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Biomedical subjects

K Korttila

Publications and source records attributed to K Korttila.

141 records · Page 8Linked to original sources
PubMed1975

Side effects and skills related to driving after intramuscular administration of bupivacaine and etidocaine.

Eleven healthy subjects were injected intramuscularly with a saline placebo, 1.3 mg/kg of 0.5% plain bupivacaine, or 2.6 mg/kg of 1.0% plain etidocaine in a double-blind cross-over fashion. Before and at 1/2, 2 and 4 h after injection, side effects were recorded, and psychomotor skills related to driving were measured. Fatigue, dizziness, and sore thighs were significantly more common with etidocaine than with bupivacaine or the saline solution. Bupivacaine significantly impaired eye-hand cooridination and flicker fusion discrimination during the whole observation period. Etidocaine impaired flicker fusion discrimination only. The subjects' adaption to darkness, sensitivity to brightness, and visual discrimination ability in bright counterlight remained unaltered after each treatment. The results suggest that such psychomotor performance as driving ability is impaired for at least 2 h after a patient receives 1.3 mg/kg of plain bupivacaine or 2.6 mg/kg of plain etidocaine intramuscularly.

Acetanilides↗
PubMed1975

Outpatient anaesthesia in Finland: drugs used and postoperative care of patients.

To shed light on the practice of outpatient anaesthesia in Finland 126 hospitals performing outpatient surgery were asked about the drugs used and about postoperative care. 64% of the hospitals replied. Intravenous were more popular than inhalation agents. Diazepam (57%), propanidid (52%) and thiopentone (52%) were the most commonly used drugs. Nitrous oxide, mostly in combination with other anaesthetics, diazepam with pethidine, and halothane were used in 48%, 41% and 36% of the hospitals respectively. Divinylether and diethylether were employed in 35% and 15% respectively. Propanidid, thiopentone and diazepam were the first choice in 29%, 21%, and 11% respectively, while divinylether was still the first choice agent in 11%. Most central hospitals used nitrous oxide (82%), thiopentone (65%), halothane (60%), propanidid (50%) and methohexitone (25%). Small hospitals, where anaesthesia was not administered by specialists, most frequently used ethers (divinylether 51%, diethylether 29%), diazepam with pethidine (54%), propanidid (49%) and diazepam alone (34%). After propanidid, thiopentone and methohexitone patients were generally kept in hospital for 3 hours and advised against driving for between 17 to 20 hours. It is concluded that the choice of drugs seems appropriate. However, supplementation with nitrous oxide could reduce the high doses of intravenous anaesthetics used and result in reduced side-effects and more rapid recoveries. The wide use of involved anaesthetic techniques in rural areas stresses the importance of teaching anaesthesiology to general practitioners.

Adjuvants, Anesthesia↗
PubMed1975

The effect of diazepam, flunitrazepam and droperidol with an analgesic on blood pressure and heart rate in man.

The effects of i.v. diazepam (0.3 mg/kg), droperidol (5 mg) and a new benzodiazepine, 5-(a-fluorophenyl)-1,3-dihydro-1-methyl-7-nitro-2H-1,4-benzodiazepin-2-one (flunitrazepam, Ro 5-4200) (0.03 mg/kg) on blood pressure and heart rate was studied in 62 healthy volunteer students. Observations were made after each drug alone, after diazepam and flunitrazepam each combined with pethidine (1 mg/kg), and after droperidol combined with fentanyl (0.2 mg). The doses of the benzodiazepines were halved in those subjects given pethidine but the dose of droperidol was the same with and without fentanyl. The blood pressure was measured by auscultation and the heart rate by counting the radial pulse. The systolic and diastolic blood pressure was regularly decreased by not more than 20 and 11 mmHg, respectively. Changes in the heart rate were slight. Flunitrazepam did not have greater effects than diazepam or droperidol through the combination of flunitrazepam and pethidine seemed to induce a greater fall in systolic blood pressure than did the combination of diazepam and pethidine. None of the changes observed was clinically significant.

Adult↗
PubMedDate not supplied

Comparison of dexmedetomidine and midazolam sedation and antagonism of dexmedetomidine with atipamezole.

