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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The cardiovascular effects of endotoxin in the unanesthetized chronically instrumented sheep were investigated. The observations were extended to include the response to intravenous infusions of dopamine to the same sheep at the height of endotoxin action. When the cardiovascular effects of endotoxin in the unanesthetized and anesthetized sheep were compared, there were distinct differences. Unanesthetized sheep tolerated considerably greater dosages of endotoxin. In anesthetized sheep, the compensatory stimulation of the sympathoadrenal system seems to have been blunted and all of the circulatory parameters deteriorate rapidly, ending in death within three hours. In the absence of anesthesia, there was clear evidence of a compensatory sympathoadrenal stimulation, as reflected by the return of most of the circulatory parameters to normal values, and furthermore, the sheep recovered from the effects of endotoxin. The exact mechanism by which anesthesia altered the response of the sheep to endotoxin was not clear. Depression of the baroreceptor and neurohumoral compensatory mechanisms was suggested. The present data indicated that dopamine was a useful agent in correcting the cardiovascular changes brought about by endotoxin.
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PMID:Circulatory effects of endotoxin on unanesthetized sheep and the response to dopamine. 47 92

A comparison was made between the physical and emotional changes experienced by patients, nursing personnel, and physicians with 2 different mid-trimester abortion techniques. 250 dilatation and extraction (D and E) procedures under general anesthesia were compared with abortions by intraamniotic injection of prostaglandins. The only major difference between the 2 sets of patients was that the amnio patients were further along in their pregnancies. At a 3-week follow-up interview, the patients differed significantly in their reactions. The D and E group had fewer complications and described the procedure as minor surgery which went smoothly. The amnio group had experienced more pain and had greater feelings of guilt, anger, and depression. The floor nursing personnel felt anger at being abandoned by the doctors to deal alone, usually in the middle of the night, with the difficult experience of an amnio delivery of a dead fetus. Operating room nurses and doctors found the D and E procedure distasteful and emotionally disturbing. Doctors perferred to perform amnio procedures and not be involved at the time of delivery. The authors' experience leads them to conclude that the D and E procedure is safer, less painful, quicker, more convenient, and less expensive for the patient than the amnio procedure. The psychological problems doctors experience with dismemberment of the fetus may be relieved with development of new techniques.
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PMID:The impact of midtrimester abortion techniques on patients and staff. 47 78

Cardiac catheters were placed in seven healthy conscious patients so that aortic and left ventricular pressures (and the derivative), cardiac output (thermodilution) and myocardial blood flow (argon washin) could be measured. Blood was drawn for measurement of arterial blood-gas and arterial and coronary venous oxygen, glucose, lactate, pyruvate and fatty acid values. After induction of anesthesia by inhalation of halothane, the measurements were made during administration of low (0.70%) and high (1.54%) end-tidal halothane concentrations. Myocardial function decreased in a dose-related fashion without a change in heart rate. Myocardial blood flow and oxygen consumption were depressed in a similar manner. Myocardial oxygen extraction decreased and lactate did not change, suggesting that myocardial oxygenation was adequate. The heart rate-systolic blood pressure product correlated poorly with myocardial oxygen consumption. Systolic blood and the contractile performance index dP/dt/IP were better correlated with myocardial oxygen consumption, but the value of the coefficient was still low. Without significant changes in heart rate, systolic blood pressure is the best correlate of myocardial oxygen consumption in healthy man during the myocardial depression produced by halothane.
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PMID:Myocardial metabolism and oxygenation in man awake and during halothane anesthesia. 47 21

Because of the calf's popularity as an experimental animal and its often noted sensitivity to anesthetics and anesthesia, the potency of halothane was studied in eight, young (x = 5.85 weeks), healthy, male Holstein-Friesian calves. The minimal alveolar halothane-O2 concentration (MAC) which just prevented calf movement in response to a tail clamp was 0.76 +/- SEM 0.03 vol% and is less than predictions based on studies in man. The addition of 50% N2O to inspired gases decreased the halothane MAC to 0.59 +/- 0.03%. In the absence of common modifying factors of anesthesia, halothane-O2 caused cardiopulmonary depression in these calves in proportion to anesthetic dose. Only two (total protein and albumin) of 17 selected blood clinical biochemical values were significantly (P less than 0.05) altered from base line within seven days of anesthesia, indicating insults to major organ systems did not occur.
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PMID:Halothane anesthesia in calves. 47 88

Occlusion pressure (Po max) was used to indicate the depression of respiratory drive following rapid administration of methohexitone 0.5 mg/kg and etomidate 0.067 mg/kg to fourteen patients under stable light anaesthesia. Methohexitone produced considerably more respiratory depression than etomidate, the difference probably being clinically significant. Po max is the maximum sub-atmospheric pressure generated in the trachea when inspiration is prevented by occlusion of the airway, at functional residual capacity. The factors concerning the use of this simple, non-invasive technique during anaesthesia are discussed, and suggestions made for producing consistent, useful, measurements.
Anaesthesia 1979 Jun
PMID:The measurement of occlusion pressure during anaesthesia. A comparison of the depression of respiratory drive by methohexitone and etomidate. 48 13

