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

Pharmacokinetic studies on atropine were performed in 52 patients under general or spinal anaesthesia. Age had a clinically significant effect on the kinetics of this alkaloid: in children under 2 years of age and in the elderly a prolonged elimination was found. This might explain, partly at least, the higher sensitivity of these age groups to the effects of atropine. Age had no effect on the serum protein binding of this alkaloid. Atropine was found in human CSF after a single i.m. administration, but not after a single i.v. administration. During anaesthesia after i.v. atropine administration, a diminished cardiovascular response was found in the elderly in comparison with healthy adult patients. This indicates changes also at the cholinergic receptor sites in the elderly.
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PMID:Pharmacokinetic studies on atropine with special reference to age. 712 3

A rare case of duplication of the middle cerebral artery with a ruptured aneurysm on its origin during pregnancy was reported. A 29-year-old woman, primipara, was admitted to our clinic at 17 weeks' gestation on June 26, 1979 with a history of sudden onset of severe headache and vomiting, followed by unconsciousness fit for 30 minutes. The patient displayed typical features of subarachnoid hemorrhage. Lumbar puncture revealed bloody CSF. Right carotid angiogram 20 days after admission demonstrated duplication of the middle cerebral artery arising from the terminal internal carotid artery and a small aneurysm at its origin. There was evidence of associated spasm in the internal carotid artery, M1 and A1 portion without hematoma. The patient was treated conservatively for 2 months and then aneurysm surgery was performed. At operation, under the hypotensive anesthesia, on August 21, 1979, the presence of duplication of the middle cerebral artery on the right side and ruptured aneurysm on its origin were confirmed. The neck of aneurysm was completely clipped. Fetal heart rates were monitored by Doptone monitor during the operation. Postoperative course was excellent. Three months postoperatively, the patient went into spontaneous labor, at 40 week's gestation, and delivered a healthy infant. Clinical management of subarachnoid hemorrhage in pregnancy and the relationship between anomaly of the middle cerebral artery and aneurysm were discussed with the literature.
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PMID:[A case of duplication of the middle cerebral artery with ruptured aneurysm on its origin during pregnancy (author's transl)]. 724 17

The effects of sodium nitroprusside on intracranial pressure were studied in 10 patients, candidates for surgical treatment, prior to anaesthesia. Blood pressure was lowered to at least 50% of its initial value. In all cases, at the beginning of nitroprusside infusion, both the mean and the pulse intracranial pressures increased (mean increase: 83.2% of the initial value). At a certain moment, however, while the blood pressure continued to fall, the mean intracranial pressure did not increase any more; on the contrary, it decreased. On the other hand, in many cases, the pulse intracranial pressure continued to increase. No neurological or EEG changes were observed. The possible changes of cerebral circulation and CSF dynamics underlying the phenomena observed are discussed.
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PMID:Sodium nitroprusside and intracranial pressure. 731 51

The concentration of procaine in the CSF of 10 adult nonpregnant cows was determined after epidural injection of 5% procaine hydrochloride solution. Samples of CSF were removed through a catheter introduced into the subarachnoid space at the lumbosacral intervertebral space and advanced craniad to the same level as the epidural injection site. The position and the location of the catheter and spinal needle were confirmed radiographically. Segmental analgesia was achieved 8 to 20 minutes after completing the procaine hydrochloride injection and extended between spinal cord segments T12 and L3 on one or both sides of the animal. The average duration of analgesia, as determined by response to superficial and deep muscular pinpricks at the L1 dermatome, was 81.3 +/- 22.8 minutes (min-max, 45-127 minutes). The average subarachnoid concentration of procaine 10 minutes after epidural injection was 120.4 +/- 42.9 microgram/ml. The highest average procaine concentration recorded was 160.7 +/- 63.7 microgram/ml at 25.0 +/- 6.7 minutes after injection. Average procaine concentration was 47.8 +/- 13.5 microgram/ml at cessation of analgesia. A similar concentration of procaine was recovered from the subarachnoid space during either unilateral or bilateral analgesia. Procaine was not found in arterial plasma after the epidural administration of procaine hydrochloride. Subarachnoid threshold concentrations of local anesthetic necessary to produce spinal analgesia were reached after repeated epidural injections, but not after a single administration. It is concluded that segmental epidural analgesia is principally due to anesthesia of dura-covered nerve roots within and outside the epidural space and is minimally, if at all, dependent on the production of analgesia of nerves within the subarachnoid space.
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PMID:Appearance of procaine in spinal fluid during segmental epidural analgesia in cows. 733 26

The brain acid-base status and metabolites were measured in 17 mongrel dogs that were anesthetized with pentobartital (20-25 mg/kg initially and 2-4 mg/kg every 2 h thereafer), or initially anesthetized with sodium pentothal (20 mg/kg) and placed on nitrous oxide (70% N2O-30% 02) for 5-51/2 h under normoxic, normocapnic conditions. In comparison with the awake, unrestrained state, both anesthetics caused a significant metabolic acidosis in both plasma and cisternal CSF. No significant differences between anesthetics were found with: (1) acid-base status in plasma or brain ECF and ICF; (2) cerebral tissue energy charge potential; or (3) creatine and phosphocreatine levels and the creatine to phosphocreatine ratios. No differences were found in the ATP to ADP ratios, but lactate to pyruvate ratios were significantly lower. Within pentobarbital anesthesia, citrate levels were higher, while other TCA metabolites measured were lower. Further, the citrate to alpha-ketoglutarate and malate to oxaloacetate ratios were significantly increased. We propose that pentobarbital anesthesia lowers metabolic activity in brain tissue and the primary site of 'crossover' inhibition is between citrate and alpha-ketoglutarate.
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PMID:Effects of prolonged N2O and barbiturate anesthesia on brain metabolism and pH in the dog. 737 40

