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Biomedical subjects

E Tassonyi

Publications and source records attributed to E Tassonyi.

70 records · Page 4Linked to original sources
PubMed1983

Muscular relaxation with atracurium, vecuronium and duador under balanced anaesthesia.

The neuromuscular effects of three new nondepolarizing neuromuscular blocking drugs, atracurium, vecuronium and Duador, were investigated in surgical patients under balanced anaesthesia. (The numbers of patients in each study are given in the tables.) There were no significant differences in the neuromuscular effects of the three agents. None showed any cumulation after repeated administration of maintenance doses. Muscular relaxation for upper abdominal surgery was adequate as long as the isometric twitch tension (P) was no more than 25% of control. Conditions for tracheal intubation were satisfactory within less than 3 min after the start of injection. Spontaneous recovery of P to 90-95% of control, after the last dose of neuromuscular blocker was the fastest with vecuronium (35.8 +/- 2.4 min) and about the same with atracurium (54.3 +/- 2.4 min) and Duador (54.2 +/- 4.7 min). The T4/T1 ratio at the time of greater than 90% recovery of P was 0.44, 0.52 and 0.56 with vecuronium, Duador and atracurium, respectively, indicating the need for the reversal of the residual neuromuscular block. This could be accomplished within 2 min by the i.v. injection of edrophonium 0.5 mg kg-1, preceded by atropine 0.01 mg kg-1. No side-effects were observed with vecuronium. Atracurium caused mild to moderate histamine release in four of 50 patients included in this study, all of whom received an initial dose of 0.5 mg kg-1. The initial dose of Duador caused a 16.7% increase in heart rate. The findings indicate that the three new muscle relaxants merit further clinical trial. In our opinion, until the results of such studies become available, atracurium should not be used in patients with a history of allergic diathesis and Duador in those in whom increased heart rate may be harmful.

Androstanes↗
PubMed1981

Determination of pipecurium bromide, a new non-depolarizing neuromuscular blocking agent, in human serum.

A method for the determination of 2 beta, 16 beta-bis (4'dimethyl-1'-piperazino)-3a, 17 beta-diacetoxy-5 alpha-androstane is described. After deproteinization a pipecurium bromide Rose Bengal complex is formed and extracted with chloroform from a mildly basic medium. The amount of pipecurium bromide is proportional to the amount of Rose Bengal in the complex, and the quantity of the latter can easily be determined by measuring its iodine content. The method is sufficiently sensitive to be used for the analysis of human serum.

Androstane-3,17-diol↗
PubMed1981

Pharmacokinetics of pipecurium bromide, a new non-depolarizing neuromuscular blocking agent, in humans.

The pharmacokinetics of 2 beta, 16 beta-bis-(4'-dimethyl-1'-piperazino)-3 alpha, 17 beta-diacetoxy-5 alpha-androstane dibromide (pipecurium bromide, Arduan), a new non-depolarizing neuromuscular blocking agent, was studied in surgical patients. Plasma concentration-time curves of pipecurium bromide were evaluated by fitting the data to a bi-exponential equation. The average half-lives were T 1/2 alpha = 4.1 +/- 1.4 (n = 8) and T 1/2 beta = 44 +/- 7 (n = 8) min. The pharmacokinetic parameters of pipecurium bromide were found as follows: apparent distribution volume V beta = 261 +/- 28 (n = 8) ml/kg, plasma clearance Cl = 320 +/- 55 (n = 8) ml/min. The microconstants of two-compartment open models were also calculated.

Adult↗
PubMed1980

The alpha-1-antitrypsin--trypsin complex in acute pancreatitis.

Production in acute pancreatitis of the trypsin-alpha-1-antitrypsin complex was studied by means of two-dimensional immunoelectrophoresis. The complex was found to appear a few hours after the first clinical manifestations and to be demonstrable for 3 to 4 weeks. The diagnostic possibilities of the method are discussed.

Acute Disease↗
PubMed1978

[Relief of pain in obstetrics using peridural anesthesia].

It is talked about the technical explanation and the theoretical foundations of the obstetrical peridural anesthesiologica. 250 births done under peridural segmental anaesthesie are compared with a control group by means of clinical dates. It was found out that this method doesn't correspond in some details to the classic de-mands of the obstetrical mitigation. Nevertheless it seems to be without any danger and effective under appropriate conditions.

Analgesia↗
PubMed1976

Postoperative apnoea following nivalin administration.

Four patients developed postoperative apnoea after neuroleptanalgesia, and were given Nivalin whilst in an apnoeic state to reverse residual neuromuscular block. Neuromuscular transmission was monitored by a peripheral nerve stimulator, and recurarization was not observed. Central respiratory depression was the cause of postoperative apnoea. The possible mechanisms and the mode of prevention are stated in this paper.

