The extent and duration of sympathetic and sensory blockade were compared in 13 patients after spinal anaesthesia with 0.5% tetracaine (20 mg) in either isobaric (n = 6) or hyperbaric solution (n = 7). Sensory blockade was assessed by pin-prick and sympathetic blockade by the sympathogalvanometric method respectively at L5/S1, L2, T8 and C8/T1 levels. The time to onset and the duration of sensory or sympathetic blockade was identical. The mean extent of sympathetic blockade was 6 segments greater than that of sensory blockade. Hypotension was related to the extent of sensory but not sympathetic blockade. This study confirms that sympathetic blockade is more extended than sensory blockade during spinal anesthesia but does not allow to predict the occurrence of hypotension.

Adult↗

PubMed1989

[Clonidine suppression of sympathetic and circulatory activation in revival from aortic surgery].

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Aorta↗

PubMed1989

Dose-related prolongation of hyperbaric tetracaine spinal anesthesia by clonidine in humans.

The effect of clonidine, an alpha 2 agonist, on sensory and motor blockade during spinal anesthesia was studied in 44 ASA physical status I II patients scheduled for orthopedic surgery. The patients were randomly allocated into three groups given 15 mg of 0.5% hyperbaric tetracaine (HT), within group I (N = 14) 1 ml isotonic saline, in group II (N = 15) 0.5 ml saline solution and 0.5 ml clonidine (75 micrograms), and in group III (N = 15) 1 ml clonidine (150 micrograms). Sensory blockade (SB) was evaluated by pinprick and motor blockade (MB) according to Bromage's scale. The level of SB was comparable in the three groups but the duration was different. The 75 micrograms clonidine was associated with 25% prolongation of SB at L2 and 29% prolongation of grade 3 MB Clonidine 150 micrograms prolonged the time of SB at L2 by 72% and grade 3 MB by 96%. Colloid infusion and the decrease in diastolic blood pressure were significantly greater in the clonidine 150 micrograms group compared to group I. A dose related prolongation of spinal anesthesia is demonstrated with clonidine.

Adult↗

PubMed1989

[Controlled hypotension using nitroprusside in surgery of intracranial aneurysm. Effect of preoperative treatment with calcium inhibitor].

Calcium entry blockers are usually used to control cerebral vasospasm in patients with subarachnoid haemorrhage due to aneurysm rupture. In this study, it's appeared that the dose of sodium nitroprusside required to decrease blood pressure is higher when calcium entry blockers are used.

Adult↗

PubMed1989

Risk factors of postoperative pulmonary complications after vascular surgery.

Smoking and chronic obstructive disease are common in patients who undergo vascular surgery. These patients seem especially at risk for postoperative respiratory complications (PRCs). The value of preoperative spirometric tests to determine the risk of PRC has been recently challenged. The current prospective study was undertaken to identify the risk factors of PRC in these patients. One hundred fifty-one patients, including 67 patients who underwent abdominal aortic surgery, were included in this study. Preoperative and peroperative parameters were collected and analyzed in a multivariate analysis. PRCs were classified as minor and major. A significantly prolonged postoperative hospital stay was associated with major complications (21.3 +/- 9.0 vs 14.3 +/- 6.0 days). The overall incidence of PRC was 37.1%, and the incidence of major PRC was 15.2%. Patients who underwent abdominal aortic surgery had a higher incidence of PRC (53%; major PRC, 24%). In addition to abdominal aortic surgery, other risk factors were chest deformation, recent bronchitis, duration of surgery, and FEV1/VC. In patients who underwent abdominal aortic surgery, the risk factors for major PRC were decreases in preoperative FEV1/VC and PaO2. This study confirms the importance of an evaluation of a patient's respiratory condition, especially by preoperative spirometry and blood gas analysis, to determine the risk of PRC in a given population. General risk factors, such as the American Society of Anesthesiologists' classification, fail to achieve this task. The identification of patients with unacceptable risks remains a challenge.

Aorta, Abdominal↗

PubMed1988

Characterization and N-terminal sequence of human platelet proteoglycan.

Human platelet proteoglycan (P.PG) was prepared from a 4 M-guanidinium chloride platelet extract in the presence of proteinase inhibitors. The purification procedure included CsCl-density-gradient centrifugation, DEAE-Sepharose CL-6B ion-exchange chromatography and f.p.l.c. on a Mono Q HR 5/5 column. P.PG was recovered as a polydisperse molecule, but the protein core appeared to be at least 90% homogeneous. This observation could be due to partial proteolysis of the core protein during extraction. The N-terminal sequence of the human P.PG core protein was determined up to residue 66 and was shown to be highly homologous to the propeptide of an embryonic rat yolk-sac tumour proteoglycan (PG19); the significance of this homology is discussed.

Amino Acid Sequence↗