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Biomedical subjects

K Korttila

Publications and source records attributed to K Korttila.

At least 127 records · Page 7Linked to original sources
PubMed1978

Residual nitrous oxide in operating room personnel.

The concentrations of nitrous oxide in the blood and end-tidal air of 10 operating-room nurses were assayed by gas chromatography immediately and 1, 2, 5, and 21 h after 3 hours of exposure to an average of 380 ppm of nitrous oxide in operating-room air. In the second trial the nurses' end-tidal air concentrations of nitrous oxide were assayed on Monday, Wednesday, Friday and Sunday morning, and on Sunday afternoon and evening to reveal a possible accumulation of nitrous oxide during a routine week. After cessation of exposure there was a rapid decrease in the blood concentrations of nitrous oxide during the first hour (from 153 +/- 110 microgram/1 to 48 +/- 20 microgram/l at 1 h; means +/- s.d.), followed by a slower decrease. Small amounts (mean +/- s.d.: 18 +/- 6 microgram/l) of nitrous oxide were still measurable on the following morning 21 h after exposure. At 2 or 5 h after exposure there was an increase in blood and end-tidal air concentrations of nitrous oxide in seven and nine nurses, respectively. The end-tidal air concentrations of nitrous oxide were greater on Wednesday (22 +/- 7 microgram/l) than on Monday morning (8.4 +/- 1.5 microgram/l), but on Friday they were similar to those measured on Monday morning. The concentrations measured on Sunday, i.e. 2 days after exposure, were similar (average 15 microgram/l) to those measured during the week. It is concluded that, after cessation of exposure to nitrous oxide, there is a rapid decrease in the concentrations in blood and end-tidal air, but small amounts of nitrous oxide remain in the body for at least 3 days after cessation of exposure.

Air Pollutants↗
PubMed1978

Untoward effects of ketamine combined with diazepam for supplementing conduction anaesthesia in young and middle-aged adults.

Fifty-six young and 29 middle-aged adults who were scheduled for lower abdominal, anorectal or extremity surgery under epidural, sacral or brachial plexus blockades received intravenous analgesic or anaesthetic doses of ketamine, combined with diazepam, immediately before the start of the operation. Forty-one patients received no supplementary drugs for the conduction anaesthesia and were divided into two groups of controls. On the day following the operation, all the patients were asked about their postanaesthetic reactions and their acceptance of the anaesthetic technique, and the nursing staff expressed their opinion on the amount of work and supervision needed during the post-operative care of the patients. Administration of ketamine 0.5 mg/kg with diazepam 0.15 mg/kg to young or middle-aged patients was not associated with more side-effects or a greater need for post-operative care and supervision than in the control groups. Administration of anaesthetic doses of ketamine 1.5 mg/kg and 3.0 mg/kg with 0.15 mg/kg and 0.3 mg/kg of diazepam, respectively, caused significantly (P less than 0.05) more post-operative anxiety and confusion, as well as a significantly greater need for post-operative care and supervision than in the control patients. It is concluded that, in young or middle-aged patients, supplementing conduction anaesthesia with ketamine 0.5 mg/kg plus diazepam 0.15 mg/kg is not associated with the untoward effects which can be expected after anaesthetic doses of 1.5 mg/kg (or more) of ketamine.

Adult↗
PubMed1978

Serum prolactin levels after a single and subchronic oral administration of chlorpromazine and sulpiride. A cross-over study in healthy volunteers.

The effect of a single antianxiety dose of chlorpromazine (100 mg) and sulpiride (200 mg) on serum prolactin and gonadotrophins was studied in 6 healthy women in a cross-over study. Another 10 healthy students, 5 women and 5 men, ingested cross-over sulpiride 50 mg t.i.d. for 2 weeks and chlorpromazine 10 mg t.i.d. for 1 week followed by 20 mg t.i.d. for the second week, and serum prolactin levels were measured on the 7th and 14th day after the beginning of the treatment. In acute study sulpiride caused a fivefold increase in serum prolactin at 1 h. Chlorpromazine induced a slower and smaller increase. Prolactin concentrations remained raised for at least 6 h. The initial raised prolactin concentration induced by sulpiride was associated with antidiuresis. The only change in gonadotrophins was the decrease of serum LH caused by chlorpromazine at 3 h. Subchronic administration of sulpiride (50 mg t.i.d.) caused in both sexes a significantly (P less than 0.05 to 0.01) greater increase of prolactin than did chlorpromazine (10 or 20 mg t.i.d.). It is concluded that in doses useful in the treatment of neurotic patients sulpiride causes a greater increase in serum prolactin levels than does chlorpromazine.

