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Biomedical subjects

C Carlsson

Publications and source records attributed to C Carlsson.

At least 91 records · Page 5Linked to original sources
PubMed1983

Narcotic antagonism by naloxone. Few side-effects after a short procedure?

Twenty patients undergoing microlaryngoscopy were anaesthetised with thiopentone and nitrous oxide. Half of the patients received 1.0-1.5 mg of fentanyl during anaesthesia, the effect of which was antagonised by naloxone 0.4 mg intravenously and 0.4 mg subcutaneously. The other patients served as controls and received saline instead of fentanyl and naloxone. Fentanyl markedly reduced mean arterial pressure and the heart rate-systolic arterial pressure product during microlaryngoscopy. Conversely, there were significant increases in these measurements after naloxone had been given. However, there were no significant differences between patients given fentanyl with naloxone, and those given saline, in respect of arterial pressure, heart rate or dysrhythmia during recovery. No patient vomited, or appeared nauseated when observed afterwards in the operating room. One patient vomited several hours after naloxone.

Aged↗
PubMed1983

Cardiac arrhythmias in non-intubated children during adenoidectomy. A comparison between enflurane and halothane anaesthesia.

The incidence of cardiac arrhythmias, heart rate, blood pressure, capillary perfusion and end-tidal CO2 tension were studied in 167 healthy children 1-12 years of age undergoing adenoidectomy (n = 82) and myringotomy (n = 85) during enflurane and halothane anaesthesia. The incidence of cardiac arrhythmias was significantly lower during myringotomy than during adenoidectomy. In children undergoing adenoidectomy the incidence of arrhythmias was 38.9% during enflurane anaesthesia and 86.6% during halothane anaesthesia (P less than 0.001). In the halothane group ventricular arrhythmias were observed in 19 patients (41.3%) but only in one child (2.8%) in the enflurane group. The ventricular arrhythmias seen during halothane anaesthesia were unifocal in six patients and multifocal in five and classified as ventricular tachycardia in eight children. Heart rate was increased by about 40% at the onset of ventricular arrhythmias. The heart rate remained unchanged with enflurane anaesthesia during surgery, which may reflect a decreased sympathomimetic activity. It is suggested that the low incidence of ventricular arrhythmias during enflurane anaesthesia may be explained by the combination of a reduced sympathomimetic activity and a lowered susceptibility of the myocardium to the actions of endogenous catecholamines.

Adenoidectomy↗
PubMed1983

Can 4-aminopyridine be used to reverse anaesthesia and muscle relaxation?

4-aminopyridine has earlier been shown to antagonize neuromuscular block and to release transmitters in CNS. In a study in man the drug was given intravenously at the end of anaesthesia in order to counteract muscle relaxation and possibly also anaesthesia. The effects were followed by clinical observations, intraarterial blood pressure recording, ECG, repetitive muscle nerve stimulation and EEG. It was shown that the drug could reverse the neuromuscular block in lightly curarized patients, but was not as efficient as synstigmine methylsulphate (Neostigmine). In two cases the drug produced a slowing of EEG activity, which was normalized by naloxone. No toxic effects of the drug were observed.

4-Aminopyridine↗
PubMed1982

The effects of high-dose fentanyl on cerebral circulation and metabolism in rats.

There is considerable controversy with respect to the effects of narcotics on the cerebral blood flow (CBF) and the cerebral metabolic rate for oxygen (CMRo2). The present study examined the effects of high doses of intravenous fentanyl (25-400 micrograms/kg) on the CBF and CMRo2 in rats. Cerebral cortical blood flow and metabolism were measured using the 133Xenon modification of the Kety-Schmidt technique. Fentanyl produced a dose-related decrease in both the CBF and the CMRo2. CBF and CMRo2 were maximally depressed by 50 and 35%, respectively, in rats given fentanyl 100 micrograms/kg compared with nitrous oxide-oxygen ventilated controls. The values for CBF and CMRo2 were 168 +/- 15 ml . 100 g-1 . min-1 and 10.3 +/- 0.7 ml . 100 g-1 . min-1, respectively in the nitrous oxide controls compared with 85 +/- 3 ml . 100 g-1 . min-1 and 7.1 +/- 0.1 ml . 100 g-1 . min-1 in animals receiving fentanyl 100 micrograms/kg. Higher doses of fentanyl did not further decrease either CBF or CMRo2 (108 +/- 12 ml . 100 g-1 . min-1 and 7.0 +/- 0.4 ml . 100 g-1 . min-1, respectively for fentanyl 400 micrograms/kg); however, seizures activity was noticed in about 25% of the rats receiving either 200 or 400 micrograms/kg fentanyl. The seizures seemed to be related to the narcotic in that they could be abolished by injections of naloxone. The seizure activity appeared to increase the CMRo2 relative to animals who received the same dose of fentanyl but did not have seizures. The CBF was not affected. The results confirm that narcotics in high enough doses may depress the CBF and CMRo2.

