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Biomedical subjects

L H Booij

Publications and source records attributed to L H Booij.

At least 73 records · Page 4Linked to original sources
PubMed1989

[Premedication in ENT operations under local anesthesia].

Midazolam 15 mg orally, was compared with the combination of pentobarbital, promethazine, opial and scopolamine as premedication for ear surgery under local anaesthesia in the first of a series of three double blind clinical trials. Sedation, pain sensation and appreciation by patient and surgeon alike were in favour of the pentobarbital regime. Anxiolysis was the same for both regimes. The number of actions needed to administer the medication was basically lower for midazolam. Comparing in a similar, second study midazolam 15 mg with higher doses of 20 mg and 25 mg, the results were satisfactory with the highest dose. Pain during the administration of the local anaesthesia was felt in 16% of the patients. Adding 10 mg morphine intramuscularly in a third study did not prove to diminish the percentage of patients with pain complaints. It is concluded that 25 mg midazolam taken orally 45 minutes pre-operatively is a satisfactory premedication for ear surgery and less troublesome than the pentobarbital, promethazine, opial, scopolamine we used before. In day-care surgery this short acting premedication in our opinion is quite useful.

Adolescent↗
PubMed1989

Propofol for induction and maintenance of anaesthesia: comparison between younger and older patients.

The propofol requirements for the induction and maintenance of anaesthesia were compared in groups of younger and older patients. Side effects, influence on the cardiovascular system and recovery times were compared between 20 unpremedicated ASA I-III, 25-40-yr-old patients and 20 65-80-yr-old patients all scheduled to undergo elective surgery. After induction with propofol, anaesthesia was maintained with a continuous infusion of the drug. Vecuronium and fentanyl were administered as required. In the young group propofol 2.2 mg kg-1 and in the elderly 1.7 mg kg-1 were needed for induction (P less than 0.05). The maintenance doses were 10.0 mg kg-1 h-1 and 8.6 mg kg-1 h-1, respectively (P less than 0.01). Side effects were more pronounced in the younger patients. Influences on the cardiovascular system were definite, but mild. The younger patients awoke sooner: 7.8 v. 14.3 min (P less than 0.01) after the discontinuation of the infusion of propofol.

Adult↗
PubMed1989

Median nerve evoked potentials during propofol anaesthesia.

Median nerve somatosensory evoked potentials (SSEP) were studied in 10 ASA I patients during general anaesthesia with propofol, vecuronium and fentanyl after premedication with diazepam. N14 and N20 latencies, central conduction time (CCT) and corresponding interpeak amplitudes were assessed at induction, after intubation, during steady state, at re-commencement of spontaneous breathing and during early recovery. Data were compared with pre-induction values. Median nerve SSEP were reproducible throughout the procedure and wave forms were suitable for assessment of neurological disorders. Intra-individual changes were considerable for latencies and amplitudes.

Adolescent↗
PubMed1989

Treatment of venous air embolism with papaverine.

Two cases of venous air embolism are described. One case occurred in a 12-year-old girl operated for ureteroileo-cutaneostomy; the other case occurred in a 44-year-old patient who underwent a hemihepatectomy. The haemodynamic and pulmonary consequences were successfully treated with intravenous papaverine.

Adult↗
PubMed1989

Effects of halothane on the conduction system of the heart in humans.

The effects of 2.0 MAC halothane on atrioventricular conduction times in humans were studied. A real-time recording system for the detection of surface His-Purkinje potentials based on signal averaging techniques was used. Recordings were made in 23 patients before and after the administration of halothane. In 18 patients we were able to measure atrial (P-H) and His-Purkinje (H-V) conduction times (78%). A small but statistically significant decrease in P-H conduction times from 115.3 +/- 3.9 (SEM) to 110.8 +/- 4.2 ms was found (P less than or equal to 0.01). H-V conduction times did not change significantly. Heart rates decreased significantly from 87.6 +/- 2.6 to 74.8 +/- 2.5 beats/min (P less than or equal to 0.01). Systolic blood pressures decreased from 118.9 +/- 3.7 to 103.6 +/- 4.2 mm Hg. It is concluded that the decrease in heart rate and the decrease in atrial conduction time caused by halothane can be explained by interactions of several different mechanisms. The specific combination of slowing heart rate and a decrease of atrial conduction time provides a possible explanation for atrial arrhythmias during the administration of halothane.

Adolescent↗
PubMed1989

Pharmacokinetics, metabolism, and renal excretion of articaine and its metabolite articainic acid in patients after epidural administration.

Articaine is metabolized into articainic acid. The half-lives of articaine are 0.54 +/- 0.05 and 2.44 +/- 0.30 h and that of its metabolite, 2.44 +/- 0.30 h. Of the administered dose approximately 2-5% is excreted unchanged, 40-70% is excreted as articainic acid, and 4-15% as articainic acid glucoronide. The percentage of the total dose recovered in the urine varies between 50% and 91%. Protein binding of articaine in patients varies between 50% and 70%, and that of articainic acid between 60% and 90%. Renal clearance of articaine varies between 12 and 28 ml min-1, while that of articainic acid is between 84 and 160 ml min-1.

Aged↗
PubMed1989

Influence of equipotent doses propofol and thiopentone on arterial pressure and heart rate at induction of anesthesia. A comparison between young and old patients.

