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F Latorre

Publications and source records attributed to F Latorre.

At least 19 recordsLinked to original sources
PubMed2004

Gastric insufflation pressure, air leakage and respiratory mechanics in the use of the laryngeal mask airway (LMA) in children.

BACKGROUND: The objective of the present study was to evaluate the prelaryngeal position of the laryngeal mask airway (LMA(TM)) in children, and to determine the influence of mask positioning on gastric insufflation and oropharyngeal air leakage. METHODS: A total of 100 children, 3-11 years old, scheduled for surgical procedures in the supine position under general anaesthesia were studied. After clinically satisfactory LMA placement, tidal volumes were increased stepwise until air entered the stomach, airway pressure exceeded 30 cmH(2)O, or air leakage from the mask seal prevented further increases in tidal volume. LMA position in relation to the laryngeal entrance was verified using a flexible bronchoscope. RESULTS: The insertion of the LMA with a clinically satisfactory position was achieved in all patients at the first attempt. Gastric air insufflation occurred in five of 49 patients with malpositioned LMA. No incident of gastric air insufflation was observed in 51 patients with correctly positioned LMA. The minimum inspiratory pressure leading to mask leakage was 17 cmH(2)O for incorrectly positioned LMA, and 25 cmH(2)O for correctly positioned LMA. Clinically unrecognized LMA malposition was associated with a significantly increased incidence of either oropharyngeal leakage (r = 0.59; P = 0.0001) or gastric insufflation (r = 0.25; P = 0.01). CONCLUSIONS: Clinically undetected LMA malpositioning is a significant risk factor for gastric air insufflation in children between 3 and 11 years, undergoing positive pressure ventilation, especially at inspiratory airway pressures above 17 cmH(2)O.

Air↗
PubMed1999

Does cocaine still have a role in nasal surgery?

Endonasal surgery is already very common and its importance is increasing. Successful anaesthesia in endonasal sinus surgery is of critical importance for the success of the procedure and many surgeons prefer to use cocaine for this purpose. However, there is a great body of evidence that suggests that use of cocaine, even in experienced hands, can cause rapid, unexpected and severe toxic reactions. Therefore, its use in endonasal surgery can no longer be recommended, especially since better tolerated alternatives are available for topical and infiltration anaesthesia. These alternatives include lidocaine (lignocaine) and tetracaine (pantocaine) in combination with epinephrine (adrenaline), naphazoline or oxymetazoline.

Absorption↗
PubMed1998

Effects of normobaric oxygen on ciliary beat frequency of human respiratory epithelium.

Respiratory infection is a major cause of morbidity after general anaesthesia. Impairment of respiratory ciliary beat frequency (CBF) by different stress factors causes a decrease in mucus transport rate (MTR). We have tested the effect of different concentrations of oxygen on CBF of human respiratory epithelium in a prospective, randomized, in vitro study. Samples of superficial mucosa of the inferior nasal turbinates of 20 non-smoking healthy volunteers were harvested and exposed to three different oxygen environments (group I = 21% oxygen, group II = 60% oxygen and group III = 95% oxygen) for 2 h. In 50% of the samples, exposure time was prolonged. At 30, 60, 90, 120 and 240 min, light microscopic images of cilia activity were videotaped and CBF was later assessed in slow motion. Compared with baseline, group I showed no difference in CBF throughout the study. CBF was increased in group II from mean 9.7 (SD 0.4) to 11.2 (0.4) Hz (16%, P < 0.001) and in group III from 9.5 (0.6) to 12.1 (0.5) Hz (28%, P < 0.001) at 120 min. After 240 min of exposure to 95% oxygen, the CBF trend in group III was reduced to 11.8 (0.6) Hz but still remained above baseline. We conclude that oxygen appeared to have a dose- and time-dependent accelerating effect on CBF. Prolonged exposure to high oxygen concentrations reversed this trend. Direct oxygen toxicity ("oxygen stress") is a possible explanation for this effect. These changes may result in impaired MTR.

Cilia↗
PubMed1998

Laryngeal mask airway position and the risk of gastric insufflation.