Animals↗
PubMed1982

Effect of cardioselective beta-blockers on the heart rate and arterial pressure responses to laryngoscopy.

The effects of the cardioselective beta-blockers practolol (Eraldin, ICI) and metoprolol (Seloken, Hässle) were studied during microlaryngoscopy. I. v. practolol (0.4 mg/kg before and 0.2 mg/kg during anaesthesia) did not protect against increases in arterial pressure, although heart rate was reduced. Oral metoprolol (0.2 g for 4 days) reduced the level of arterial pressure both before and during anaesthesia. Variations in arterial pressure were not attenuated. Very low levels of arterial pressure were seen, and variations in arterial pressures were attenuated when metoprolol was combined with fentanyl.

Adrenergic beta-Antagonists↗
PubMed1982

Continuous maternal glucose measurements and fetal glucose and insulin levels after administration of terbutaline in term labor.

Maternal blood glucose and fetal blood glucose and insulin levels were studied in 16 women at full-term labor after administration of terbutaline 250 microgram i.v. The maternal blood glucose level was registered by a continuous blood glucose monitoring unit. In all patients studied, the terbutaline injection was followed by a rise in maternal blood glucose within 15 min, lasting for at least one hour. The fetal glucose levels paralleled those of the mothers, but on a lower level. None of the infants demonstrated hypoglycemia during the first 90 min after birth. We conclude that terbutaline administrated in this way has a direct effect on the maternal blood glucose release, and report that no harmful effects on fetal carbohydrate metabolism could be demonstrated.

Blood Glucose↗
PubMed1981

Uncoupler-reversible inhibition of mitochondrial ATPase by metal chelates of bathophenanthroline. I. General features.

(1) Certain metal chelates of 4,7-diphenyl-1,10-phenanthroline (bathophenanthroline, BPh) are potent inhibitors of soluble mitochondrial F1-ATPase. (2) The BPh-metal chelate inhibition of soluble mitochondrial F1-ATPase is relieved by uncouplers of oxidative phosphorylation. (3) The uncouplers appear to interact directly with the inhibitory chelates, forming stoichiometric adducts. (4) A complex between F1 and bPh3Fe2+, containing 3 mol BPh3Fe2+/mol F1, has been isolated. The enzymically inactive F1-BPh3Fe2+ complex binds uncouplers, yielding an enzymically active F1-BPh3Fe2+-uncoupler complex.

Adenosine Triphosphatases↗
PubMed1981

Uncoupler-reversible inhibition of mitochondrial ATPase by metal chelates of bathophenanthroline. II. Comparison with other inhibitors.

(1) Trisbathophenanthroline-Fe2+ (BPh3Fe2+)alters the hyperbolic relationship between concentration of ATP and reaction velocity of F1-ATPase to sigmoidal, with a simultaneous decrease in maximal velocity. (2) BPh3Fe2+ binds to the beta-subunit of F1 and competes with the binding of aurovertin. The reversal of this effect uncouplers in enhanced by ADP and diminished by ATP. BPh3Fe2+ also changes the hyperbolic concentration dependence of aurovertin binding to sigmoidal. (3) BPh3Fe2+ stabilizes F1 against the cold inactivation and cold dissociation in an uncoupler-reversible manner. (4) BPh3Fe2+ efficiently protects F1 against the light-induced inactivation occurring in the presence of Rose Bengal, and the effect is reversed by uncouplers. (5) The results are discussed in relation to the reaction mechanism of F1-ATPase and other enzymes catalyzing the reversible hydrolysis of pyrophosphate bonds.

Adenosine Triphosphatases↗
PubMed1981

Single injection of terbutaline in term labor: placental transfer and effects on maternal and fetal carbohydrate metabolism.

Maternal and fetal blood glucose and insulin levels were studied in 10 women in the second stage of labor after administration of terbutaline, 250 micrograms intravenously. The transport of the drug across the placenta was also studied. Saline solution was administered to four other women who served as controls. A rise in maternal plasma insulin levels occurred in all patients but was more pronounced in patients treated with terbutaline less than 25 minutes before delivery than in those treated more than 45 minutes prior to delivery. No difference was found in maternal blood glucose levels between terbutaline-treated patients and controls. Blood glucose increased in the fetuses during the second stage of labor and paralleled that of the mothers, but on a lower level. None of the newborn infants demonstrated hypoglycemia during the first 90 minutes after birth. Terbutaline crossed the placenta rapidly, and fetal plasma levels up to 55% of the maternal plasma levels were found. The conclusion is that this form of administration of terbutaline does not seem to have any negative short-term influences on the fetal carbohydrate metabolism.

