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Biomedical subjects

G Rolly

Publications and source records attributed to G Rolly.

At least 145 records · Page 8Linked to original sources
PubMed1977

I.C.I. 35868 - The effect of a change of formulation on the incidence of pain after intravenous injection.

I.C.I. 35868 is a promising new intravenous induction agent, but intravenous injection of the initial 2% formulation frequently caused pain. The solvent vehicle of the 2% formulation, which contained Cremophor E.L. and ethanol, was therefore investigated to see if this could be the cause of the pain. Twenty volunteers received both 5 ml isotonic saline and 5 ml solvent vehicle intravenously. The injection of saline never caused pain, but the solvent caused mild or moderate pain in 9 patients. I.C.I. 35868 was therefore reformulated in a 1% solution, excluding ethanol from the solvent. When intravenous injection of I.C.I. 35868 1% was compared to methohexitone 1% in 24 patients, both agents caused pain. Four out of 12 patients reveiving I.C.I. 35868 1% felt pain, with a total pain "score" of 6, but 6 out of 12 patients who received methohexitone 1%, felt pain, with a total pain "score" of 12. In no instance was intravenous injection followed by persistant pain, or evidence of thrombosis or phlebitis.

Anesthesia, Intravenous↗
PubMed1977

Total intravenous anesthesia with etomidate. III. Some observations in adults.

An investigation was undertaken to determine the dosage of etomidate required to maintain sleep in adults undergoing surgery under regional local anesthesia. Premedication of diazepam 10 mg and atropine 0.5 mg was given, and sleep was induced and maintained by intermittent intravenous injections of etomidate 0.1/mg/kg, given whenever the patient would open his eyes on request. A mean overall dose of etomidate 17.4 microgram/kg/min. was required to maintain sleep, but great individual variation occurred, with older patients requiring less drug. The investigation was discontinued after 18 patients because of the frequency and intensity of side-effects, particularly pain and myoclonia, which caused the technique to be abandoned in two cases. It is considered unlikely that etomidate will prove to be the hypnotic of choice for a totally intravenous anesthetic technique in adults because of the high incidence of myoclonia after prolonged administration. In several patients uncontrollable muscle movements persisted for many minutes after complete recovery of consciousness.

Adolescent↗
PubMed1977

Clinical experiences with naloxone in neuroradiology.

In 17 patients, the reversal by naloxone of a short duration narcotic anesthesia done for neuroradiology, was studied. Neuroleptanalgesic technique comprised d-hydrobenzperidol (5-10 mg) and fentanyl (+/- 0.4 mg) after barbiturate induction, and curarization with pancuronium, reversed by neostigmine. In group A 2 microgram/kg naloxone I.V. was given and 1 microgram/kg I.M. 30 min. later and in group B 1 micrometer/kg I.V. and 30 min. later 0.5 micrometer/kg. Reversal of narcotic depression was good and well maintained for 60 min. in both groups, as evidenced by respiratory rate, respiratory minute volume, pHa, PaCO2. Marginal temporarily cardiovascular stimulation occurred with arousal. Tolerance was good. It is concluded that antagonisation of respiratory depression due to narcotic anesthesia is possible with small titrated dosis of naloxone.

Adjuvants, Anesthesia↗
PubMed1976

Meptazinol: I.M. use in postoperative pain.

In a population of 39 patients, the new analgesic drug Meptazinol was tested in postoperative period at a dose of 100 mg I.M., administered only on request of the patient. Cardiovascular and respiratory parameters were not altered significantly. The onset of analgesia was rapid (+/- fifteen minutes) with a maximum reached after thirty minutes; the provided analgesia was good for about two hours as evaluated by the anesthetist and the nurse. The patient asked for a new dose only after about five hours.

Analgesics↗
PubMed1976

First experience with a new analgesic drug: buprenorphine.

Buprenorphine, a new analgesic drug, was used for treatment of immediate postoperative pain in a group of 30 patients. A standard dose of 4 mug/kg was given IM. Onset of action occurred 10 to 20 min. later; pain relief was very good to good in 73%, fairly good in 23% and insufficient in 3%. Duration of action was very long (Mean + SEM: 360 +/- 32 min.) Side effects were few.

Aged↗
PubMed1976

Clinical use of etomidate.