UNLABELLED: A potential risk of the laryngeal mask airway (LMA) is an incomplete mask seal causing gastric insufflation or oropharyngeal air leakage. The objective of the present study was to assess the incidence of LMA malpositions by fiberoptic laryngoscopy, and to determine their influence on gastric insufflation and oropharyngeal air leakage. One hundred eight patients were studied after the induction of anesthesia, before any surgical manipulations. After clinically satisfactory LMA placement, tidal volumes were increased stepwise until air entered the stomach, airway pressure exceeded 40 cm H2O, or air leakage from the mask seal prevented further increases in tidal volume. LMA position in relation to the laryngeal entrance was verified using a flexible bronchoscope. The overall incidence of LMA malpositions was 40% (43 of 108). Gastric air insufflation occurred in 19% (21 of 108), and in 90% (19 of 21) of these patients, the LMA was malpositioned. Oropharyngeal air leakage occurred in 42%, and was independent of LMA position. We conclude that clinically unrecognized LMA malposition is a significant risk factor for gastric air insufflation. IMPLICATIONS: Routine placement of laryngeal mask airways does not require laryngoscopy. In our study, fiberoptic verification of mask position revealed suboptimal placement in 40% of cases. Such malpositioning considerably increased the risk of gastric air insufflation.

Adult↗
PubMed1997

[The interaction between rocuronium and smoking. The effect of smoking on neuromuscular transmission after rocuronium].

UNLABELLED: Recent studies have shown different results concerning the effects of smoking on neuromuscular blocking agents. Some reports indicate that smokers need higher doses of vecuronium, but are more sensitive to atracurium. The aim of this study was to evaluate the effects of smoking on onset and recovery time after a single 0.6 mg/kg intubating dose of rocuronium an analog of vecuronium. METHODS: Following institutional approval and informed consent, 20 smokers (> 10 cigarettes/day) and 20 nonsmokers were included in the study. Following oxazepam premedication and induction with fentanyl and thiopental, single-twitch stimulation of the ulnar nerve was performed every 10 s. Following stabilisation of control responses, patients received rocuronium 0.6 mg/kg for intubation. Anaesthesia was maintained with enflurane < or = 0.8 vol.% (end-tidal) and 65% nitrous oxide in oxygen. Onset time and recovery to 25% and 75% of the twitch control values were recorded. RESULTS: Onset and recovery times were not different between smokers and nonsmokers. CONCLUSIONS: The results of the present study suggest that chronic nicotine exposure does not change onset time or duration of rocuronium neuromuscular blockade. A previous study found a greater need for vecuronium in smokers and discussed stimulation of the neuromuscular junction and enhanced biotransformation due to the enzyme-inducing properties of nicotine. The differences in our results could be partly due to a longer period of refraining from smoking in our patients, leading to very low nicotine blood concentrations without the proposed receptor-stimulating effect. Another cause for different behaviour of the two analogs could be different elimination pathways. Recent investigations suggest that rocuronium may not be eliminated principally by the liver. Therefore, enhanced nicotine-induced biotransformation, as suggested for vecuronium, would not occur with rocuronium.

Adult↗
PubMed1997

Respiratory mechanics, gastric insufflation pressure, and air leakage of the laryngeal mask airway.

A potential risk of the laryngeal mask airway (LMA) is incomplete mask seal, which causes air leakage or insufflation of air into the stomach. The objective of the present study was to assess respiratory mechanics, quantify air leakage, and measure gastric air insufflation in patients ventilated via the LMA. Thirty patients were studied after induction of anesthesia but prior to any surgical manipulations. After the insertion of the LMA, patients were ventilated with increasing tidal volumes until one of the three following end points were reached: 1) gastric air insufflation, 2) airway pressure > 40 cm H2O, or 3) limitation of further increase in tidal volume by air leakage. The following variables were determined:inspired volume (VI), expired volume (VE), maximum inspiratory pressure (Pmax), airway pressure at gastric inflation (Pinfl), respiratory time constant (RC), compliance (C), resistance (R), and leakage fraction (FL). Respiratory mechanics were in the physiological range. Gastric insufflation occurred in 27% of the patients at inspiratory pressures between 19 and 33 cm H2O. Air leakage of more than 10% was evident at inspiratory pressures between 25 and 34 cm H2O. The end point of 40 cm H2O airway pressure was reached in only three patients. We conclude that the LMA is not better in preventing airway pressure transmission to the esophagus than a conventional face mask. However, a high FL is associated with reduced gastric air insufflation.

Adolescent↗
PubMed1996

[The effects of cimetidine on the pharmacodynamics of rocuronium].