Blood Glucose↗
PubMed1981

Can postoperative continuous positive airway pressure (CPAP) prevent pulmonary complications after abdominal surgery?

Twenty-four patients underwent elective cholecystectomy. They were randomized into two groups, one consisting of 13 patients having CPAP* by face-mask for 4 h after surgery and the other, consisting of 11 patients serving as control. The patients were all given intravenous anesthesia and were manually ventilated during anesthesia without using PEEP. The groups were comparable as concerns sex, age, weight, smoking-habits, preoperative pulmonary status, type of surgery and anesthesia-time. The study showed that both groups had a reduction in VC and PaO2 and a high percentage of them developed chest X-ray changes. In none of the variables mentioned was there any significant difference between the groups after surgery. Hypoxemia after abdominal surgery can thus not be prevented by only using CPAP for 4 h postoperatively.

Abdomen↗
PubMed1981

Maternal and fetal concentrations of morphine after epidural administration during labor.

In this study of 20 healthy women in labor we attempted to determine the efficacy of epidural morphine as an obstetric analgesic. Four patients experienced some relief of pain while 16 patients reported no effect on pain. One newborn infant demonstrated possible morphine-induced respiratory depression. It was concluded that morphine is ineffective as an obstetric analgesic.

Anesthesia, Epidural↗
PubMed1981

The effect of diazepam on the cerebral metabolic state in rats and its interaction with nitrous oxide.

It has previously been shown in rats that diazepam alone has no effect on the cerebral metabolic rate (CMRO2) but that it interacts with nitrous oxide to produce a 40 per cent reduction in the CMRO2 value. In the present study, the effect of sedative doses of diazepam on the cerebral energy state, glycolysis, citric acid cycle, and amino acid metabolism in rats was determined in the presence and absence of a simultaneous administration of 70 per cent nitrous oxide, 45 s to 30 min after the diazepam injection. The metabolic response was very similar in the two groups despite the differences in metabolic rates of oxygen consumption. There were no changes in the cortical concentrations in ATP, ADP, AMP, phosphocreatine and creatine. The brain glycogen concentration was elevated during diazepam sedation, whereas brain glucose levels remained close to normal values except at 30 min after administration of diazepam alone, when the glucose level showed a 30 per cent increase. The onset of diazepam sedation was associated with an inhibition of glycolysis at the phosphofructokinase step in both groups. The reduced pyruvate concentration subsequently leads to a reduction in the pool size of the citric acid cycle intermediates. The concentrations of alanine and glutamate decreased during the period of diazepam sedation, while those of aspartate and glutamine increased. GABA and ammonia concentrations remained unchanged. Based on the cerebral metabolic response, the onset of diazepam sedation appears to be associated with an inhibition of rate of metabolism (glycolysis), both in the presence and absence of nitrous oxide. In that respect, diazepam has a metabolic profile similar to barbiturates.

Amino Acids↗
PubMed1981

Silent gastropharyngeal regurgitation during anesthesia.

The incidence of gastric regurgitation was studied in 138 women during gynecologic operations performed under general endotracheal anesthesia. Laryngoscopy at the conclusion of anesthesia revealed no instance of gross regurgitation. The average pH of secretions suctioned from the pharynx before extubation averaged 5.6 +/- 1.0. Seven of 35 (20%) patients having emergency laparoscopy in the head-down position had pharyngeal contents with pH of 3 or less. Position had no effect in the incidence of highly acid pharyngeal contents in patients having elective surgery, and there was no correlation between pH of pharyngeal contents and age, duration of anesthesia or type of muscle relaxant.

Adolescent↗
PubMed1981

Acute treatment of bleeding oesophageal varices. A retrospective study of 88 patients.

The records of 88 patients bleeding 140 times from oesophageal varices were retrospectively evaluated. The treatment consisted mainly of intravenous vasopressin and balloon tamponade. Percutaneous transhepatic and transoesophageal sclerotherapy were used as additional treatments. Acute operation was avoided as long as possible. With this conservative attitude the hospital mortality was 24%. A high mortality was correlated with low serum albumin, initial unconsciousness, high blood transfusion demand, and alcoholism. The first bleeding episode of the patient had a higher mortality than the following ones. Our experience with a conservative attitude in stopping bleeding from oesophageal varices has made it possible to construct an outline for treatment which can be followed in most of these patients.

Blood Transfusion↗