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Query: UMLS:C0278134 (anesthesia)
 110,339 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In 14 patients anaesthetized before undergoing an orthopedic surgical intervention, the variations induced by anaesthesia in the 17 hydroxycorticosterone rate, catecholamine, somatotropic hormone (STH), insulin, glycemia, free fatty acids and thyrotropin (TSH), all these variations were studied before the surgery. The patients were divided into 2 groups of 7, the first one being anaesthestized by chlorprothixene dextromoramide Neurolept-Analgesia and the second one by Alfadione Fentanyl venous anaesthesia.
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PMID:[Comparison of the endocrine response under 2 kinds of anesthesia: neuroleptanalgesia of the chlorprothixene-dextromoramide type and venous anesthesia of the type alfadione-fentanyl]. 0 35

We have been using narconeuroleptanalgesia for anesthesia in cardiac surgery under extra-corporeal circulation since 1969, and we have carried out about 3,500 anesthetics of this type on the 1st of October 1975. For all these anesthetics, the neuroleptic used was droperidol. The other components were: - in the case of the narcotic, penthiobarbital, then more recently Alfatesine; - in the case of the analgesic, either dextromoramide or phenoperidine or Fentanyl; in the case of the curare derivative, D, tubocurarine, and above all, pancuronium dibromide. The advantages of neuroleptanalgesia for such surgery seemed to us mainly: - greater cardio-vascular stability in patients with a heart lesion; - the possibility of better control of cardiac output, i.e. by fillingor by inotropic drugs, thanks to the relative vasoplegia produced by the neuroleptic. Finally, in a recent study, we attempted to determine the hemodynamic effect of droperidol and its association on various analgesic drugs measuring in a few patients the cardiac output, the peripheral resistances the the circulating blood volume. We will report the preliminary results of this study.
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PMID:[Current place of neuroleptics in cardiac surgery under extracorporeal circulation. Cardiovascular effects of different combinations]. 1 67

The study of the effect of analgesics in the newborn is difficult in the clinical situation and resort must be made to animals. Pethidine given within 1 hour of delivery is believed to cause less depression than when the time interval is longer. This study investigates whether it is pethidine or its metabolites which cause respiratory depression by comparing the respiratory effects of pethidine and its metabolites in the newborn rabbit. Fentanyl and buphrenorphine were also investigated as alternative analgesics. The response in the newborn rabbit to anoxia, is periods of dyspnoea, primary apnoea, and gasping. The metabolites of pethidine increased the primary apnoea signifying depression almost as much as pethidine. Depression was also produced when anoxia was induced 5 minutes after pethidine. Fentanyl caused less depression than pethidine or its metabolites excepting normeperidinic acid. Buphrenorphine administration resulted in the least depression with little difference between the low and high doses. Thus both pethidine and its metabolites are factors in the persisting depression, while buphrenorphine compared well with pethidine and fentanyl.
Anaesthesia 1977 Apr
PMID:The role of analgesics in respiratory depression: a rabbit model. 1 6

It is a clinical impression that less fentanyl is needed for anesthesia during hyperventilation and hypocarbia. If true, it might be due to both increased penetration of fentanyl, a highly lipid-soluble agent, into the brain and increased brain tissue binding. Serum and brain concentrations of fentanyl were determined in dogs anesthetized with halothane during normocarbia, hypocarbia by hyperventilation, and hypercarbia by addition of CO2 to the inspired mixture. Fentanyl, 12.5 micrograms/kg, was injected iv, and serum and brain samples were taken for fentanyl analysis by radioimmunoassay. Brain fentanyl values peaked latest (15--20 min) and were highest during hypocarbia; brain fentanyl values peaked earliest (0--5 min) and were lowest during hypercarbia; values during normocarbia were intermediate in time to peak (10--15 min) and concentration. Thereafter, brain levels declined, but during hypocarbia were significantly higher and during hypercarbia were significantly lower than during normocarbia. Interestingly, serum fentanyl levels were also significantly higher during hypocarbia. The brain--blood fentanyl ratios for each of the three CO2 levels increased for 30 min and thereafter stayed relatively constant. The brain--blood ratios were highest with hypocarbia and lowest with hypercarbia. At 35 min, when clinical analgesia may be considered terminated, hypocarbic brain levels were double those of normocarbia. The authors feel this reflects, to a large extent, higher serum fentanyl concentrations and delayed cerebral wash-out because of decreased blood flow. To a small but unknown extent the higher brain fentanyl levels result from increased brain--blood penetration due to increased lipid solubility, and increased brain tissue binding of fentanyl during respiratory alkalosis.
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PMID:Fentanyl concentrations in brain and serum during respiratory acid--base changes in the dog. 3 75

Fentanyl is a strong, synthetic analgesic which may cause muscular rigidity when administered intravenously. To obtain a quantitative measure of the possible increase in muscle tone after intravenous fentanyl, the muscular tension of the right rectus abdominis was measured in 20 patients before and after administration of this drug. A traction transducer apparatus was fastened between the anterior and posterior rectus sheath in a right oblique laparotomy incision. Premedication was with pentobarbitone, and the anaesthesia and muscle relaxation were effected by thiopentone or enibomal and nitrous oxide-oxygen with 75% nitrous oxide, and suxamethonium infusion (0.2%) until the measurement of tension was started. Immediately after the action of suxamethonium had ceased, fentanyl, about 0.004 mg/kg body weight, was administered. An increase in tone was found in 15 cases (75%). The mean increase was 9.2 N. The influence of the anaesthesia upon the result is discussed, and it is concluded that fentanyl must be responsible for the increase in muscle tone.
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PMID:Muscle tone under fentanyl-nitrous oxide anaesthesia measured with a transducer apparatus in cholecystecomy incisions. 13 72