UNLABELLED: Cimetidine is a commonly used H2-receptor antagonist that has been recommended for the prevention of acid aspiration syndrome and has been shown to potentiate vecuronium-induced neuromuscular block. The present study was designed to investigate the influence of a single IV dose of cimetidine on the neuromuscular effects of rocuronium, an analogue of vecuronium with a short onset time. METHODS: Twenty adults aged 18-65 years were included in the study with their informed consent and approval of the Ethics Committee. Following oxazepam premedication, 10 patients were randomly allocated to receive cimetidine 400 mg IV 30 min before anaesthesia. After fentanyl and thiopentone induction, single-twitch stimulation of the ulnar nerve was performed every 10 s. Following stabilisation of control responses, patients received rocuronium 0.6 mg/kg for intubation. Anaesthesia was maintained with enflurane < or = 0.8 vol.% (end-tidal) and 65% nitrous oxide. Onset time and recovery times to 25% and 75% of the twitch control values were recorded. RESULTS: Onset and recovery times did not differ between groups. CONCLUSIONS: The results of the present study demonstrate that cimetidine does not increase the duration of rocuronium neuromuscular blockade. Inhibition of the cytochrome P450 system or a direct effect at the neuromuscular junction have been suggested as the mechanisms of drug interaction associated with cimetidine. Impairment of hepatic microsomal drug metabolism results in a prolonged duration of action of vecuronium, which appears to be eliminated primarily via the liver. Data on the elimination pathway of rocuronium in humans are not available. The fact that cimetidine does not alter the recovery from rocuronium-induced neuromuscular block confirms a previous suggestion that rocuronium may not be eliminated principally by the liver. A direct effect of cimetidine on the neuromuscular junction could not be confirmed by this study. Therefore, cimetidine can be given as premedication without a risk of prolonged rocuronium block.

Adolescent↗
PubMed1996

[The effects of age on onset and recovery from atracurium, rocuronium and vecuronium blockade].

UNLABELLED: Elderly patients may show an age-related decline in physiologic functions, which may be responsible for the prolonged duration of some neuromuscular blocking agents. Previous studies have yielded conflicting results as to the effects of these drugs in the elderly. METHODS: After obtaining informed consent and approval of the Ethics Committee, we compared onset and recovery times of single IV doses of atracurium, rocuronium, and vecuronium given to 108 patients divided into three groups according to age (18-50, 51-64, > or = 65 years). Following oxazepam premedication and fentanyl and thiopentone induction, patients were randomly allocated to receive atracurium, rocuronium or vecuronium (0.5, 0.6, or 0.1 mg/kg, respectively) in < or = 0.8 vol.% enflurane (end-tidal)-nitrous oxide anaesthesia. Muscular relaxation was assessed by electromyographic (EMG) recording of the adductor pollicis muscle after supramaximal single-twitch stimulation of the ulnar nerve every 10 s. Onset time and recovery to 25%, 75% and 90% of twitch control values (DUR25, 75, 90) were recorded. Creatinine clearance predicted from serum creatinine (Ccr) was correlated with recovery from neuromuscular block. RESULTS: Onset time was not different among groups or relaxants. The results showed a prolonged duration of action for atracurium (DUR75, DUR90), rocuronium (DUR25, DUR75), and vecuronium (DUR25) in the elderly. A number of patients did not reach DUR75 or DUR90. There was a significant relationship between age and failure to return to control values during recovery from neuromuscular block, especially after atracurium and rocuronium. Ccr showed a negative correlation with age for all relaxants, but a negative significant correlation between Ccr and recovery was found only for rocuronium. CONCLUSIONS: This study suggests that onset time for atracurium, rocuronium and vecuronium is not age-dependent. Recovery was prolonged in the elderly for all three relaxants. This effect appears to be secondary to changes in body composition and function accompanying the aging process. Neither atracurium nor vecuronium depends significantly on the kidney for elimination, but the negative correlation between Ccr and rocuronium suggests an appreciable role for the kidney in the elimination of this relaxant. The long recovery times observed in this study could also be related to enflurane anaesthesia. We suggest that failure of EMG responses to return to baseline values during recovery from neuromuscular block may be related to age, especially for atracurium and rocuronium.

Adolescent↗
PubMed1996

[The effect of preischemic blood sugar concentration on hemodynamics and regional organ blood flow during and following cardiopulmonary resuscitation (CPR) in swine].