Adult↗
PubMed1977

Recovery, psychomotor skills, and simulated driving after brief inhalational anesthesia with halothane or enflurane combined with nitrous oxide and oxygen.

Recovery from anesthesia was assessed in a controlled manner in 34 healthy student volunteers, using a psychomotor test battery 1 and 5 hours and a driving simulator 2, 4.5, and 7 hours after 3.5 minutes of anesthesia with halothane or enflurane combined with nitrous oxide and oxygen. Psychomotor performances remained significantly (P less than 0.05 to P less than 0.001) worse than in an unanesthetized control group for 5 hours after both halothane and enflurane. However, impairment of driving skills 4.5 hours after anesthesia was measurable only after halothane (P less than 0.05). It is concluded that after even brief periods of halothane or enflurane anesthesia patients should not drive or operate machinery for at least 7 hours. The magnitudes and durations of the residual effects of both agents on psychomotor performance were, however, less than those previously found after thiopental, methohexital, or diazepam.

Adult↗
PubMed1977

Lack of impairment in skills related to driving after intramuscular administration of prilocaine or mepivacaine.

A saline placebo, 3 mg/kg of 2% plain prilocaine, and 3 mg/kg of 2% plain mepivacaine were injected into the deltoid muscles of 10 healthy subjects in a doubleblind, cross-over trial. Before and at 0.5, 1.5 and 3 h after injection, psychomotor skills related to driving were measured. When compared to the saline placebo, neither prilocaine nor mepivacaine impaired the parameters of psychomotor function measured. Blood concentrations of prilocaine were significantly (P less than 0.001) lower than those of mepivacaine during the whole observation period. It was concluded that in comparison to lidocaine, bupivacaine, or etidocaine, which have been tested previously and found to impair psychomotor performance, mepivacaine and, especially, prilocaine are the anaesthetic agents to be preferred when effects on central nervous system should be avoided, e.g. in outpatient practice.

Adult↗
PubMed1977

Unchanged protein binding and the increase of serum diazepam levels after food intake.

Seven subjects received diazepam 0.3 mg/kg intravenously twice with a 2-week interval between the doses. The subjects ingested a fatty or carbohydrate meal in a cross-over fashion 4 hours after the injection on both experimental days. Venous blood samples were drawn 2, 3, 4, 5 and 6 hours after the injection of diazepam for measurement of the serum levels of total and free (unbound) diazepam, N-desmethyldiazepam, and free fatty acids. Serum levels of diazepam decreased progressively with time until the food intake, after which a significant (P less than 0.01) postprandial increase (average 23%) occurred with both diets as compared to the preprandial levels at 4 hours (average 240 ng/ml). Serum levels of free fatty acids decreased significantly both after a fatty (P less than 0.01) and a carbohydrate (P less than 0.05) meal. Diazepam was extensively (96 to 98%) bound to proteins and no changes in its protein binding was found. It is concluded that the late impairment of psychomotor skills that occurs with an increase in the diazepam serum level after its intravenous administration is due rather to its re-mobilization from a storage site than to variations in its protein binding.

Adult↗
PubMed1976

Prolonged recovery after diazepam sedation: the influence of food, charcoal ingestion and injection rate on the effects of intravenous diazepam.

Thirteen subjects received diazepam 0.3 mg/kg i.v. twice with a 2-week interval between the doses. In seven subjects who had eaten at 3 h after the injection, reactive skills in a choice reaction test were impaired significantly (P less than 0.05) and there was a 20% increase in the serum diazepam concentrations at 5 h. When the meal was eaten at 7 h, a 50% increase (P less than 0.01) in the serum diazepam concentration was not associated with a significant impairment in psychomotor skills. In a second group of six subjects charcoal ingestion failed to hasten the clearance of diazepam from serum, and did not affect recovery of co-ordinative skills. In a third group of 12 subjects receiving diazepam 0.15 mg/kg i.v. twice at an interval of 2 weeks, the rapid injection of diazepam resulted in a significantly greater (P less than 0.05) degree of drooping of the upper eyelid and in a greater incidence of amnesia to abdominal pinching. The subjects also experienced more pain in the arm during the faster injection (P less than 0.01). Late effects on psychomotor skills were similar with both rates of injection. The results suggest that the remobilization of diazepam from its storage site after food intake induces a late impairment of psychomotor skills, especially if the food is eaten within less than 5 h after the injection. A rapid i.v. injection of diazepam induces greater sedative and amnesic effects than a slow injection of the same dose, but the slow injection of a greater dose is preferable because of the possibility of thrombophlebitis after rapid injection.