In anaesthesiology of today, due to the increased use of strong analgetics, it is necessary to have an effective antagonist for mini- mizing the danger of respiratory depression in postoperative period. Naloxone, ( Narcan , R-Endo Laboratories Inc., Subsidiary of E. J. du Pont de Nemours and Co., (Inc.), USA), a new narcotic antagonist was investigated in this study. It has been applied to 58 patients in cases of respiratory depression at the end of anaesthesia in which fentanyl was given, (these cases constituted 14% of all anaesthesias). Fentanyl was given intravenously in fractional doses, (fig 1), during NLA, and other general anaesthesias, for operation and diagnostic examination ( exeption of cardiosurgery), in children and adolescents from two month-to nineteen years of age, (tab. 1.). Naloxone was given intravenously, in fractional doses from 1 microgram to 5 micrograms/kg body weight. As a criterium of an antidepressive effect of Naloxone--in addition to clinical evaluation, blood gases analyses and continuous capnographic recording has been accepted. In all 58 cases diminition of respiratory depression was observed 2-3 min. after injected each dose of Naloxone. Respiratory rate increased from 15 to 22/min. concentration of CO2 in expired gases decreased from 5-6% to 4,5%, (fig. 2 and 3), and regain of consciousness, and return of intensive reaction to endotracheal tube stimulation was observed. Naloxone produced neither changes in the cardiovascular system, nor side effects. Based on these results Naloxone has been suggested as an effective narcotic antagonist. It increase of the possibility of applying strong analgetics in children--allowing to keep a steady level of anaesthesia with easy elimination respiratory depression in the desired period of time.
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PMID:[Naloxone as a drug for improving anesthesia results in children]. 26 40

In a retrospective study a comparison was made of the doses of Fentanyl used by anaesthetists to induce and maintain neurolept analgesia for a variety of surgical operations (158 cases). Dosages differed widely both for different surgical procedures and for different anaesthetists. A method, based on pharmacokinetic considerations, was developed for calculating Fentanyl requirements during any stage of anaesthesia. The dose/time relation, as represented by y = At + B (1--e-kt) makes it possible to calculate the required doses of Fentanyl; this enables the anaesthetist to maintain a stable level of anaesthesia and makes antagonization of Fentanyl unnecessary. Methods for determining the coefficients of the dose-time equation are described. Simulation by an analogue computer showed that by using the suggested procedure substantial variations of Fentanyl concentration in the brain and other body compartments can be avoided.
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PMID:[An attempt to determine optimum dosage of fentanyl in neurolept analgesia (author's transl)]. 49 24

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

The cardiovascular effects of three doses of intravenous fentanyl (50, 100, and 200 microgram) were determined in 42 adult patients undergoing intraabdominal surgical procedures with enflurane (2--3%) and nitrous oxide (50%) in oxygen. Fentanyl was administered a minimum of 40 minutes after induction of anesthesia and 30 minutes after initiation of the surgical procedure. Stroke volume, heart rate, cardiac output, mean arterial and central venous blood pressures, and peripheral arterial resistance were determined by computer analysis of the central aortic pulse-pressure curve according to the method of Warner. Measurements were made before and 2, 4, 6, 8, and 10 minutes after fentanyl. Fentanyl (50 microgram) produced increases in stroke volume and cardiac output as well as a decrease in peripheral arterial resistance but did not alter heart rate or mean arterial blood pressure. Fentanyl (100 microgram) did not significantly change any variable at any time. Fentanyl (1l (200 microgram) produced sustained decreases in stroke volume, cardiac output and mean arterial blood pressure and increased central venous pressure but did not alter heart rate or peripheral arterial resistance. The data indicate that fentanyl (50--100 microgram) stimulates or has no effect on cardiovascular dynamics during enflurane-nitrous oxide anesthesia but fentanyl (200 microgram) produces significant cardiovascular depression. Our findings suggest that small doses of intravenous fentanyl may be of benefit during enflurane-nitrous oxide but larger doses should probably be avoided.
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PMID:Cardiovascular effects of fentanyl during enflurane anesthesia in man. 57 55

The effects of fentanyl (1 microgram/kg) supplementing an alfathesin infusion technique were assessed in a double blind study in 53 healthy unpremedicated female patients undergoing therapeutic abortion as outpatients. The addition of fentanyl reduced the tachycardia, tachypnoea and hyperventilation seen in those patients receiving alfathesin alone, without unduly prolonging recovery time. Two patients receiving alfathesin alone developed marked coughing or laryngospasm. Fentanyl would seem to be a desirable addition to an alfathesin infusion technique in unpremedicated patients presenting for outpatient anaesthesia.
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PMID:The influence of fentanyl on an alfathesin infusion technique. 66 76


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