STUDY OBJECTIVE: To evaluate the effects of dexmedetomidine, an alpha-2 agonist, as an intravenous sedative drug and the effects of atipamezole, an alpha-2 antagonist, on recovery. DESIGN: Randomized, double-blind study with three parallel groups. An open dose-finding study preceded it to optimize the atipamezole dose. SETTING: Outpatient operating room at the gynecologic and obstetric university hospital in Helsinki, Finland. PATIENTS: Seventy-two healthy women scheduled for legal termination of pregnancy. INTERVENTIONS: Patients were assigned to one of three groups of 24 patients each to receive either dexmedetomidine 2 micrograms/kg and atipamezole 50 micrograms/kg; dexmetomidine 2 micrograms/kg and saline; or midazolam 0.15 mg/kg and saline. In addition to paracervical block, each patient received two different study drugs: study drug 1 was a sedative agent (either dexmedetomidine or midazolam), administered before the procedure. If the sedation was not deep enough and the patient reacted to the procedure, a low dose of propofol was administered. Study drug 2 was a reversing agent or a placebo, administered following the procedure. MEASUREMENTS AND MAIN RESULTS: The mean time to regain consciousness was shorter in the dexmedetomidine-atipamezole and the dexmedetomidine-saline groups compared with the midazolam group. Postoperative sedation, tested both by subjective and objective assessments, decreased more quickly in the dexmedetomidine-atipamezole group compared with the dexmedetomidine-saline and the midazolam groups. CONCLUSION: Atipamezole is an effective antagonist for reversing psychomotor impairment following dexmedetomidine sedation.

Abortion, Induced↗
PubMedDate not supplied

Comparison of domperidone, droperidol, and metoclopramide in the prevention and treatment of nausea and vomiting after balanced general anesthesia.

Women (185) undergoing elective orthopedic surgery under balanced general anesthesia were given 5 or 10 mg of domperidone, 1.25 mg of droperidol, 10 mg of metoclopramide, or a saline placebo intravenously in a double-blind random fashion 5 minutes before the end of anesthesia to prevent postoperative vomiting. Administration of the same antiemetic was repeated intramuscularly during the first 24 hours postoperatively if the patient complained of nausea or retched or vomited. Sigificantly (p less than 0.05 to p less than 0.001), fewer of the patients given droperidol were nauseated (25%) or vomited (17%) in comparison with patients given saline (incidence of nausea was 55% and vomiting 40%). Incidences of nausea and vomiting were similar in patients given domperidone, metoclopramide, or saline. Furthermore, 39 to 45% of the patients given domperidone, metoclopramide, or saline needed additional doses of the same drug, whereas only 22% of the patient given droperidol required a second dose. It is concluded that droperidol is effective in the prevention and treatment of postoperative nausea and vomiting after balanced general anesthesia but that domperidone or metoclopramide are not.

Adult↗
PubMedDate not supplied

Reduction of gain and time constant of vestibulo-ocular reflex in man induced by diazepam and thiopental.

The effect of intravenous administration of two sedatives, diazepam (0.3 mg/kg) and thiopental (6.0 mg/kg), on the vestibulo-ocular reflex (VOR) in man was investigated on 9 volunteers. The VOR was evoked with a velocity step rotation test and gain and time constant of prerotatory and postrotatory nystagmus were measured. Both drugs reduced VOR gain. Diazepam-induced reduction lasted 8 h and thiopental-induced reduction 1 h. A reduction of the VOR time constant was found lasting about 1 h for both drugs, but with a tendency for the thiopental effect to last longer. These findings, not previously described in man, differ from what has been found in macaques and rabbits injected with diazepam. The reduction of gain and time constant were not correlated with the blood concentration of either drug. The present results suggest that in man the VOR gain and time constant are both reduced by different types of sedatives although with different time courses. On the basis of previously shown effect of alertness on the VOR, it is hypothesized that diazepam and thiopental, besides having a specific effect on central nervous system structures important to the VOR, also induce reduction of the VOR through a general sedation of the CNS.

Adult↗
PubMedDate not supplied

Recovery following general anesthesia with isoflurane or enflurane for outpatient dentistry and oral surgery.

Anesthesia was induced in 120 unpremedicated, healthy patients undergoing outpatient dentistry or oral surgery with methohexital, and endotracheal intubation facilitated with succinylcholine. Anesthesia was maintained randomly with either enflurane or isoflurane in nitrous oxide and oxygen (50%) administered in a nonrebreathing circuit using spontaneous respiration. After both enflurane and isoflurane anesthesia, it took 12-13 minutes before the patients were oriented as to time and place. The patients' ability to walk along a straight line normalized significantly (p < .05) more quickly after isoflurane than after enflurane anesthesia. Long enflurane anesthesia (>90 minutes) was associated with a significantly (p < .05-p < .01) slower recovery of walking ability and of psychomotor performance in a perceptual speed test than was short enflurane anesthesia (<40 minutes). With isoflurane the speed of recovery did not depend on the duration of anesthesia. After both anesthetic techniques, 25-26% of the patients had nausea or vomited. We conclude that using spontaneous respiration recovery is faster after isoflurane anesthesia than after enflurane anesthesia and that isoflurane should be preferred to enflurane for long anesthesia of outpatients.

Adult↗