl (1 or 2 micrograms kg-1) on hemodynamic changes during tracheal extubation and emergence from anesthesia in 60 ASA physical status I or II patients undergoing elective gynecological surgery. Anesthesia was maintained with 0.5%-1.5% isoflurane and 60% nitrous oxide (N2O) in oxygen. Muscle relaxation was achieved with vecuronium. The patients were randomly assigned to three group (each, n = 20), and fentanyl (1 or 2 micrograms kg-1), or saline (as a control) was given at the time of peritoneal closure. Changes in heart rate (HR) and blood pressure (BP) were measured during and after tracheal extubation. Adverse effects, including postoperative sedation and respiratory depression, were also assessed. The HR, systolic BP, and diastolic BP increased significantly during tracheal extubation in the control group (P < 0.05). Fentanyl 2 micrograms kg-1 attenuated the increases in these variables more effectively than fentanyl 1 microgram kg-1. The time interval from the study drug to extubation was similar in each group. Postoperative somnolence and respiratory depression were not observed in any patients in any of the three groups. We concluded that a bolus dose of intravenous fentanyl 2 micrograms kg-1 given at the time of peritoneal closure was of value in attenuating the cardiovascular changes associated with tracheal extubation and emergence from anesthesia, and that this treatment did not prolong the recovery. However, further studies are required to assess this technique in patients with cardiovascular or cerebrovascular diseases.
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PMID:Fentanyl attenuates cardiovascular responses to tracheal extubation. 772 88

The purpose of this double-blind randomized work was to study the effect of alfentanil and esmolol and their half-dose combination on the increases of heart rate and arterial pressure and on the prolongation of the QTc interval of the ECG occurring during anaesthetic induction. Sixty ASA class I-II patient with mean age ranging from 26 to 32 yr among the groups. Patients were allocated to one of four equal groups to receive saline, esmolol 2 mg.kg-1, alfentanil 0.03 mg.kg-1 and alfentanil 0.015 mg.kg-1+esmolol 1 mg.kg-1. Anaesthesia was induced with thiopentone. Succinylcholine was used to facilitate tracheal intubation. Haemodynamic variables were measured non-invasively and the QTc interval with the aid of a microcomputer. Comparisons between the groups were performed using two-way analysis of variance with repeated measures. Both alfentanil and alfentanil-esmolol prevented the increase of heart rate and arterial pressure caused by intubation whereas esmolol prevented only the increase of the heart rate. None of the treatments prevented prolongation of the QTc interval after intubation and only alfentanil prevented that after succinylcholine. The present results suggest that in the prevention of the haemodynamic responses to tracheal intubation, the half-dose combination of alfentanil and esmolol is as effective as alfentanil and superior to esmolol. The combination is preferable to relatively large doses of either drug in circumstances where side effects, such as respiratory depression due to alfentanil or bradycardia due to both drugs should be minimized.
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PMID:Modification of the haemodynamic responses to induction of anaesthesia and tracheal intubation with alfentanil, esmolol and their combination. 778 27

We have determined the effect of pretreatment with mivacurium on the potency of suxamethonium and the effect of prior administration of suxamethonium on the potency of mivacurium. We studied 100 ASA I or II patients during thiopentone-fentanyl-nitrous oxide-isoflurane anaesthesia. Neuromuscular block was recorded as the evoked thenar mechanomyographic response to train-of-four stimulation of the ulnar nerve (2 Hz at 12-s intervals). Single dose-response curves were determined by probit analysis. Pretreatment with mivacurium had a marked antagonistic effect on the development of subsequent depolarizing block produced by suxamethonium. The dose-response curves for suxamethonium alone and after pretreatment with mivacurium did not deviate from parallelism, but those constructed after mivacurium were shifted significantly to the right (P < 0.0001). The calculated doses producing 50% depression of T1 (ED50) were 86 (95% confidence intervals 83-88) and 217 (208-225) micrograms kg-1 for suxamethonium alone and after mivacurium, respectively. This study also demonstrated that prior administration of suxamethonium did not appear to influence either the slope of the regression lines or the potency of mivacurium. Combining the results of this study with a previous study (mivacurium ED50 = 20.8 (20.3-21.3) micrograms kg-1 during isoflurane-nitrous oxide anaesthesia), we suggest that the potency of mivacurium did not differ from that observed after suxamethonium (17.4 (16.9-17.9) micrograms kg-1).
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PMID:Dose-response studies of the interaction between mivacurium and suxamethonium. 788 Jul

