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A J Lessing

Publications and source records attributed to A J Lessing.

11 recordsLinked to original sources

[Clinical experience with atracurium--a continuous infusion technic].

A continuous infusion technique for atracurium was investigated. It provided a stable neuromuscular block, with a mean infusion rate of 0.008 mg/kg/min after an initial bolus of 0.5 mg/kg. A wide individual response was found and an arbitrary infusion rate based on mass alone is therefore not possible. The above rate is thus a starting point and should be adjusted according to individual requirements, preferably by using a peripheral nerve stimulator. The technique obviates the need for repeated increments of atracurium during lengthy surgical procedures.

Adult↗

Comparison between atracurium and alcuronium for muscle relaxation during laparoscopy.

Atracurium 0.3 mg/kg was compared with alcuronium 0.25 mg/kg as the sole muscle relaxant for tracheal intubation and abdominal relaxation for gynaecological laparoscopy in 46 patients during nitrous oxide, oxygen and halothane anaesthesia. Speed of onset, intubation conditions, effect on blood pressure and pulse rate, and ease of reversal were compared. Alcuronium had a significantly faster onset of action than atracurium; intubation conditions were adequate and abdominal relaxation was satisfactory for both drugs. The effect of atracurium was readily reversible within 10 minutes; in contrast alcuronium was significantly more resistant and mean recovery time was 28.03 minutes. Although alcuronium provided good muscle relaxation, it is not suitable for short procedures because of difficulty in reversing its action. Atracurium allowed earlier and more complete reversal of neuromuscular block.

Adult↗

Apnoeic diving safety--experimental approaches to oxygen augmentation.

A study was undertaken to determine whether a volume of oxygen injected from a 100 ml syringe and inhaled during a 10 m ascent would be exhaled again fully or partially by two experienced male divers. Each performed one apnoeic dive with and another without O2 augmentation. Analyses of mouth gas showed that the injected O2 had disappeared when the divers reached the surface. Any movement of the injected O2 to the alveoli through an open glottis probably resulted from simple diffusion as well as from agitation and mixing of gases by simulated respiratory activity. High-frequency positive-pressure ventilation applied by several authors, whereby sufficient gas exchange is achieved by oscillating small tidal volumes at frequencies of up to 900 per minute, may substantiate this possibility. The injected O2 was found also to have disappeared from the alveolar gas, shown by a comparison of O2 fraction differences between augmented and non-augmented dives. Injection and inhalation of the additional O2 will raise the partial pressure of O2 in the alveoli and increase oxygen transfer across the alveolar membrane into the blood, with more molecules being taken up within seconds during the ascent time. O2 augmentation in larger volumes during apnoeic diving could lead to a burst lung and must be regarded with suspicion. There is evidence that O2 augmentation by means of a small syringe attached to a trained diver's snorkel will help prevent apnoeic blackout.

Adult↗

[Anesthetic aspects of heart tamponade due to amebic liver abscess. A case report].

The problem of tamponade due to rupture of an amoebic abscess, although rare, is extremely complex, and in the planning of the anaesthetic technique the following factors should receive attention: (i) the low cardiac output in which bradycardia, vasodilation, high inflation pressures and excessive fluid load must be avoided: (ii) pulmonary complications in which a double-lumen endotracheal tube should be considered; and (iii) sepsis.

Adult↗

Oxygen transport.

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Diphosphoglyceric Acids↗