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Biomedical subjects

C D Blitt

Publications and source records attributed to C D Blitt.

45 records · Page 3Linked to original sources
PubMedDate not supplied

Reversal of lorazepam delirium by physostigmine.

Two adult patients suffered postoperative delirium following administration of lorazepam, a new benzodiazepine sedative. Physostigmine was found effective in reversing all untoward central nervous system effects.

Anti-Anxiety Agents↗
PubMedDate not supplied

Prolonged neuromuscular blockade with pancuronium in the presence of acute renal failure: a case report.

Prolongation of neuromuscular block following pancuronium administration to anephric patients has been reported. A patient is described whose postoperative course after resection of gangrenous bowel was complicated by acute renal failure and prolonged neuromuscular blockade. A large intraoperative dose of pancuronium was administered without monitoring neuromuscular transmission with a peripheral nerve stimulator. The course was further complicated by administration of gentamicin, an antibiotic known to potentiate neuromuscular blocking drugs. Complete return of neuromuscular transmission occurred 60 hours after administration of last dose of pancuronium and subsequent to peritoneal dialysis. After rapid distribution from plasma, pancuronium, like curare, is eliminated by the renal pathway. The absence of renal excretion considerably increases the duration of action of curare when given in high doses. It has been suggested that doses of pancuronium greater than 3.6 mg/sq m or multiple doses would result in prolonged neuromuscular block in patients without renal function. The case reported illustrates the importance of monitoring neuromuscular transmission during administration of pancuronium in the presence of renal insufficiency to avoid this complication.

Acute Kidney Injury↗
PubMedDate not supplied

Clinical evaluation of injectable lorazepam as a premedicant: the effect on recall.

A double-blind comparison of lorazepam and placebo, lorazepam and pentobarbital, and a comparison of lorazepam IV drip versus lorazepam IV bolus as a premedicant showed this new agent to offer promise as a sedative premedicant. However, the potency of the drug demands caution, and its use for outpatient premedication is not recommended.

Anesthesia, Intravenous↗
PubMedDate not supplied

Correlation of plasma cholinesterase activity and duration of action of succinylcholine during pregnancy.

Correlation between plasma cholinesterase activity and duration of neuromuscular blockade following succinylcholine (SCh) was studied in 30 healthy women undergoing laparoscopic tubal coagulation and 20 pregnany women indergoing elective repeat cesarean section. All patients received N2O-thiopental anesthesia. Cholinesterase activity in nonpregnant patients was significantly greater than in pregnant patients. Time to 90 percent recovery of control twitch height following 40 or 80 mg/m2 BSA of SCh was not significantly different in pregnant versus nonpregnant patients. There also was no correlation between plasma cholinesterase activity and duration of paralysis from SCh. The authors conclude that pregnant patients have lower cholinesterase activity, but prolonged neuromuscular blockade from SCh should not occur unless the patient is grossly overdosed with SCh. Routine use of a peripheral nerve stimulator is recommended to avoid such overdosage.

Adult↗