We have studied the neuromuscular effects of pipecuronium, vecuronium and their combination in 130 ASA group I or II patients. Patients were anaesthetized with 0.8% halothane and 60% nitrous oxide in oxygen. Neuromuscular block was recorded as the evoked thenar mechanomyographic response to train-of-four stimulation of the ulnar nerve (2 Hz at 10-s intervals). The dose-response curves were determined by probit analysis. The calculated doses producing 50% depression of the first twitch height were 15.6, 16.9 and 15.0 micrograms kg-1 for the pipecuronium, vecuronium and pipecuronium-vecuronium combination groups, respectively. Isobolographic and algebraic (fractional) analyses were used to assess quantitatively the combined neuromuscular effect of pipecuronium and vecuronium and to define the type of interaction between these drugs. The interaction between pipecuronium and vecuronium was found to be additive.
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PMID:Isobolographic and dose-response analysis of the interaction between pipecuronium and vecuronium. 790 51

The speed of onset (T1 = 95% twitch depression) and the duration of action (T1 = 25% control) of equipotent doses of atracurium 0.5 mg/kg and vecuronium 0.1 mg/kg were compared in 21 ASA physical status I and II adult patients. Train-of-four (TOF) ratios (height of T4/T1) were also compared with the first response in the TOF recovered to 25% and 50% control, respectively. Neuromuscular function was measured by the Datex NMT 221 electromyograph at the hypothenar muscles. No significant difference was seen in the onset of action of these two drugs, but a significantly shorter duration of action was observed with vecuronium (P < 0.5). Vecuronium was also found to exhibit significantly more TOF fade on offset of block than atracurium. Vecuronium may offer a distinct advantage over atracurium when a nondepolarizer is required for a relatively short clinical case. However, it appears that vecuronium causes more TOF fade during recovery from neuromuscular blockade than atracurium.
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PMID:A comparison of the onset time, duration of action, and fade characteristics of atracurium and vecuronium. 790 5

The relationship between the changes in haemodynamic function and the electroencephalogram (EEG) during rapid-sequence induction of anaesthesia was studied in 15 ASA I patients. Anaesthesia was induced with a bolus thiamylal (5 mg.kg-1 iv) followed by succinylcholine (1 mg.kg-1). Tracheal intubation was attempted one minute after the injection of succinylcholine. The EEG was monitored by a computerized aperiodic analysis device, the Lifescan (Neurometrics, San Diego, CA) using the activity edge (AE) to detect brain electrical activity. After induction of anaesthesia, systolic blood pressure (sBP) decreased by 11% from the baseline value, and the AE decreased from 13.0 Hz to 3.4 Hz. Following tracheal intubation, the sBP increased from the post-induction values by 44% (P < 0.05), and the AE increased to 13.1 Hz (P < 0.05) simultaneously. In conclusion, rapid-sequence induction using thiamylal (5 mg.kg-1) caused depression in brain activity as assessed by AE, while laryngoscopy and tracheal intubation caused an increase in activity. This indicates that this dose of thiamylal for rapid-sequence induction may not be sufficient to sustain an adequate anaesthetic level and blunt the haemodynamic responses to intubation.
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PMID:Haemodynamic and EEG changes during rapid-sequence induction of anaesthesia. 792 18

The effect of epidural bupivacaine on potency and duration of action of vecuronium-induced neuromuscular blockade (NMB) was evaluated in 30 general surgical paediatric patients (ASA I-II) of three to ten years of age. Premedication was midazolam 0.5 mg kg-1 orally (max 15 mg). In addition to general anaesthesia, 15 of the children received a lumbar epidural block with 0.5% bupivacaine 2.5 mg kg-1. Anaesthesia was induced and maintained with N2O:O2 (2:1), propofol and alfentanil. NMB was monitored by adductor pollicis EMG with the train-of-four stimulus every 20 sec. Thirty minutes following the epidural bupivacaine injection (mean plasma concentration 0.86 micrograms ml-1) or induction of anaesthesia a cumulative dose-response curve of vecuronium was established to achieve a 95% depression of the twitch response. Thereafter, NMB was allowed to recover spontaneously. ED doses of vecuronium were 19-22% greater in the control group than in the epidural group. ED50 doses were 33.8 (s.e. mean 1.3) micrograms kg-1 and 28.4 (2.2) micrograms kg-1, respectively (P < 0.05). There were no differences in recovery times from NMB between control and epidural group, the recovery index (time of twitch height to recover from 25 to 75%) being 6.4 (0.4) min and 7.0 (0.9) min, respectively. However, a negative correlation was found between bupivacaine plasma concentration and an ED50 dose of vecuronium (P = 0.01). Our results indicate that vecuronium is slightly more potent in children with bupivacaine epidural block than in children without it.
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PMID:The effect of epidural bupivacaine on vecuronium-induced neuromuscular blockade in children. 794 39


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