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

The French technique of anaesthesia by electrostimulation described in 1972 by Cara and coworkers, consists of transcranial electrostimulation by means of a high frequency current combined with administration of a neuroleptic drug, a benzodiazepine, a curare and nitrous oxide with oxygen. Fentanyl is also given by some authors. In order to assess the benefit of such electrostimulation, this study compared two randomized groups of ten patients, scheduled for abdominal and pelvic surgery. Both groups received the same drugs (i.e. droperidol, flunitrazepam, pancuronium and nitrous oxide with oxygen), whereas patients in group I were also submitted to electrostimulation. This study describes and discusses the clinical behaviour of patients and the hormonal reactions before, during and after surgery. In both groups, operative conditions were satisfactory. Recovery and onset of spontaneous ventilation were rapid and no patient had an unpleasant recall of the operation itself. However, most of them complained of postoperative pain. Electrostimulation did not reduce the quantity of drugs required during and after surgery. In both groups, circulatory activity was significantly increased. In group I, the arterial pressure and the heart rate were significantly higher than in group II during and after surgery. The hormonal reactions showed that in both groups adrenocorticotrophic hormone, growth hormone and antidiuretic hormone increased during surgery. Adrenocorticotrophic hormone concentration was higher in group I during the operation. The serum levels of cortisol decreased before surgery in group I and rose in both groups during and after laparotomy; prolactin increased before surgery.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Electro-drug anesthesia. Clinical and hormonal effects of transcranial electrostimulation]. 299 Feb 60

The authors used the absence of vocalization and movement during application of a hemostat clamped to the first ratchet at the base of the tail as an indication of anesthesia for evaluation of the anesthetic properties of fentanyl in the dog. Eighty-six unpremedicated, unrestrained, untrained mongrel dogs were given one of eight doses of fentanyl citrate (125, 250, 500, 750, 1000, 1500, 2000, and 3000 micrograms/kg) as a single intravenous bolus injection. Dogs breathed spontaneously without oxygen supplementation. Anesthesia was assessed every 5 min until absence of anesthesia was recorded for two consecutive evaluations. Venous plasma samples were obtained in two or three dogs receiving each of the doses of fentanyl 5 min after fentanyl injection and again when application of the tail clamp elicited either vocalization or movement (positive response). Fentanyl resulted in recumbency in all animals except two receiving 125 micrograms/kg. Although all doses of fentanyl produced anesthesia in at least one animal 5 min after injection, the duration of anesthesia was short, responses unpredictable, and anesthesia achieved in all animals only with a dose of 3000 micrograms/kg. Increasing doses of fentanyl resulted in higher plasma fentanyl concentrations 5 min after injection and at the time of the first positive response to tail clamp but there was great variability. All doses of fentanyl caused statistically significant decreases in heart and respiratory rates but none produced apnea or a PaCO2 higher than 67 mm Hg.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Is fentanyl an anesthetic in the dog? 310 33

Midazolam, with a half-life of about 1.5-3.5 h, is inappropriate for the maintenance of anaesthesia during long procedures, especially when rapid recovery is necessary. The efficacy of flumazenil, a specific benzodiazepine antagonist, in the treatment of patients with benzodiazepine overdose suggests that rapid recovery from anaesthesia induced and maintained with midazolam might be obtained in patients needing immediate assessment. The rate of recovery, the side-effects and the feasibility of an early and accurate neurological assessment were studied in 18 ASA III patients after craniotomy in whom the prolonged effects of midazolam had been antagonized by flumazenil. Surgery lasted 5.5 +/- 1.3 h (means +/- SD). The induction dose of midazolam was 0.32 +/- 0.08 mg.kg-1 and the infusion rate was 0.2 +/- 0.08 mg.kg-1.h-1. Fentanyl was added at a dose and rate of 5.0 +/- 3.6 micrograms.kg-1 and 2.0 +/- 0.9 micrograms.kg-1.h-1 respectively. At the end of the dressing, 0.5 mg of flumazenil (t0) was injected, followed by 0.1 mg every minute up to a total of 1 mg. After 2 min, 14 patients (78%) opened their eyes (p less than 0.05) and 13 (72%) obeyed orders (p less than 0.05). After 10 min, 16 patients (89%) were extubated and speaking. During the first 10 min, the Glasgow score and the sedation score used for this study showed the same progression, with 13 patients (72%) having a Glasgow score of 14-15 (p less than 0.05). Thereafter, both scores decreased progressively till t60, then increased again, reaching their t10 level at t120. Three patients required another dose of antagonist.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Use of flumazenil (RO 15-1788) after prolonged infusion of midazolam in anesthesia for intracranial surgery]. 312 85

