Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0344307 (analgesia)
 28,200 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A rise in fetal Paco2 was observed after elective cesarean section in patients anesthetized both with a barbiturate and with nitrous oxide/oxygen. Epidural analgesia seemed to be a good alternative in order to attain better blood gas values in the newborn infant. Fourteen healthy mothers and their infants were studied in connection with elective cesarean section. Epidural analgesia with plain bupivacaine 0.75% was used. Doses varied between 90 and 120 mg. The time between the epidural injection and delivery was around 50 min. In six cases the fetal heart rate was registered continuously. Most of the mothers were sedated with diazepam intravenously or fully anesthetized, after delivery. The mothers were interviewed later. The respiratory adaptation of the infants was studied by blood gas and acid-base measurements in repeated arterial samples during the first 3 hours of life. A comparison was made with a group previously studied, where general anesthesia with a barbiturate, nitrous oxide/oxygen was the method used. The present material showed no differences concerning Pao2 and Paco2 but clearly indicated a tendency towards an earlier normalization of the initial metabolic acidosis. Mothers showed a respiratory alkalosis which was overcompensated by the metabolic component. Maternal blood pressure falls were observed in four cases, and fetal effects could be detected. Although epidural analgesia has a more favorable effect upon the newborn's metabolic component, both the compared methods allow good respiratory adaptation provided they are used correctly. Mothers can be given the opportunity to choose between being conscious or asleep when their child is delivered.
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PMID:Anesthesia for cesarean section III: effects of epidural analgesia on the respiratory adaptation of the newborn in elective cesarean section. 0 47

Two comparable groups of ten patients were studied. After nitrous oxide-oxygen fentanyl-pancuronium anesthesia, half the patients were reversed with a titrated dose of naloxone. Even in titrated doses naloxone rapidly abolished residual post-operative fentanyl analgesia in 80 p. 100 of the patients. In the control group none of the patients complained of pain for an average of six to eight hours. Blood gases in the recovery room were practically the same in reversed and non-reversed patients and were satisfactory.
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PMID:[Effects of naloxone on postoperative analgesia]. 1 85

The purpose of this study was to assess the degree and frequency of hypoxaemia in elderly patients with fractured neck of femur and to note the effect of manipulation and internal fixation on these measurements. Twenty-seven patients aged between 44 and 93 were studied for 5 days after the fracture and for 5 days after surgery. The fractures were treated by internal fixation under either general anaesthesia or spinal analgesia. The arterial oxygen tension following the fracture but before surgery was low relative to the ages of the patients, and the arterial carbon dioxide tension was low in twenty-five out of twenty-seven patients. There was also a significant increase in the dead space/tidal volume ratio (VD/VT) and the alveolar-arterial oxygen tension difference, (A--a)DO2 in eight out of nine patients in the first 5 days following the fracture. The mean arterial oxygen tension was still reduced up to 5 days postoperatively. The VD/VT ratio returned to normal postoperatively although the (A-a)DO2 remained elevated. The haemoglobin and platelet levels following the fracture and before surgery were low, although not remarkably so, and there was no significant change post-operatively. There were no significant changes in the electrocardiograph or the chest radiographs. These results and their implications are discussed.
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PMID:Hypoxaemia in elderly patients suffering from fractured neck of femur. 2 3

A prospective study of 79 fit young adults who underwent oral dental surgery was undertaken with five different anaesthetic techniques. Anaesthesia was commenced with methohexitone or flunitrazepam, muscle relaxants, and cuffed nasal intubation, and anaesthesia was maintained with 50% nitrous oxide, 50% oxygen, halothane or fentanyl with or without intermittent positive pressure ventilation (IPPV). Six of the 33 patients who received methohexitone and halothane developed dangerous dysrhythmias. Flunitrazepam, IPPV, adequate analgesia and anaesthesia provide maximum cardiovascular stability.
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PMID:Cardiovascular changes during general anaesthesia: for dental surgery. A prospective study of five different anaesthetic techniques. 12 36

Arterial blood gas tensions and acid-base status of spontaneously-breathing, unanesthetized Wister rats were compared with values obtained during 4 hr of thiopental and 6 hr of halothane (1%) anesthesia. During thiopental anesthesia, marked respiratory depression occurred (PaCO-2:57.0 plus or minus 10.0 MM Hg, PaO-2:70.4 plus or minus 11.2 MM Hg). Thirty-six percent of the rats died. During inhalation of room air and 1% halothane, PaO-2 decreased also, whereas PaO-2 did not change. Twenty-seven percent of the original number of rats died. Lowered arterial oxygen tension may have caused death; no rats died during inhalation of oxygen and 1% halothane. This technic insured sufficient analgesia for surgical procedures without marked alterations of the acid base status and is recommended for long-term anesthesia of small laboratory animals like rats.
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PMID:Arterial blood gas tensions and acid-base status of Wistar rats during thiopental and halothane anesthesia. 23 43

