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Biomedical subjects

D Crass

Publications and source records attributed to D Crass.

3 recordsLinked to original sources

[Spinal anaesthesia].

In spinal anaesthesia, surgical analgesia and in most cases motor block is achieved by injecting one or more drugs into the cerebrospinal fluid. As one of the earliest methods of anaesthesia it was introduced into clinical practice in the late nineteenth century. Although later on it was more or less replaced by "modern" general anaesthesia, it has regained popularity due to its benefits for certain patient populations. In spite of being a technically simple procedure, performing spinal anaesthesia requires a sound knowledge of applied physiology and pharmacology, especially in high-risk groups such as pregnant women or former preterm babies. For some patients even under anticoagulant therapy, spinal anaesthesia might be the best option, considering the individual risk of alternative methods.

Anesthesia, Spinal↗

[Epidural analgesia during childbirth].

Epidural analgesia is the most effective means of pain relief during labor and is considered to be the "gold standard". For sufficient epidural analgesia, a wide range of nerve-block has to cover the segments Th10 to S4. This article includes the pathophysiological background as well as aspects of risk information and informed consent. Practical issues such as the insertion of the epidural catheter, choice of medication and application modes are described. The influence of epidural analgesia on labor, instrumental delivery and rate of caesarean section is discussed.

Adult↗

Effect of the dopamine D2 receptor agonist quinpirole on renal sympathetic nerve activity and renal norepinephrine spillover in anesthetized rabbits.

Cardiovascular and sympathetic nervous system effects of the dopamine D2 receptor-selective agonist quinpirole were studied in anesthetized rabbits. Sodium nitroprusside was administered for comparison. The animals received a tracer infusion of [3H] norepinephrine i.v. Arterial and renal venous concentrations of endogenous norepinephrine and epinephrine and [3H]norepinephrine, the firing rate of the renal sympathetic nerves and renal blood flow were determined. Quinpirole (100 micrograms kg-1 + 5 micrograms kg-1 min-1 i.v.) lowered blood pressure and renal vascular resistance. The firing rate of the renal sympathetic nerves was increased, but there was no reflex tachycardia. Despite the increase in renal sympathetic firing, the renal spillover of norepinephrine into blood was decreased. The increase in total body norepinephrine spillover during quinpirole-induced hypotension was less than expected from baroreflex activation. Effects of quinpirole were antagonized by domperidone (1000 micrograms kg-1 + 200 micrograms kg-1 h-1). The distinguishing feature of this study is the simultaneous measurement of sympathetic firing and norepinephrine spillover in the same organ, the kidney, under conditions of intact sympathetic impulse traffic. Quinpirole activated presynaptic D2 receptors and thus reduced the released norepinephrine per action potential. Consequences of the presynaptic inhibition were reductions of blood pressure and renal vascular resistance and absence of reflex tachycardia.

Animals↗