UNLABELLED: Blood glucose alterations prior to cerebral ischaemia are associated with poor neurologic outcome, possibly due to extensive lactic acidosis or energy failure. Cerebral effects of hyper- or hypoglycaemia during cardiopulmonary resuscitation (CPR) are less well known. In addition, little information is available concerning cardiac effects of blood glucose alterations. The aim of this study was to evaluate the effects of pre-cardiac-arrest hypo- or hyper-glycaemia compared to normoglycaemia upon haemodynamics, cerebral blood flow (CBF) and metabolism (CMRO2), and regional cardiac blood flow during CPR subsequent to 3 min of cardiac and respiratory arrest and after restoration of spontaneous circulation. METHODS: After approval by the State Animal Investigation Committee, 29 mechanically ventilated, anaesthetised pigs were instrumented for haemodynamic monitoring and blood flow determination by the radiolabeled microsphere technique. The animals were randomly assigned to one of three groups: in group 1 (n = 9) blood glucose was not manipulated; in group II (n = 10) blood glucose was increased by slow infusion of 40% glucose to 319 +/- 13 mg/dl; in group III (n = 10) blood glucose was lowered by careful titration with insulin to 34 +/- 2 mg/dl. After 3 min of untreated ventricular fibrillation and respiratory arrest, CPR (chest compressor/ventilator (Thumper) and epinephrine infusion) was commenced and continued for 8 min. Thereafter, defibrillation was attempted, and if successful, the animals were observed for another 240 min. Cerebral perfusion pressure (CPP), CBF, CMRO2, coronary perfusion pressure (CorPP), and regional cardiac blood flow were determined at control, after 3 min of CPR, and at 10.30, and 240 min post-CPR. RESULTS: In group 1. 4/9 animals (44%) could be successfully resuscitated; in group II 4/10 (40%); and in group III 0/10 (0%). Prior to cardiac arrest, mean arterial pressure, CPP, and CorPP in group III were significantly lower compared to groups I and II. In group I. CPP during CPR was 26 +/- 6 mmHg; CBF 31 +/- 9 ml/ min/100g CMRO2 3.8 +/- 1.2 ml/ min/100 g; CorPP 18 +/- 5 mmHg; and left ventricular (LV) flow 35 +/- 15 ml/min/100 g. In group II; CPP = 21 +/- 5; CBF 21 +/- 7; CMRO2 1.8 +/- 0.8; CorPP 16 +/- 6; and LV flow 22 +/- 9; and in group III: CPP 15 +/- 3; CBF 11 +/- 8; CMRO2 1.5 +/- 1.1; CorPP 4 +/- 2; and LV flow 19 +/- 10. During the 240-min post-resuscitation period, there were no differences in CBF, CMRO2, or LV flow between groups I and II. CONCLUSION: Hypoglycaemia prior to cardiac arrest appears to be predictive for a poor cardiac outcome, whereas hyperglycaemia does not impair resuscitability compared to normoglycaemia. In addition, hyperglycaemia did not affect LV flow, CBF, or CMRO2. However, it has to be kept in mind that haemodynamics and organ blood flow do not permit conclusions with respect to functional neurologic recovery or histopathologic damage to the brain, which is very likely to be associated with hyperglycaemia.

Anesthesia↗
PubMed1996

[Adaptive lung ventilation (AVL). Evaluation of new closed loop regulated respiration algorithm for operation in the hyperextended lateral position].

The lateral decubitus position is the standard position for nephrectomies. There is a lack of data about the effects of this extreme position upon respiratory mechanics and gas exchange. In 20 patients undergoing surgery in the nephrectomy position, we compared a new closed-loop-controlled ventilation algorithm, adaptive lung ventilation (ALV), which adapts the breathing pattern automatically, to the respiratory mechanics with conventionally controlled mandatory ventilation (CMV). The aims of our study were (1) to describe positioning effects on respiratory mechanics and gas exchange, (2) to compare ventilatory parameters selected by the ALV controller with traditional settings of CMV, and (3) to assess the individual adaptation of the ventilatory parameters by the ALV controller. The respirator used was a modified Amadeus ventilator, which is controlled by an external computer and possesses an integrated lung function analyzer. In a first set of measurements, we compared parameters of respiratory mechanics and gas exchange in the horizontal supine position and 20 min after changing to the nephrectomy position. In a second set of measurements, patients were ventilated with ALV and CMV using a randomized crossover design. The CMV settings were a tidal volume of 10 ml/kg body weight, a respiratory rate of 10 breaths/min, an I:E ratio of 1:1.5, and an end-inspiratory pause of 30% of inspiratory time. With both ventilation modes F1O2 was set to 0.5 and PEEP to 3 cm H2O. During ALV a desired alveolar ventilation of 70 ml/ kg KG.min was preset. All other ventilatory parameters were determined by the ALV controller according to the instantaneously measured respiratory parameters. Positioning induced a reduction of compliance from 61.6 to 47.9 ml/cm H2O; the respiratory time constant shortened from 1.2 to 1.08 s, whereas physiological dead space increased from 158.9 to 207.5 ml. On average, the ventilatory parameters selected by the ALV controller resembled very closely those used with CMV. However, an adaptation to individual respiratory mechanics was clearly evident with ALV. In conclusion, we found that the effects of positioning for nephrectomy are minor and may give rise to problems only in patients with restrictive lung disease. The novel ALV controller automatically selects ventilatory parameters that are clinically sound and are better adapted to the respiratory mechanics of ventilated patients than the standardized settings of CMV are.