In a randomized, prospective, double-blind trial we investigated the efficacy and safety of the benzodiazepine antagonist RO 15-1788 in 57 patients undergoing general surgery. Anesthesia was induced and maintained by a combination of Flunitrazepam-Fentanyl-Pancuronium. Inhalation anesthetics were excluded from the study. After reversal of any residual relaxant effect we titrated RO 15-1788 or placebo by repeated i.v. administration of 0.1 mg (= 1.0 ml) up to a maximum dosage of 1.0 mg or to a definite arousal reaction. Before as well as 5, 10, 15, 30, 60, and 120 min after injection of the trial substance we evaluated efficacy (sedation, comprehension and collaboration, orientation in time and space), presence of anterograde amnesia, side-effects, hemodynamics, and subjective patient assessment by a point scale. RO 15-1788 significantly improved the level of consciousness (P less than 0.005) at a dosage of 0.59 +/- 0.29 mg at 5, 15, 30, and 60 min after administration as well as orientation in time and space (P less than 0.005) after 30 min. There was significantly less anterograde amnesia (P less than 0.005) after 15, 30, and 60 min. Symptoms of a benzodiazepine rebound effect after 120 min indicate a short half-life time of RO 15-1788. We did not observe any hemodynamic side effects. Local tolerance was good. Side effects in terms of nausea (1 case), vomiting (4), euphoria or dysphoria (2), benign cardiac arrhythmias (1) or a state of excitation (1) occurred several times after RO 15-1788 as well as after placebo (nausea 2, vomiting 6, muscular tremor 1). Our results indicate the efficacy and safety of RO 15-1788.
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PMID:[Efficacy and safety of the benzodiazepine antagonist RO 15-1788]. 313 35

Fentanyl and alfentanil may cause bradycardia if used in combination with succinylcholine during induction of anaesthesia. We therefore studied the influence of atropine, fentanyl and alfentanil on the haemodynamics of 90 urological patients (ASA I, II), who were allocated at random to six groups containing 15 patients each. Induction of anaesthesia was carried out using atropine 0.01 mg/kg-1, fentanyl 0.15 mg or alfentanil 1.5 mg depending on the assigned group: I atropine + fentanyl, II: atropine + alfentanil, III: fentanyl, IV: alfentanil, V: control (no atropine, no analgetic), VI: atropine. Following 2 mg alcuronium and thiopentone 4 mg/kg-1 intubation was performed with 2 mg/kg-1 succinylcholine. Atropine in combination with fentanyl caused a significant increase in heart rate following endotracheal intubation (p less than 0.05). Arrhythmias occurred in the groups with atropine in 4 out of 45 cases, while a chest wall rigidity was not influenced by atropine. Bradycardia occurred after fentanyl or alfentanil with atropine in the same frequency as without atropine. According to our results the routine use of atropine for induction of anaesthesia with thiopentone/fentanyl or alfentanil even in combination with succinylcholine is not required in ASA I or II patients.
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PMID:[The effect of atropine, fentanyl and alfentanyl on cardiocirculatory parameters and thoracic rigidity in the induction phase of intubation anesthesia]. 314 55

In 1987 a new law was enacted in Czechoslovakia which decreed that mini-abortions (MA) ought to be performed without general anesthesia if possible. At the Prague-Podoli institute for maternal and child health, there had been plenty of experience with this procedure, as it was the first facility to carry out MAs. From 1977-87 6008 MAs were performed mostly with generally anesthesia. In prior years there had been experience with a host of anesthetics and analgesics: Thiopental, Epontol, Sombrevin, Ketalar, Althesin, Dormicum, Hypnomidate, Penthrane, Anecotan, Fortal, Tramal, Valoron, Fentanyl, and Alfentanyl. However, none of these was used in this facility for preparation, as they did not fulfill the requirements of anesthesia for MA. On the other hand, a ketamine-diazepam combination was eventually used on the advice of specialists from a Prague obstetrical clinic. After premedication with .5 mg of atropine iv, 5 mg of diazepam was given iv, and subsequently ketamine (Narcamon) was administered in doses of .5 mg/kg body weight. As the dose proved to be sometimes too small, the total dose had to be increased to .6-.7 mg/kg body weight. This method provided sufficiently deep anesthesia for performing MA. Most patients recovered 30-45 minutes after the procedure, but in about 10% of cases hallucinations with extensive disturbance and temporal disorientation set in. These symptoms disappeared 15 minutes after the end of the procedure. In 1987, 1140 MAs were done by using this method. The preconditions of the operation are the proper collaboration of the gynecologist and anesthesiologist, as well as the requisite staff and material resources. Some other principles include: proper selection of patients (term of pregnancy, exclusion of diseases, psychic conditions); evaluation of the physical condition of the patient; and exclusion of disturbing factors. In 1987, 100,000 induced abortions were carried out in Czechoslovakia, 70% of which were MAs. The new law assures that the patient suffers the least physically and psychologically.
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PMID:[Anesthesia for mini-abortions]. 316 96

