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

The clinical effects and pharmacokinetics of ketamine, administered as an i.v. infusion, were studied in 31 patients. Anaesthesia was induced with ketamine 2 mg kg-1 i.v. and maintained using an i.v. infusion of ketamine, supplemented by nitrous oxide. The plasma concentrations of ketamine, nor-ketamine and dehydro-nor-ketamine were analysed using gas-liquid chromatography. The average maintenance dose of ketamine was 41 +/- 21 microgram kg-1 min-1, but there was an obvious decrease in the dose required as anaesthesia progressed. This dose gave a stable plasma concentration of ketamine of 9.3 +/- 0.8 mumol litre-1. Patients recovered at 2.7 +/- 0.9 mumol litre-1. Plasma half-life of ketamine was 79 +/- 8 min. Maximum concentration of nor-ketamine was 4.7 +/- 2.4 mumol litre-1 and of dehydro-nor-ketamine 3.2 +/- 1.9 mumol litre-1. There were transient increases (15-30% of pre anaesthetic values) in arterial pressure, heart rate and cardiac output during operation. No post-operative respiratory depression was seen.
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PMID:Ketamine infusions: pharmacokinetics and clinical effects. 52 85

The haemodynamic effects of the induction of anaesthesia with Althesin 0.1 ml.kg-1 were studied in eight patients with valvular heart disease before tracheal intubation and surgery. A 20 per cent reduction in stroke index was compensated for by an increase in heart rate of similar magnitude. Cardiac index, mean arterial, pulmonary arterial, central venous and pulmonary capillary wedge pressures and systemic vascular resistance were unaffected. Pulmonary vascular resistance declined by nearly 30 per cent. It is therefore conclude that Althesin causes only minimal cardiovascular depression in patients with valvular heart disease.
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PMID:Cardiovascular haemodynamics after induction of anaesthesia with althesin in patients with valvular heart disease. 52 70

The interaction between (--)-cocaine and responses to 5-HT elicited through serotonin receptors on autonomic neurones has been investigated on the rabbit heart and the guinea-pig ileum. Low concentrations of (--)-cocaine or its stereoisomer, (4)-pseudococaine, produced shifts to the right of the 5-HT dose-response curves on heart and ileum with no depression of the maximum responses to electrical stimulation or dimethylphenylpiperazinium remained unaffected. A Schild analysis of data obtained on heart and ileum indicated competitive antagonism of 5-HT by (--)-cocaine. Antagonism of 5-HT by the cocaine isomers cannot be ascribed to local anaesthesia per se since neither lignocaine, tetracaine, benzocaine nor bu tacaine were selective antagonists of 5-HT. Similarly, inhibition of monoamine uptake seems of minimal relevance since desipramine proved only a weak antagonist of 5-HT on the heart and did not influence the 5-HT antagonist potency of (--)-cocaine. Selective blockade of 5-HT neuronal responses is a property shared by several structural analogues of (--)-cocaine and (+)-pseudococaine; nor-(--)-cocaine proved the most potent of these, being active at a concentration of 2 x 10(-8) M. These data indicate that (--)-cocaine and several of its derivatives inhibit 5-HT stimulation of both adrenergic and cholinergic autonomic neurones through competition with the agonist at serotonin receptor sties. Since morphine, the tool normally used to identify responses mediated through neuronal serotonin receptors, acts only at certain "morphine-sensitive" junctions and then, non-discriminately, the cocaine analogues, and particularly nor-(--)-cocaine would seem to offer real advantages as tools for differentiating such responses.
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PMID:Blockade of serotonin receptors on autonomic neurones by (-)-cocaine and some related compounds. 52 45

A retrospective evaluation was made of the blood pressures of 131 patients with hypertensive late gestosis who had undergone caesarean section for maternal or foetal indications, between 1971 and 1977. Rauwolfia preparations should be avoided in both long-term and acute hypotensive treatment of late gestosis patients not only for their unfavourable impact upon circulation at large, but also for their cumulative effects in terms of drastic depression of blood pressure in case of anaesthesia necessary for whatever reason. Acute hypotensive-sedative treatment should be discontinued and resumed, only if necessary, not until anaesthesia is over following surgical termination of pregnancy. Imminent eclamptic fit would be the only exception acceptable. Anaesthesia should be induced, using the base anesthetic propanidid which worked extremely well in terms of circulatory stabilisation. It is obviously superior to barbiturates in that particular respect.
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PMID:[Blood pressures in gestosis patients under general anaesthesia following hypotensive treatment (author's transl)]. 53 34

Central circulation, renal function, and fluoride formation and excretion were studied in nine patients during enflurane anaesthesia and surgery. Cardiac output and mean systemic arterial pressure remained unchanged compared with preoperative control values. During anaesthesia and surgery, urine flow rate, inulin clearance, PAH clearance and fractional sodium excretion were 60, 65, 55, and 45% of control values, respectively. Mean peak plasma level of fluoride was 20.0 microM. It was reached 4 hours after termination of anaesthesia. Fluoride clearance (CF) decreased from 23.9 ml . min-1 to 2.7 ml . min-1 during anaesthesia. Postoperative, CF increased to 41.6 and 76.0 ml . min-1, respectively, during two consecutive measurement periods. There was no correlation between plasma fluoride levels and depression of any renal function variable.
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PMID:Renal function and fluoride formation and excretion during enflurane anaesthesia. 53 40