Chronic renal insufficiency was produced surgically in Fischer 344 rats in order to evaluate the effects of enflurane anesthesia in animals with impaired renal function. Three groups of rats were anesthetized with enflurane: a control group without impairment of renal function (n = 7); a group with minimal impairment of renal function (n = 6); and a group with moderately severe renal impairment (n = 9). Another group of rats with moderately severe renal impairment (n = 8) was anesthetized with halothane. Two hours of anesthesia resulted only in mild transient depression of urea clearance in all groups. Six hours of anesthesia resulted in a 5 to 10 ml/day increase of urinary output in all groups and small increases in urea nitrogen levels in both groups with moderately severe renal impairment. Deterioration of the model was noted late in the experiment; at sacrifice, animals that had been anesthetized with enflurance and four with halothane had terminal renal failure. The morphological lesion in both groups was similar, resembling glomerulonephritis. Thus, there was no difference in the renal response to enflurane or halothane anesthesia among rats with chronic renal insufficiency.
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PMID:Renal effects of enflurane anesthesia in Fischer 344 rats with pre-existing renal insufficiency. 49 Mar 24

The purpose of this study was to determine the incidence of ST-segment depression during anesthesia and operation. Graded exercise testing has demonstrated a high correlation between ST-segment depression and myocardial ischemia. Therefore, 11 patients without and 29 patients with known coronary-artery disease were monitored during surgical procedures with a commercially available exercise electrocardiographic monitor (Viagraph). Comparisons were made between this device, which monitored lead V5, and the standard operating room monitor, which monitored lead 11. Eleven of 29 patients in the disease group demonstrated significant ST depression. Nine of the 11 ischemic episodes were not recognized on the standard operating room monitor. Retrospective review of anesthetic records of those 11 patients with ST-segment depression revealed rate--pressure product values greater than 11,000 for ten of them. Postoperatively, three of the 11 patients with significant ST-segment depression had changing electrocardiograms compatible with ischemia. None of the control group demonstrated significant ST-segment depression. The incidence of ischemia was 38 per cent during anesthesia and operation in the coronary-artery-disease group. Lead V5 analysis is superior to lead 11 analysis in detecting ST-segment depression. The period in which intubation is performed is one of the highest-risk intervals during anesthesia and operation, particularly when it is associated with an increased rate--pressure product.
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PMID:Myocardial ischemia during non-cardiac surgical procedures in patients with coronary-artery disease. 49 52

Local anesthetics administered intrathecally seen more effective when in hypobaric solution than when in hyperbaric solution. To test whether an unrecognized osmotic effect might be playing a part in this, sheathed vagus nerves of rabbit were incubated in electrolyte-deficient or electrolyte-free media of various degrees of hypo-osmolarity. The nerves gained weight over a period of 15 min. They lost nearly half their sodium, but very little potassium, within 5 min. Electrolyte depletion by incubation in sucrose solutions depressed the amplitude of the C-fiber component of the compound action potential more rapidly in hypo-osmotic than in iso-osmotic solutions. In iso-osmotic sucrose, 50 per cent depression developed in 61 +/- 12 min (mean +/- SD, n = 5), but in 0.6 iso-osmotic sucrose, 50 per cent depression was reached in 17 +/- 3 min (n = 5). Lidocaine, 100 microM (approximately 0.003 g/100 ml) in iso-osmotic sucrose was without observed effect; lidocaine, 100 microM in 0.6 iso-osmotic sucrose produced 50 per cent depression in 7 +/- 2 min (n = 4). Thus, osmotic swelling plus electrolyte depletion, but not electrolyte depletion alone, markedly intensified inhibition of conduction by lidocaine. All effects were reversible by returning the nerves to isotonic physiologic incubation medium. The results suggest that intrathecal osmotic swelling of neural tissue may contribute to the conduction block in hypobaric spinal anesthesia.
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PMID:Osmotic swelling effects on neural conduction. 49 57

Hemodynamic monitoring and care of the patient at high risk for anesthesia require a careful and systematic approach. During preoperative evaluation the patient at increased risk must be identified and correctable problems must be solved. The patient's current medications must be reviewed because they may influence the choice of anesthetic approach and may alter the physiologic response to the stresses commonly associated with anesthesia. In addition to conventional clinical and electrocardiographic monitoring, perioperative hemodynamic monitoring may be desirable for patients at special risk, who are likely to have significant associated medical problems or to undergo complicated surgical procedures. No ideal induction agent exists, and hypotension secondary to peripheral vasodilation or myocardial depression, or both, is a potential problem. Patients with an inordinately high risk may benefit from mechanical circulatory assistance prior to induction of anesthesia. Attention to oxygenation, blood volume replacement and the prevention of hypertensive episodes are particularly important during anesthesia so that optimal cardiac performance is ensured and ischemia avoided. The stresses during emergence from anesthesia contribute to lability of the cardiovascular status and hypoxemia. The period of risk does not conclude with immediate recovery from anesthesia but extends through the postoperative phase. Careful monitoring and attention to the control of pain, prevention of hypotension and hypertension, adequate oxygenation, early mobilization and resumption of the administration of cardiac medications are important factors in a successful outcome.
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PMID:Hemodynamic monitoring and care of the patient of high risk for anesthesia. 49 83

The philtrum point VG 26 (Jen Chung) was needled in 69 cases of respiratory depression or apnoea in dogs and cats during induction or maintenance of general anaesthesia. Respiration was restored to normal or near normal rates within 10 to 30 seconds of insertion of the needle in all the cases. In seven cases of anaesthetic apnoea with concurrent cardiac arrest and absence of vital signs, the revival rate was 43 per cent. Those which recovered required four to 10 minutes of acupuncture stimulation. In eight cases of collapse due to other causes, the revival rate was 25 per cent. The cases included five sheep in shock following liver biopsy, two cases of haemorrhagic shock (dog, cat) and one terminal collapse in chronic congestive heart failure (dog).
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PMID:Respiratory and cardiac arrest under general anaesthesia: treatment by acupuncture of the nasal philtrum. 51 10


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