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Biomedical subjects

H Breivik

Publications and source records attributed to H Breivik.

At least 73 records · Page 4Linked to original sources
PubMed1983

Effects of hypo-, normo-, and hypercarbia in dogs with acute cardiac tamponade.

The hemodynamic effects of changes in PaCO2 during intermittent positive pressure ventilation (IPPV) were studied in nine dogs with acute cardiac tamponade. During steady state light thiopental anesthesia, measurements were performed during hypocarbia (24.0 +/- 2.6), normocarbia (40.4 +/- 2.4), and hypercarbia (56.8 +/- 3.1 mm Hg; mean +/- SD). The study was carried out at a standardized level of cardiac tamponade that gave a 60% reduction in cardiac output (CO) at normocarbia. Changes in airway pressure were avoided by adding CO2 to the inspiratory gas to obtain the desired PaCO2. Hypercarbia increased pericardial pressure 2-4 mm Hg and significantly decreased CO. During hypocarbia CO increased as pericardial pressure decreased 3-6 mm Hg. These findings are the reverse of changes seen when tamponade is not present. The changes in pericardial pressure most likely influence myocardial tone and cardiac volume and, thus, CO. The results suggest that patients with cardiac tamponade requiring general anesthesia should not breathe spontaneously if there is any danger of respiratory depression and hypercarbia.

Acute Disease↗
PubMed1983

Changes in oncotic pressure, osmolality and electrolytes following transurethral resection of the prostate using glycine as irrigating solution.

Thirteen patients undergoing resection of benign prostatic hyperplasia were given furosemide 40 mg at the end of the procedure. The changes in body weight, colloid oncotic pressure (COP), osmolality, electrolyte concentrations and several haematological variables were compared with the values of 13 patients treated similarly, but without furosemide. During the operation there was an estimated mean absorption of 300 ml of irrigating fluid (glycine 1.5%). There was a significant peroperative decrease in serum sodium concentration, osmolality, COP, and haemoglobin concentration in both groups. The furosemide group had a more rapid return of COP towards preoperative values, and this group did also approach the preoperative weight more rapidly than the control group. In 10 selected patients variations in the total aminoacid pattern were measured. There was a significant increase in glycine concentration, with the maximum increase ten times the preoperative value. In the absence of uncontrolled bleeding, the resorption of fluid during TUR leads to hypervolemia and reduction in serum sodium and COP. This may lead to the TUR syndrome, as illustrated by one of our patients. Treatment in the symptomatic patient consists of reduction of circulating blood volume and when this is achieved, hypertonic saline may be beneficial if there are neurological symptoms.

Aged↗
PubMed1982

Avoiding psychic adverse effects during induction of neurolept anaesthesia with levomepromazine. A double-blind study of levomepromazine and droperidol.

Levomepromazine 0.1 mg/kg or droperidol 0.15 mg/kg for induction of neurolept anaesthesia were compared in a double-blind prospective study of 60 patients undergoing upper abdominal surgery. On the morning after surgery, eight of 30 patients (26.7%) who received droperidol remembered having had unpleasant anxiety, or nightmarish or panicky experiences during induction of anaesthesia, whereas only one of 30 patients (3.3%) receiving levomepromazine experienced such unpleasant adverse effects (P less than 0.01). During anaesthesia, the patients induced with levomepromazine needed somewhat less fentanyl, had somewhat less pain intensity, during the first 3 h after surgery, and they required the first postoperative dose of morphine 1.5 h later than the patients receiving droperidol (P less than 0.02). There was no difference in the number of patients receiving naloxone at the end of anaesthesia in the two groups. However, 21 of 30 patients (70%) in the levomepromazine group and only seven of 30 patients (23.3%) in the droperidol group were given physostigmine for arousal at the end of anaesthesia (P less than 0.01). There was no difference between the two groups in the occurrence of postoperative nausea, restlessness, hallucinations, or sedation in the recovery ward. This study shows that levomepromazine is superior to droperidol for induction of neurolept anaesthesia because it gives less psychic adverse effects, more analgesia, and a deeper sedation, which is easily reversed with physostigmine at the end of anaesthesia.