The pulmonary and circulatory reactions to insertion of the acetabular and of the femoral prosthesis were studied during total hip replacement surgery in 22 patients with osteoarthrosis. The patients were given lumbar epidural analgesia and were divided into two groups. One group of 15 awake patients breathed air spontaneously (group A). The other group of seven patinets received additional anaesthesia with controlled ventilation with air (group B). This permitted an evaluation of the influence of the ventilatory pattern on the pulmonary and circulatory reactions to the surgical events. The greatest alterations were observed following impaction of the femoral prosthesis. This event caused the following statistically significant changes in both groups: An increase in total pulmonary venous admixture (from a mean value of 6.8 to 12.2% in group A and from 8.2 to 10.5% in group B) and a decrease in arterial oxygen tension (group A: 80.3 to 71.5 mmHg; group B: 82.6 to 76.9 mmHg); an increase in pulmonary vascular resistance (group A: 122 to 155 dyn -s- cm-5; group B: 129 to 164 dyn -s- cm-5) and an increase in mean pulmonary arterial pressure (group A: 17.3 to 19.0 mmHg; group B: 21.8 to 24.4 mmHg). Furtheremore, within the first 2 min after impaction a distinct transient rise in mean pulmonary arterial pressure by 2-4 mmHg was noted in a few patients, and in many patients the mean systemic arterial pressure decreased by 5 mmHg or more. No significant changes were found in cardiac output, pulmonary capillary wedge pressure, oxygen uptake, mixed venous oxygen tension, acid-base values, ratio of total dead space to tidal volume, or total airway resistance. The above findings indicate a tendency to pulmonary vascular and peripheral airway constriction leading to transient ventilation/perfusion disturbances and a decrease in arterial oxygen tension, and peripheral vasodilatation leading to a transient decrease in systemic arterial pressure.
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PMID:Pulmonary and circulatory reactions during total hip replacement surgery. 24 Nov 94

Some circulatory effects of thoracic epidural analgesia (TEA) were investigated in splenectomized, open-chest sheep during normoxia, hypoxia and isoproterenol administration. During normoxia, TEA caused comparatively marked reductions in systemic arterial blood pressure, total peripheral resistance and cardiac output. A fall in heart rate was not compensated for by any rise in stroke volume. Myocardial contractility (LV dd/dt/IP) was not affected by TEA. The proportion of cardiac output diverted to the blocked area was markedly increased. Compensatory vasoconstriction was not observed within the unblocked area in six out of nine animals. Myocardial blood flow showed a pronounced reduction in accordance with the calculated changes of heart work, so that myocardial oxygen extraction remained unchanged. Studies under hypoxia revealed that cardiac responses to hypoxia in the sheep are mediated chiefly by neurogenic factors. TEA abolished the hypoxia-induced rise in heart rate but did not affect the increase in pulmonary vascular resistance caused by hypoxia. The administration of isoproterenol during TEA increased systemic arterial blood pressure, but due to further fall in total peripheral resistance it was not fully normalized. Cardiac output and heart rate increased markedly. Myocardial oxygen consumption and blood flow increased but did not reach control levels.
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PMID:Cardiovascular effects of epidural analgesia. I. Thoracic epidural analgesia. An experimental study in sheep of the effects on central circulation, regional perfusion and myocardial performance during normoxia, hypoxia and isoproterenol administration. 27 92

Eight patients suffering from severe ergotamine-induced peripheral ischaemia were transferred to our institution for hyperbaric oxygen treatment after unsuccessful therapy in the primary hospital. The patients were exposed to 3 ATBS oxygen for 1 hour 2-3 times daily and they were given an epidural block for the purpose of analgesia where there was severe pain. The circulation and vitality of tissue were restored in all patients. One had tarsal amputations performed half a year later. Hyperbaric oxygen in combination with epidural analgesia is recommended in severe cases of ergotism.
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PMID:Ergotism treated with hyperbaric oxygen and continuous epidural analgesia. 27 60

To evaluate the hypothesis that inhalation of low levels of nitrous oxide-oxygen produces an altered state of consciousness similar to hypnosis, 20 subjects were given three suggestions (analgesia, compulsive behavior, and amnesia) during double-blind administration of either nitrous oxide-oxygen or oxygen. Results suggest that administration of nitrous oxide-oxygen may be of increased clinical usefulness if it is combined with careful use of suggestion.
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PMID:The relationship between nitrous oxide conscious sedation and the hypnotic state. 29 18

The haemodynamic effects of dobutamine (2 microgram/kg . min and 4 microgram/kg . min) and dopamine (4 microgram/kg . min and 8 microgram/kg . min) were studied in 17 patients with coronary artery disease prior to coronary bypass surgery. The study was performed under general anaesthesia (modified neurolept analgesia) and controlled ventilation. Dopamine improved cardiac index significantly, increased mean aortic pressure slightly while heart rate and total peripheral resistance remained unchanged. Dobutamine failed to increase cardiac and stroke index significantly, but increased mean aortic pressure distinctly due to an elevated total peripheral resistance. Both catecholamines increased left ventricular filling and mean pulmonary artery pressure. The HR x ASP-product which is closely related to left ventricular oxygen consumption was found to be augmented to a greater extent during dobutamine. For the above reasons dopamine should be favoured for increasing cardiac output in patients undergoing aortocoronary bypass surgery. Our study does not confirm earlier results which have shown dobutamine to be the preferable catecholamine. The possible reasons for this discrepancy are discussed.
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PMID:[The haemodynamic effects of dobutamine and dopamine in patients with coronary artery disease. A study performed under general anaesthesia (author's transl)]. 31 60


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