To compare the influence on arterial pressure (AP) and heart rate (HR) at induction, twenty-eight 25-40 years and twenty-nine 65-80 years old unpremedicated patients were anesthetized with propofol 1.5 mg/kg or thiopentone 2.5 mg/kg. Simultaneously respectively propofol 9 mg/kg/h or thiopentone 6 mg/kg/h was infused. Additional bolus were eventually supplied (propofol 20 mg, thiopentone 25 mg). All patients received fentanyl 1.5 microgram/kg and vecuronium 0.1 mg/kg. Baseline values for both young and both old groups were identical. Immediately and 3' post-intubation HR in young thiopentone patients increased significantly (p less than 0.05) compared with propofol youngsters. AP decrease before intubation was identical in both old groups and slightly more important in young propofol than young thiopentone patients. AP increased significantly more (p less than 0.01) in both thiopentone groups immediately and 3' post-intubation, when also rate pressure products were significantly higher. It was concluded that propofol provided a more favorable cardiovascular situation than thiopentone, especially in the elderly.

Adult↗
PubMed1988

A comparison of alfentanil and fentanyl in short surgical procedures with special reference to postoperative effects.

A comparison of alfentanil and fentanyl was made with special reference to their postoperative effects. The study was performed double-blind in one hundred patients of either sex, undergoing elective surgery for hernia nuclei pulposi. All patients received thiopental, pancuronium, droperidol and 1-2 ml of a randomly selected ampoule, containing either 0.5 mg per ml alfentanil or 0.05 mg per ml fentanyl, for induction of anaesthesia. After positioning the patient, a 3-4 ml bolus dose of the analgesic was administered and occasional increments were given thereafter. There were significantly fewer responses to intubation in the 'alfentanil patients' than in the 'fentanyl patients'. Extubation time, although of little clinical importance, was significantly shorter in the alfentanil group. 12 Patients who were treated with alfentanil and 10 patients who were treated with fentanyl required the administration of an analgesic after mean time intervals of 65 and 64 min, respectively. Recovery of consciousness was similar in the two groups, but alertness 45 min after completion of the operation was significantly better in the alfentanil group: 52% were fully awake, as compared with 30% after administration of fentanyl.

Adult↗
PubMed1988

Effects of neostigmine, edrophonium, 4-aminopyridine and their combinations.

A study was carried out in the in-vitro rat phrenic nerve hemidiaphragm preparation to find a fast and strong working antagonist of non-depolarizing muscle relaxants. We studied neostigmine, edrophonium, 4-aminopyridine and their combinations from the cumulative concentration response curves of pancuronium. Neostigmine, edrophonium and 4-aminopyridine all antagonized the effect of pancuronium. Neostigmine and 4-aminopyridine did potentiate each other as did neostigmine and edrophonium. The combination of edrophonium and 4-aminopyridine showed less total effect than the addition of their individual effect. We conclude that the mechanisms of action of neostigmine and edrophonium are different.

4-Aminopyridine↗
PubMed1988

Cardiorespiratory effects of the sitting position in neurosurgery.

The hemodynamic and respiratory effects of raising patients from the supine into the sitting position for neurosurgical procedures were investigated in fifteen patients under fentanyl-nitrous oxide anesthesia. The change of position caused a significant decrease in the cardiac output and in the mean arterial blood pressure. An increase in the systemic vascular resistance and in the pulmonary vascular resistance occurred. Half an hour after positioning the patients the mean arterial blood pressure decreased so far that in one third of the patients the cerebral perfusion was threatened. In the sitting position the central venous pressure, measured at right atrium level, became subatmospheric in three patients. The central venous pressure and the capillary wedge pressure decreased, but the pressure gradient between the right and the left atrium reversed in most patients, bearing the risk of paradoxical air embolism. The alveolar-arterial difference in oxygen tension and the intrapulmonary shunt fraction were decreased after raising the patients; the dead space ventilation showed a significant increase.

Adult↗
PubMed1988

Alizapride in prevention of postoperative nausea and vomiting.

A series of 90 ASA class 1 or 2 young adult female out-patients, randomly assigned to four groups, were treated with placebo (saline solution), alizapride 50 mg, alizapride 100 mg or alizapride 200 mg. The incidence of postoperative nausea and vomiting has been estimated. The incidence of nausea and vomiting was lower with the alizapride-treated patients, while, contrary to the experience with other antiemetics, prolonged recovery was not observed. The incidence of vomiting in the placebo-group was twice as high as in the alizapride-groups. Of the placebo-treated patients, 20 percent requested further antiemetic medication within four hours while none of the alizapride-treated patients needed this. Alizapride 100 to 200 mg intravenously is efficacious in the prevention of postoperative nausea and vomiting.

Anesthesia, General↗
PubMed1987

Influence of renal and hepatic function on pharmacodynamics and pharmacokinetics of non-depolarizing muscle relaxants.

Liver and kidney function disturbances influence the pharmacodynamic and pharmacokinetic behaviour of drugs. Because of the differences in metabolism and excretion between the various muscle relaxants, liver and kidney disturbances do influence their pharmacodynamics and pharmacokinetics to a different extent. A description of the changes is given for the most frequently used non-depolarizing muscle relaxants. It is related to the practical clinical implications of the difference in the pharmacokinetics.

Humans↗