Adult↗
PubMed1975

A new concept in the measurement of neuromuscular transmission and block.

The discovery of the safety margin of neuromuscular transmission has brought forth the requirement for an improvement in the clinical examination of curarization, since the safety margin, i.e. the reserves, should also be measured. For this purpose a peripheral nerve stimulator and an electromechanical recorder unit have been produced, suitable for both the examination of manifest curarization and of the neuromuscular reserves. The measurements of muscle relaxation are performed making use of 30 Hz stimulation, while the safety margin of neuromuscular transmission is measured using stimulation at 200 Hz one.

Electric Stimulation↗
PubMedDate not supplied

Pharmacokinetics of pipecuronium in infants, children and adults.

In order to explain the reported shorter clinical duration of action of cumulative ED95 of pipecuronium in infants as compared to children or adults, the pharmacokinetic profiles of pipecuronium were compared in infants (n = 6; mean age 6.8 months; mean weight 7.3 kg) in children (n = 6; mean age 4.6 years; mean weight 19.2 kg) and in adults (n = 7; mean age 42 years; mean weight 58.2 kg). Equipotent doses (2 x ED95) of pipecuronium were injected i.v. as single bolus and arterial blood was sampled for 4-5 h. Pipecuronium was quantified by complex formation with [125I]-labelled rose bengal. Pharmacokinetic parameters were calculated using a two-compartment open model. The median for the distribution half-life of pipecuronium was 2.54 min (interquartile range: 1.0-2.5 min) in infants and 2.04 min (0.26-2.04 min) in children; both were significantly shorter than in adults (5.75 [3.7-9.7] min). The plasma clearance of pipecuronium was significantly decreased in infants (1.50 [0.6-1.5] ml.min-1.kg-1; P < 0.05) as compared to children and adults (2.27 [0.88-2.27] and 2.45 [1.7-3.2] ml.min-1.kg-1, respectively). The total volume of distribution was similar in all three groups. We conclude that the pharmacokinetic features of pipecuronium are age-dependent: differences as compared to adults consisted of a faster distribution in both infants and children and a slower elimination in infants. The pharmacokinetic profile of pipecuronium does not explain the faster recovery from neuromuscular blockade in infants as compared to children. Because of the low total plasma clearance in infants, pipecuronium dosage should be carefully monitored to avoid accumulation and prolonged paralysis.

Adolescent↗
PubMedDate not supplied

Pharmacokinetics of atracurium besylate in the pig after a single i.v. injection.

A pharmacokinetic study of atracurium besylate was performed in the pig after a single i.v. bolus injection of 2 mg/kg, the dose needed to produce surgical neuromuscular blockade. The plasma concentration values were obtained by high performance liquid chromatography. Using a two-compartment pharmacokinetic model, the elimination half life was found to be 28.6 +/- 6.3 min (mean +/- SEM), the total volume of distribution 341 +/- 56 ml/kg and the plasma clearance 8.7 +/- 1.1 ml/min/kg. Although the doses required to obtain a satisfactory neuromuscular blockade as well as the plasma level, volume of distribution and plasma clearance values were higher in the pig than in man, the distribution and elimination half-lives were similar to those recently reported.

Animals↗
PubMedDate not supplied

The effect of nalbuphine and droperidol on spontaneous movements during induction of anesthesia with propofol in children.

STUDY OBJECTIVE: To investigate the effects of droperidol and nalbuphine on spontaneous movements during induction of anesthesia with propofol in children. DESIGN: Randomized, double-blind study. SETTING: Inpatient ear, nose, and throat (ENT) surgical clinic at the University Hospital of Geneva. PATIENTS: Forty-five children, ages 4 to 12 years, undergoing routine elective ENT surgery. INTERVENTIONS: Children were randomly assigned to receive either nalbuphine 0.1 mg/kg, droperidol 0.025 mg/kg, or isotonic saline 3 minutes before anesthesia induction. Induction was performed with a loading dose of propofol 3 mg/kg. MEASUREMENTS AND MAIN RESULTS: Spontaneous movements were observed in 33%, 87%, and 100% of patients in the nalbuphine, droperidol, and control groups, respectively. The movements were dystonic and choreiform in nature and were similar in all three groups. The frequency of spontaneous movements was significantly reduced (p < 0.05) in the nalbuphine group as compared with the droperidol and control groups. CONCLUSIONS: Nalbuphine, but not droperidol, decreases the frequency of spontaneous movements induced by propofol during induction of anesthesia in children; neither quality of induction and recovery nor interval between the end of propofol administration and tracheal extubation were modified by nalbuphine as compared with the control group.

Adjuvants, Anesthesia↗