Adult↗
PubMed1996

Cocaine or phenylephrine/lignocaine for nasal fibreoptic intubation?

In order to assess if a mixture of phenylephrine/lignocaine is as effective as cocaine for local analgesia and vasoconstriction during nasal fibreoptic intubation, 99 patients receiving topical nasal analgesia either with cocaine 10% or a mixture of phenylephrine 1% and lignocaine 4% were studied in a randomized double-blind investigation. After topical analgesia a flexible fibreoptic endoscope was advanced through a nostril. Larynx, glottis and trachea were endoscopically sprayed with lignocaine. Following induction of anaesthesia a nasotracheal tube was inserted fibreoptically. Pain intensity and amount of epistaxis during endoscopy were assessed. Blood pressure, heart rate and ECG-ST segment were determined before and after topical nasal analgesia, after induction of anaesthesia and after nasotracheal intubation. There were no significant differences in pain intensity of epistaxis between groups during endoscopy, nor significant alterations in haemodynamic parameters or ST-segment. It is concluded that the mixture of phenylephrine and lignocaine is a useful alternative to cocaine for local analgesia and vasoconstriction during nasal fibreoptic intubation.

Administration, Intranasal↗
PubMed1996

[Intubation requirements after rocuronium and succinylcholine].

OBJECTIVE: Rocuronium is a new non-depolarising steroidal muscle relaxant with a short onset time. The present study was undertaken to compare intubating conditions as well as onset and clinical duration of a single dose of 0.6 mg/kg (2 x ED95) with a single dose of 1 mg/kg suxamethonium (3 x ED95). METHODS: After obtaining informed consent and approval of the Ethics Committee, 40 adult patients (ASA I-III) participated in this study. After premedication with oxazepam, anaesthesia was induced with fentanyl and propofol and maintained with propofol, N2O and supplements of fentanyl as needed. Muscular relaxation was assessed by EMG recording of adductor pollicis muscle after supramaximal single twitch stimulation of the ulnar nerve every 10 s. Patients were allocated randomly to receive either rocuronium 0.6 mg/kg or suxamethonium 1 mg/kg. The following parameters were measured: intubating conditions 60 s after injection, onset time and clinical duration of neuromuscular block, % block at intubation, heart rate, blood pressure and arterial oxygen saturation. RESULTS: (mean +/- SD). Intubating conditions after rocuronium and suxamethonium were found to be clinically acceptable (excellent or good) in 90% of patients, though there was only a partial blockade of the adductor pollicis muscle with rocuronium (71 +/- 23%) compared to suxamethonium (95 +/- 14%) (p < 0.05). The onset time and clinical duration of relaxation was shorter after suxamethonium (p < 0.05) and occurred at 0.8 +/- 0.2, 7 +/- 2.1 and 3.2 +/- 1.3, 29 +/- 11 min after suxamethonium and rocuronium respectively. CONCLUSION: At a dosage of 0.6 mg/kg, rocuronium has an onset time of about 3 min and a clinical duration of relaxation of nearly half an hour. These data are supported by various studies, while others show shorter times, probably due to different monitoring techniques. In spite of the pharmacodynamic differences between suxamethonium and rocuronium, the intubating conditions after administration of both compounds are comparable and develop at the same rate.

Adolescent↗
PubMed1993

[Effect of physical exercise on nasal resistance in normal subjects and in patients with vasomotor rhinopathy].