Abdomen↗
PubMed1982

Monocyte functions are depressed during and after surgery under general anaesthesia but not under epidural anaesthesia.

Monocyte functions have been investigated in 18 patients undergoing total hip arthroplasty performed under either general anaesthesia or epidural anaesthesia. Serum cortisol increased significantly both per- and postoperatively in the general anaesthesia group compared to minor changes in the epidural group. The spreading of monocytes on plastic surfaces possibly reflects the phagocytic capacity of the cells. This spreading index of monocytes derived from patients operated under epidural anaesthesia and cultured in medium containing autologous serum showed a significant increase per- and postoperatively compared to the spreading index of monocytes from patients operated under general anaesthesia. This difference increased with increasing culture time. The ability of monocytes to induce lysis in malignant cells was reduced to 45% peroperatively in monocytes derived from patients operated under general anaesthesia and cultured in medium containing autologous serum. In the epidural group the lysis was nearly unchanged from the preoperative value, making the difference between the groups highly significant (P less than 0.01). On the first postoperative day, the difference between the groups was less pronounced. The differences in spreading index and cytolytic capacity were not seen when the monocytes were cultured in medium with pooled AB-serum, thus indicating a serum factor responsible for the monocyte depression when the patients were operated under general anaesthesia.

Aged↗
PubMed1981

Paracetamol, tiaramide and placebo for pain relief after orthopedic surgery.

Eighty patients took part in this double-blind, single-dose group-comparative study, comparing the analgesic efficacy of tiaramide hydrochloride 100 mg and 200 mg, paracetamol 1000 mg, and placebo for pain after orthopedic operations. The four treatment groups were similar on entry to the trial. Pain relief was assessed up to 6 h after treatment, using a visual analogue pain scale and a pain score, both giving similar results. Statistically significant pain relief (mean pain intensity differences and sum of pain intensity differences) was seen in the group receiving paracetamol compared to those receiving placebo or tiaramide from 1 h to 6 h after drug ingestion. There was no significant difference between placebo and tiaramide 100 or 200 mg. No adverse reactions were reported.

Acetaminophen↗
PubMed1980

Life-supporting first aid self-training.

The authors studied the acquisition of life-supporting first aid knowledge and skills by 230 lay people in self-training group instruction without qualified first aid instructors and self-training at home. The self-training course consisted of audiotape-recorded instructions, flipover charts, an instruction booklet, first aid materials and a "Resusci Anne" training mannikin. The same instruction booklet and first aid materials were used for self-training at home. The two teaching systems were equally effective in providing theoretical first aid knowledge, but the course proved superior in teaching practical skills.

Adolescent↗
PubMed1980

Epidural versus general anaesthesia for total hip arthroplasty in elderly patients.

Sixty elderly patients were given at random either epidural analgesia with bupivacaine 0.75% or general anaesthesia with thiopentone, fentanyl, pancuronium, N2O/O2 for total hip replacement. Preoperatively the patients were of equal physical status with normal and similar laboratory values. All patients were mentally normal for their age. On the 1st postoperative day, the general anaesthesia group had a significantly lower than PaO2 than the epidural group (P less than 0.025). PaO2 in the general anaesthesia group was significantly lower than the preoperative value on the 1st and 3rd days (P less than 0.001 and P less than 0.01, respectively). None of the 29 patients in the epidural group but seven of 31 patients in the general anaesthesia group has significant mental changes postoperatively (P less than 0.01). Five of these patients still had mental changes which reduced the quality of life several months later. In the general anaesthesia group one patient died from acute myocardial infarction. Low postoperative PaO2 might have contributed to this death. Two patients in the epidural group had symptoms of pulmonary embolism postoperatively. Thus elderly patients appear to do better after hip replacement with less deterioration of cerebral and pulmonary functions when given epidural analgesia than when surgery is performed under general anaesthesia. These patients should therefore be offered epidural analgesia whenever possible.

Acid-Base Equilibrium↗