Absorption↗
PubMed1976

Recovery after intravenous sedation. A comparison of clinical and paper and pencil tests used in assessing late effects of diazepam.

Twelve healthy subjects received intravenously 0-15 mg/kg of diazepam twice, with a two-week interval between doses. They were tested in a cross-over manner before and after the injection either with a clinical test battery plus paper and pencil tests, or with a carefully selected psychomotor test battery having a correlation to real traffic behavior. Neither the clinical tests nor the paper and pencil tests demonstrated impairment of performance 1/2 and 2 1/2 hours after the injection, whereas the psychomotor tests revealed considerable impairment of reactive and co-ordinative skills 2 1/2 hours after the injection. The results stress the importance of the presence of an escort when patients are discharged from hospital after outpatient anaesthesia or sedation.

Adult↗
PubMed1976

Residual effects and skills related to driving after a single oral administration of diazepam, medazepam or lorazepam.

Psychomotor skills and visual functions related to driving were measured double-blind cross-over in ten healthy volunteers before, and 1,3,5 and 7 h after a single oral administration of diazepam (10mg), medazepam (15 mg) or lorazepam (2.5 mg). The late effects of lorazepam were tested in seven other subjects 12 and 24 h after the administration. Lorazepam impaired almost all the measured skills more (P less than 0.05 to 0.001) than diazepam, medizepam or the placebo. The lorazepam impairment of reactive skills and flicker fusion discrimination remained statistically significant (P less than 0.05) for as long as 12 h. Medazepam impaired only reactive skills and flicker fusion, the latter remaining impaired (P less than 0.05) for as long a 5 h after the administration. The magnitude and duration of the effects of diazepam were intermediate between those of lorazepam and medazepam. Diazepam impaired perceptual speed and reactive and co-ordinative skills as well as flicker fusion discrimination and visual parameters related to driving. Slight impairments in performance were measurable for up to 5 h after administration but at 7 h the results resembled those measured after the placebo. The lack of alterations in adaptation to darkness, sensitivity to brightness or visual discrimination ability in bright counterlight at a time when flicker fusion discrimination was severely depressed suggests that an impaired ability to discriminate flickering light is of no or little clinical significance to driving ability. It is concluded that patients receiving a 2.5 mg dose of lorazepam should not drive or operate machinery for 24 h after the administration. After diazepam (10 mg) or medazepam (15 mg) patients should refrain from driving or participating inskilled performances for only 5 to 7 hours.

Adult↗
PubMed1976

Amnesic action of and skills related to driving after intravenous flunitrazepam.

Amnesic action, skills related to driving and the ability to discriminate the fusion of flickering light were measured double-blind in 29 healthy volunteers before and after three doses of intravenous flunitrazepam. Every subject experienced amnesia for the pinching of the abdomen after being injected with flunitrazepam. Even the smallest dose of flunitrazepam (0.01 mg/kg) caused the amnesia without affecting the level of consciousness. The late effects of flunitrazepam were the most harmful to coordination. With 0.01 mg/kg eye-hand coordination was slightly impaired for as long as 6 h after the injection, and after 0.02 and 0.03 mg/kg the impairment was still significant (P less than 0.05) at the last observation period 10 h after the injection. It was concluded that, because the amnesic action of flunitrazepam is more effective than that of clinically comparable doses of diazepam, further clinical experiments with flunitrazepam are warranted. Its longer and more harmful effects on psychomotor performance than those of equipotent doses of diazepam suggest that doses of 0.02 mg/kg or more of flunitrazepam should be avoided in outpatient anaesthesia or sedation.

Adult↗
PubMed1976

[First aid at medical congresses].

The sixth International Congress of Pharmacology in Helsinki, July 1975, was held on a campus area 5 km from the nearest hospital. The congress was attended by 2 600 active participants and one thousand social members, traveling from 54 countries. The equipment at the Congress first aid station allowed for all kinds of emergency treatments, ranging from the care of minor complaints to cardiopulmonary resuscitation. A mobile intensive care unit was kept outside the station throughout the day and was also available at the major social events in the evening. The great majority of the symptoms necessitating a visit to the station were minor complaints. Most participants received their medication direct from the first aid station, the most common drugs being mild analgesics, anticholinergics and antibiotics. According to our experience, at a congress with 3 500 participants it is sufficient to have one physician present at the first aid station, or at least on call, and one to three additional first aid assistants. In general, it is of utmost importance to make adequate plans for the provision of medical as well as dental care at large congresses.