The study has evaluated the behaviour of the nasal resistances, studied using Anterior Active Rhinomanometry, after physical exercise, in normal subjects and in allergic and non allergic vasomotor rhinopathics. The results, in accordance with the literature, show a reduction of nasal resistances in all subjects, particularly in the rhinopathics, immediately after the effort and a return to the starting values after a rest period of 30 minutes. Among vasomotor patients, only the non-allergic group has shown very significant variations in the resistances, because in these subjects there is almost always an exaltation of the neurovegetative system, which we did not observe in the allergic subjects in the intercritical phase. The effort test is therefore, among the aspecific tests of nasal reactivity useful, perhaps, more to therapy than to diagnostic aims.

Adolescent↗
PubMed1993

[Muco-ciliary transport in chronic inflammatory pathology of the middle ear].

The Authors have studied the behaviour of nasal mucociliary transport (MCT) in the chronic phlogistic pathology of the middle ear, in subjects suffering from simple and cholesteatomatous otitis. In both groups the duration of MCT was longer than a control group of normal subjects; instead no significant difference was observed either between the two kind of pathologies nor between the two different phases of the otitis (quiescence and breakthrough). The Authors conclude therefore that, in the recurrent phlogistic pathology of the middle ear, the function of MCT must be carefully studied, possibly corrected if damaged, to prevent the evolution in the breakthrough.

Adolescent↗
PubMed1993

[Fiberoptic intubation and stress].

Nasotracheal intubation of the trachea by means of fiberoptic endoscopy is an accepted approach to difficult airways. The associated avoidance of direct laryngoscopy may affect the stress response to nasotracheal intubation. We tested this hypothesis by means of a prospective, randomized, controlled clinical study. METHODS. Informed consent was obtained from 30 patients presenting for maxillofacial surgery for participation in this study. Patients were allocated to three groups: nasotracheal intubation to be performed either fiberendoscopically (group 1) or laryngoscopically, with (group 2) or without (group 3) topical anaesthesia of the larynx. Haemodynamic variables (arterial blood pressure and heart rate) and concentrations of catecholamines* in plasma (adrenaline, noradrenaline; HPLC) were documented at four (two*) time points, respectively: prior to induction of anaesthesia*, after induction, 1 min after tracheal intubation*, 5 min after tracheal intubation. Differences between time points and between groups were analysed with the chi-square test; a probability of P < 0.05 was considered statistically significant. RESULTS. With respect to age, body-weight and gender, the groups were comparable. No major hemodynamic or endocrine stress responses were observed in any group. Diastolic blood pressures were significantly lower in groups one and two, one minute after tracheal intubation. DISCUSSION. Nasotracheal intubation does not provoke a major stress response, when performed in accordance with the protocol of this study. However, topical anaesthesia of the larynx, as well as the fiberendoscopic approach proved superior to control with respect to diastolic arterial pressure. We conclude that fiberoptic nasotracheal intubation, or laryngoscopy preceded by topical anaesthesia of the larynx may be useful in patients for whom an increase in rate pressure product would be undesirable.

Adolescent↗
PubMed1992

[Atropine in the premedication of patients at risk. Its effect on hemodynamics and salivation during intubation anesthesia using succinylcholine].

Should atropine be administered for premedication? This question continues to be controversial; in particular, the combined administration of atropine and succinylcholine has been investigated with conflicting results by numerous researchers. The present study was carried out to assess the effect of premedication with atropine on hemodynamic variables and salivation in patients assigned to ASA class II and III. METHODS. Eighty ASA class II or III patients received pethidine 1.0 mg/kg and promethazine 0.5 mg/kg i.m. 30 min prior to induction of anesthesia and atropine, either 0.01 mg/kg i.v. 10 min or 0.01 mg/kg i.m. 30 min prior to a standardized anesthetic induction with alcuronium (precurarizing dose), thiopental, and succinylcholine. In the control groups (20 patients each), no atropine was given. Systolic, diastolic, and mean arterial pressures (MAP) were measured. The ECG was monitored for arrhythmias. Salivation was assessed semiquantitatively using swabs positioned within the pharyngeal space. RESULTS. Ten minutes after the administration of atropine i.v., a significant increase in heart rate (HR) was observed; this did not occur within 30 min after administration of atropine i.m. At the time of tracheal intubation, HR was significantly increased in both i.v. atropine risk groups. After atropine i.m., an increase in heart rate during intubation was observed in ASA class II patients only. No increase in heart rate occurred in the control groups during tracheal intubation. Neither i.m. nor i.v. atropine had any significant effect on blood pressure. Arrhythmias occurred in a few cases with both routes of administration; several instances of marked tachycardia were recorded.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