Etomidate and methohexital were administered for induction of anesthesia in 45 patients who had to undergo open heart surgery. The anesthesia technique was otherwise standardised. Measurements of blood pressure and heart rate were obtained during a period of ten minutes after injection of the induction agent, and in a selected group of 16 patients cardiac index and stroke volume index were obtained by impedance cardiography. In the group of 45 patients, blood pressure one minute after induction was unchanged with Etomidate, but decreased (-6%) with methohexital. During intubation, important variations of systolic blood pressure occurred, specially with Etomidate (+ 36%) and less with methohexital (+ 21%). Heart rate increased in both groups during intubation (+ 41%) and returned towards starting value after ten minutes. In the group of 16 patients, cardiac index varied with Etomidate, decreasing during intubation (- 21%), increasing to + 32% and then returning to starting value afterwards. Heart rate increased with intubation (+ 39%) and was still somewhat elevated at ten minutes. Stroke volume index decreased with intubation (- 36%) and was still lower than the initial value at ten minutes (- 14%). With methohexital, cardiac index variations were less pronounced (+ 11%). Cardiac index was lower than the initial value at ten minutes (- 14%). Stroke volume index decreased with intubation (- 36%) and was still lower than the initial value at ten minutes (- 14%). This was compensated by an increase in heart rate. These measurements made during induction reflect the complex interaction of drug administration and technical manipulations. Blood pressure lowering one minute after the injection of methohexital can be ascribed to vasodilatation and myocardial depression. The important blood pressure and cardiac index variations observed with Etomidate are probably due to the short action and the lack of analgesic properties of this agent.

Adult↗
PubMed1976

Influence of etomidate, a new short acting anesthetic agent, on cerebral blood flow in man.

Cerebral blood flow was measured by means of a ten channel cerebrograph. This investigation was done after a corotid angiography; 2 to 3 miCi of Xenon133 was injected in the internal carotid artery. Beside CBF we measured arterial bloodpressures, heart rate, stroke volume, cardiac output, central venous pressures, blood gases and glucose in arterial blood, blood gases and glucose in the bulbus of the internal jugular vein and blood gases in mixed venous blood. In most regions CBF decreased significantly after Etomidate. The other parameters did not change. Only the heartrate slowed significantly.

Blood Pressure↗
PubMed1976

Mobile intensive care unit. Present conception and realisation.

A new Mobile Intensive Care Unit has been put in use at the "Service 900" of the Ministry of Health in Belgium. Its size was decided to enable efficient treatment of one patient. The type of suspension was chosen to give the patient adequate protection against untoward effects of travelling sickness. Radio-communication with the control center and hospital is ensured. The O2 supply-system provides an autonomy of 11 hours. Besides an electric distribution of 12 V. DC, a 220 V. AC is also available.

Ambulances↗
PubMed1976

[Anesthesia for lung grafts].

The problems of anaesthesia for pulmonary transplantation are discussed from the theoretical and practical points of view. The problems of elimination of carbon dioxide and adequate oxygenation of the arterial blood, and protection of the transplanted lung, are considered. In the phase immediately after transplantation, the efficacy of gas exchanges are determined by reciprocal values of the resistance of the pulmonary artery, the resistance of the airways and the compliance of the transplanted and non-transplanted lung.

Acid-Base Equilibrium↗
PubMed1976

Clinical use of meptazinol.

Meptazinol, a new analgesic, was used at two different times of surgery: a) by the I.V. route peroperatively (1.6 mg/kg bodyweight with a maximum of 125 mg), b) by the I.M. route postoperatively (100 mg). When used I.V. peroperatively it does not seem to be a real progress, due to its poor neurovegetative protection and side-effects. However used I.M. postoperatively it seems a good analgesic drug with rapid onset and with few side effects.

Adult↗
PubMed1976

Buprenorphine as postoperative analgesic.

In 150 patients buprenorphine was given as postoperative analgesic in a dose of 4 microgram/kg. Pain suppression was judged very good (71%), fairly good (24%) and insufficient (5%). Analgesic activity lasted at least 325 +/- 15 min. Side effects were few.

Adult↗
PubMed1975

Anesthesia for congenital aortastenosis correction.

This case report analyses the anesthetic technique and early postoperative treatment of a five months old baby with congenital aortic stenosis. Administration of cardiotonics and diuretics was necessary before surgery because of severe heart failure. The patient was anesthetized with halothane in pure oxygen and ventilated by means of an Engström ventilator. Surgical treatment consisted of valvulotomy under extracorporeal circulation and normothermia. Recovery was uneventful.

Anesthesia, Inhalation↗
PubMed1975

Experience with continuous monitoring of lungcompliance and airway resistance.

Recently the Auprem apparatus is developed and enables to compute automatically on line the values of compliance and airway resistance, by means of a pneumotachograph. The application in anesthesiology are manifold. As illustration, a study of enflurane (Ethrane) on respiratory dynamics is described. In a group of 10 patients, we found a slight although not significant decrease of airway resistance by +/- 10% (5.2 +/- 0.5 before enflurane and 4.9 +/- 0.4 cm H2O/1/sec. after enflurane). Elastance was nearly unchanged as well as compliance. Some examples of the study of ventilation patterns are given. In a same patient the Engström respirator 300 and the Servoventilator with constant flow pattern and with increasing flowpattern are compared. When the plateau phase is suppressed, the computed values of airway resistance and elastance differ markedly. The ability to use central venous pressure instead of oesophagial pressure is an important innovation and opens a new research area for studying critical care patients.

Airway Resistance↗