To estimate the compatibility of opiates with tissue we measured the pH of opiate solutions in comparison to local anaesthetics. Piritramide and opium solutions revealed very low pH values (3.96 and 3.38). Two patients, who underwent EOA for the last two and a half three weeks before their death showed, macroscopically and microscopically, no signs of effect on tissue. The examination of the compatibility of opiate solutions and local anaesthetics with CSF showed a deproteinisation of CSF after Piritramide and a rise of opacity after opium. Of the local anaesthetics tested, only Editocaine interferred by crystallizing of the substance. In conclusion, all opiates except piritramide and opium can be used in EOA. In our opinion bupivacaine but not editocaine can be used for spinal anesthesia. All opiates tested can be mixed either with bupivacaine or editocaine.
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PMID:[Epidural opiate analgesia (EOA), compatibility of opiates with tissue and CSF (author's transl)]. 744 49

1. A sample of patients having attempted to commit suicide by using violent methods (hanging, jumping) was investigated according to the following procedure: for each patient, some evaluative tests (the MADRS, the SCL 90 and an agressivity scale) were administered and DSM III diagnosis was provided as well as the therapeutical orientation. 2. The 5 HIAA' level was measured in the CSF soon after the suicide attempt except for patients with rachis fracture or exposed to a cerebral oedeme. 3. Results were compared to those of a control group composed with patients having operated with rachi-anesthesia for orthopedic surgery. 4. The preliminary results show that 5 HIAA' levels were lower for suicide patients except for one schizophrenic patient. 5. This study suggests the possible link between a low 5 HIAA' level in CSF and the clinical aspects of severe suicidal behaviour.
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PMID:Serotonine and suicide: a preliminary study concerning a sample of violent suicidal patients. 752 19

A 4-year-old English Springer Spaniel with ataxia was examined because of progression of neurologic signs. Complete physical examination and results of CBC and serum biochemical analysis revealed no other abnormalities. The dog developed respiratory arrest and was euthanatized during recovery from general anesthesia, which had been performed to obtain a CSF sample. Results of CSF analysis were within reference limits. Necropsy revealed a single, well-circumscribed mass in the cerebellum, which was diagnosed as lymphosarcoma. The dog had no peripheral lymphadenopathy or organomegaly suggestive of the generalized form of the disease.
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PMID:Ataxia associated with lymphosarcoma in a dog. 755 25

The objective of the study was to assess total cerebrospinal creatinine-kinase activity (CSF-CK) measurement in differential diagnosis of "metabolic" and organic causes of coma. The setting for the study was a tertiary care reference medical center and community general hospital. The design of the study was a series of consecutive patients with profound coma (Glasgow scale ratings between 3 and 6) as the presenting complaint to the emergency room and controls. Measurements and main results were as follows: CSF-CK was measured in 103 consecutive patients including 18 patients with metabolic causes of coma, 27 patients with organic causes of coma, 18 patients scheduled for elective orthopedic surgery with epidural anesthesia and 27 patients with compressive myelopathy and radiculopathy. CSF-CK activities were significantly different between groups (H = 29.48, p < 0.001, Kruskal-Wallis test), controls had a median of 0 mU/ml (range 0-16 mU/ml), patients with metabolic causes of coma had a median of 0 mU/ml (range 0-65 mU/ml), patients with compressive myelopathy or radiculopathy had a median of 19 mU/ml (range 0-80 mU/ml), and patients with organic causes of coma had a median of 20 mU/ml (range 0-400 mU/ml). The test sensitivity was 83% (95% confidence interval (CI 65-100%) specificity 62% (CI 43-80%) positive predictive value 60% (CI 49-79%) and negative predictive value 85% (CI 75-95%). The conclusion of the study was that the test is useful for ruling out metabolic causes of coma when CSF-CK activity is high (i.e., above 16 mU/ml).
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PMID:An assessment of cerebrospinal fluid's total creatine-kinase activity in the differential diagnosis of metabolic and organic causes of coma. 771 42

The aim of this study was to evaluate the influence of perfusion media with different glucose concentrations on dialysate levels of lactate, pyruvate, aspartate (Asp), and glutamate (Glu) under basal and hypoxic conditions in rat brain neocortex. Intracerebral microdialysis was performed with the rat under general anesthesia using bilateral probes (o.d. 0.3 mm; membrane length, 2 mm) perfused with artificial CSF containing 0.0 and 3.0 mM glucose, respectively. Basal dialysate levels were obtained 2 h after probe implantation in artificially ventilated animals. Dialysate levels of glucose were also measured for the two different perfusion fluids. The mean absolute extracellular concentration of glucose was estimated by a modification of the no-net-flux method to be 3.3 mmol/L, corresponding to an average in vivo recovery of 6% for glucose. Hypoxia was induced by lowering the inspired oxygen concentration to 3%. Hypoxia caused a disturbance of cortical electrical activity, evidenced by slower frequency and lower amplitudes on the electroencephalogram compared with prehypoxic conditions. This was associated with significant elevations of lactate, Asp, and Glu levels. There were no statistically significant difference in dialysate metabolite levels between the two perfusion fluids, during either normal or hypoxic conditions. We conclude that microdialysis with glucose-free perfusion fluid does not drain brain extracellular glucose in anesthetized rats to the extent that the dialysate lactate, pyruvate, Asp, and Glu levels during basal or hypoxic conditions are altered.
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PMID:Influence of perfusate glucose concentration on dialysate lactate, pyruvate, aspartate, and glutamate levels under basal and hypoxic conditions: a microdialysis study in rat brain. 779 Aug 68


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