Screening studies are carried out of the pharmacological activity of 3,4-dihydropapaverine (DHP) and three of its newly-synthesized derivatives: 6'-iodo-DHP, 6'-bromo-DHP and 6'-iodu-DHP methiodide. All compounds studied manifest central depressive action which is manifested in general depression, potentiation of hexobarbital anaesthesia, without inducing sleep when independently applied, as well as inhibition of the spontaneous and amphetamine-induced motor activity of mice. 6'-Iodo-DHP and its methiodide manifest analgesic effect. All four compounds studied reduce the blood pressure of urethane-anaesthesized cats, but they do not change the noradrenaline and the acetylcholine effects. The hypotensive effect of the compounds is preserved even after atropinization of the cats. The compounds studied manifest no antitussive effect. DHP-derivatives eliminate the spasms in guinea-pig colon, induced by BaCl2 and nicotine, while DHP has no effect on them. 6'-Iodo-DHP methoiodide inhibits the hypertensive nicotine effect on cats. DHP and 6'-iodo-DHP methoiodide manifest vasoconstricting action upon perfusion of the blood vessels of isolated rat hind legs.
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PMID:Screening pharmacological studies of four dihydroisoquinoline derivatives. 53 51

Total I.V. anesthesia was given to 20 patients using an Etomidate continuous infusion to maintain sleep, combined to Fentanyl analgesia, Droperidol, Pancuronium for muscular relaxation and artificial ventilation with an oxygen-air mixture. All these patients were carefully observed during and for several hours after the anesthesia and the results noted. With the Fentanyl dosages used in this technique, peroperative analgesia was frequently insufficient. More Fentanyl would probably be needed with the inherent dangers of prolonged postoperative depression.
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PMID:Total I.V. anesthesia using a continuous etomidate infusion. 54 55

Minaxolone, a new steroid induction agent, was administered to unpremedicated patients at three dose levels and at 0.5 mg . kg-1 to patients receiving three different premedicant regimes. The main side effects observed at induction were involuntary muscle movements but hypertonus and tremor were also seen. Respiratory complications consisted mainly of hiccough. Over the range of doses studied only the latter complication appeared to be dose-related. Premedication with diazepam and especially opiate combinations reduced the frequency and severity of excitatory effects and respiratory upset and increased the proportion of acceptable anesthesia. Marked respiratory depression and hypotension of greater than 20 mm Hg were rare even after opiate premedication.
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PMID:The influence of dosage and premedication on induction of anesthesia with minaxolone. 54 59

An hemodynamic study has been performed in eight patients (age 68 +/- 7) suffering from complete atrioventricular block. They had to undergo the definitive implantation of a cardiac pace maker under general anesthesia. The fixed cardiac frequency may help to understand the effect of the anesthetic agent used on the cardiac muscle function. Ketamine is the only agent used directly at an initial intravenous dose of 3 mg.kg-1 followed by a perfusion in a constant rate of 0.20 mg.kg-1. min-1. Hemodynamic data (arterial pressure, pulmonary pressures, thermodilution cardiac output) are performed before induction, then every 5 minutes after induction for a 20 minute period. The absence of respiratory depression (PaCO2: 38 +/- 3 mm Hg) shows that hemodynamic changes are entirely due to ketamine. The peak of these changes takes place after 5 minutes (significant rise (p < 0.05) in systemic and pulmonary resistances, in systemic arterial pressure and in pulmonary arterial pressure). Stroke index decreases moderately. After 20 minutes all the parameters have returned to control values. Use of ketamine is not desirable for two reasons: 1 degree The rise of the afterload may alter the hemodynamic state which can be previously deteriorated in patients suffering from atrio-ventricular block. 2 degree Post-anesthetic agitation can displace the right ventricular electrode.
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PMID:[Ketamine anesthesia for definitive implantation of a cardiac pace maker (author's transl)]. 55 78

It is not uncommon to observe prolonged CNS depression for several hours following controlled hypotension and halothane anesthesia for neurosurgery. The present study evaluates possible contribution of large doses of trimethaphan to CNS depression. Four adult sheep were placed on transapical left ventricular bypass (TALVB) withdrawing blood from the apex of the left ventricle through a roller pump, Pall Ultipor filter, and returning the blood to a carotid artery. In the awake and unanesthetized animals, 1 to 2 gm of trimethaphan were administered IV during each experiment while maintaining mean arterial pressure at 60 to 75 torr. Two sheep stood up and knelt down without obvious correlation with dose of trimethaphan administered at the time; two remained standing and continued eating during the trimethaphan infusion. Cardiovascular recovery from these large doses of trimethaphan was within 15 to 30 minutes after the conclusion of drug infusion. The data strongly suggest that large doses of trimethaphan have no significant CNS depression in the awake and unanesthetized sheep.
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PMID:Lack of CNS depression from large doses of trimethaphan in sheep. 55 10


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