This study investigated blood pressure in guinea pigs while they were 1) alert and free moving, 2) anesthetized with different anesthetics, and 3) exposed to continuous, 115 dB SPL white noise under anesthesia. The animals were prepared with a carotid artery catheter and permitted to recover for 48 h before blood pressure levels were measured. Mean arterial blood pressure in the resting, unrestrained guinea pig was 64 mmHg (+/- 1.38 S.E.). Ketamine Hydrochloride (Ketamine) significantly decreased, and Fentanyl-Citrate significantly increased, blood pressure. Fentanyl-Droperidol produced no substantial blood pressure change. Guinea pigs anesthetized with Fentanyl-Citrate and Fentanyl-Droperidol demonstrated significant blood pressure increases when exposed to noise, with the Fentanyl-Citrate group showing a greater response. Animals anesthetized with Ketamine Hydrochloride exhibited no significant blood pressure changes when exposed to the noise.
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PMID:Blood pressure in resting, anesthetized and noise-exposed guinea pigs. 317 Mar 63

This study was designed to determine whether alterations in the median nerve somatosensory evoked potentials occur during the stimuli of tracheal intubation and skin incision. Twenty-two patients scheduled for elective surgery and who required tracheal intubation were studied. Median nerve somatosensory evoked potentials were recorded, analysed and stored approximately every 40 seconds. Anaesthesia was induced with thiopentone and vecuronium used for neuromuscular blockade; the trachea was intubated 2 minutes after induction. Fentanyl 1.5 micrograms/kg was administered subsequently. Evoked potential monitoring was continued until at least 2 minutes after surgical incision. Induction of anaesthesia was associated with an increase in evoked potential latency of 0.8 msec and reduction in amplitude of 1.7 microV. Small, statistically insignificant changes occurred between induction of anaesthesia and tracheal intubation. Surgical incision was accompanied by a statistically significant mean decrease in evoked potential latency of 0.5 msec and a statistically significant increase in evoked potential amplitude of 0.6 microV. The fact that surgical stimulation produced an activating effect on evoked potentials suggests that they may be used as a measure of the neurophysiological effects of anaesthesia.
Anaesthesia 1988 Oct
PMID:The effect of tracheal intubation and surgical stimulation on median nerve somatosensory evoked potentials during anaesthesia. 320 97

The effects of propofol on cerebrospinal fluid pressure, mean arterial pressure, cerebral perfusion pressure and heart rate were studied during induction, tracheal intubation and skin incision in 23 patients scheduled for elective craniotomy. Premedication consisted of midazolam 0.1 mg/kg intramuscularly and metoprolol 1 mg/kg orally. Measurements were made or derived at time zero and 0.5, 1, 1.5, 2 and 3 minutes after an induction dose of propofol 1.5 mg/kg. A continuous infusion of propofol was started at time zero at a rate of 100 mg/kg/minute. Fentanyl 2 micrograms/kg was added before tracheal intubation, application of the pin head holder and skin incision. Cerebrospinal fluid pressure and mean arterial pressure decreased significantly 2 minutes after propofol alone, by 32% and 10% respectively, while a cerebral perfusion pressure above 70 mmHg was maintained. Heart rate did not change. Propofol combined with moderate dose of fentanyl, obtunded the usual cerebrospinal fluid and arterial pressure responses to intubation and other noxious stimuli. Thus propofol seems to be a suitable intravenous anaesthetic agent for induction and maintenance in neuroanaesthesia.
Anaesthesia 1988 Mar
PMID:Effect of propofol on cerebrospinal fluid pressure and cerebral perfusion pressure in patients undergoing craniotomy. 325 94

Fifty women of ASA grade 1 or 2 scheduled to undergo minor gynaecological procedures were allocated randomly to two groups. Group A received fentanyl 100 micrograms intravenously before induction; group B received no sedative or analgesic drugs. Anaesthesia was induced with propofol intravenously and maintained using 67% nitrous oxide in oxygen with incremental doses of propofol. Induction time and dose were significantly less and mean arterial pressure decreased significantly lower in Group A. These differences were, however, small and the ranges of values were large. The incidence of side effects and subjective assessment of quality of anaesthesia were similar in both groups. Fentanyl did not confer any practical advantage when used with propofol in the techniques described above.
Anaesthesia 1988 Mar
PMID:The effect of fentanyl on propofol requirements for day case anaesthesia. 325 4


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