Congresses as Topic↗
PubMed1975

Recovery and skills related to driving after intravenous sedation: dose-response relationship with diazepam.

Skills related to driving, the ability to discriminate the fusion of flickering light, and hand and foot proprioception, were measured double-blind in 34 healthy volunteers before and after three doses of i.v. diazepam. The effects of diazepam were most harmful to co-ordination. With 0.15 mg/kg, 0.30 mg/kg and 0.45 mg/kg of diazepam the impairment of co-ordinative skills was statistically significant (P less than 0.05) up to 2, 6 and 8 hr respectively. No impairment of performance on any test was measurable at 6 hr after 0.15 mg/kg or at 10 hr after 0.30 or 0.45 mg/kg of diazepam. There were large interindividual variations in serum concentrations of diazepam within each dose level. The increases in serum concentrations of diazepam after the intake of food support the concept of an enterohepatic cycle for diazepam. It was concluded that patients should not drive or operate machinery for at least 6 hr after 0.15 mg/kg of i.v. diazepam and at least 10 hr after 0.30 mg/kg and 0.45 mg/kg.

Amnesia↗
PubMed1975

Absorption and sedative effects of diazepam after oral administration and intramuscular administration into the vastus lateralis muscle and the deltoid muscle.

The absorption of diazepam 10 mg after oral administration and intramuscular administration into the vastus lateralis muscle or the deltoid muscle was compared in a double-blind cross-over study in eight healthy subjects. Serum diazepam concentrations were measured, and the presence of tiredness was noted 20, 40, 60, 90 and 150 min after the drug administration. Peak concentrations in serum were 209+/-49, 152+/-60 and 143+/-62 ng/ml ((means+/-SD) at 90, 60 and 60 min after oral, shoulder and thigh administration respectively. Absorption was more rapid after intramuscular than after oral administration, serum mean diazepam concentrations at 20 min after oral administration being only 26% of those after shoulder administration. The rapid rate of absorption from the shoulder was associated with a more rapid feeling of tiredness and a greater sedative effect than after oral or thigh administration. There was no evidence that diazepam induced its own metabolism after one or two administrations. The results suggest that, if rapid preanaesthetic medication with diazepam is needed, shoulder administration might be superior to oral or thigh administration.

Absorption↗
PubMed1975

Psychomotor skills related to driving after intramuscular administration of diazepam and meperidine.

Psychomotor skills related to driving and the ability to discriminate the fusion of flickering light were measured in a double-blind cross-over fashion in 11 healthy volunteers before, and 1, 3, 5, and 7 hours after, intramuscular injection of saline solution, 10 mg diazepam, or 75 mg meperidine. The late effects of meperidine were tested in five other subjects 12 and 24 hours after the injection. The effects of diazepam were the most harmful to coordinative and reactive skills, which were significantly impaired for as long as 5 hours. Meperidine impaired reactive skills for as long as 3 hours and flicker-fusion discrimination and coordinative skills for as long as 12 hours. It is concluded that patients should not drive or operate machinery for at least 7 hours after receiving 10 mg diazepam intramuscularly and for 24 hours after receiving 75 mg meperidine intramuscularly.

Adult↗
PubMed1975

Recovery and simulated driving after intravenous anesthesia with thiopental, methohexital, propanidid, or alphadione.

Recovery from anesthesia was assessed in a double-bind manner in 40 healthy volunteer students after intravenous anesthesia with thiopental (6.0 mg/kg), methohexital (2.0 mg/kg), propanidid (6.6 mg/kg), or alphadione (Althesin), 85 mul/kg using a driving simulator 2,4, 6, and 8 hours after injection of the drugs. Clinical recovery was faster after propanidid and methohexital than after thiopental or alphadione. Driving performances remained significantly (P less than 0.05) worse than in a control group for 6 hours after thiopental and for 8 hours after methohexital, and reaction times 8 hours after thiopental remained worse than in the control subjects. After alphadione driving skills were impaired at 6 hours only. Propanidid produced no impairment in driving skills at any time during the experiment. It is concluded that after the doses used in this study patients should not drive or operate machinery for at least 2 hours after propanidid and for at least 8 hours after alphadione. After methohexital and thiopental patients should probably not drive for 24 hours because of the severity of the disturbances at 8 hours.

Adult↗