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Biomedical subjects

M U Werner

Publications and source records attributed to M U Werner.

17 recordsLinked to original sources
PubMed2001

[Gabapentin--yet another antiepileptic agent for the treatment of neuropathic pain?].

Gabapentin is a recently introduced anti-epileptic drug used as an adjuvant in partial and secondarily generalised tonic-clonic seizures. Its mechanism of action has not been fully elucidated, but it seems that gabapentin may regulate voltage-dependent calcium channels, presumably on a spinal level, in the nociceptive system. Two large, controlled clinical trials of painful diabetic neuropathy and postherpetic neuralgia have demonstrated its analgesic efficacy. The adverse effects associated with gabapentin treatment are relatively harmless, mild to moderate in severity, and usually transient, with tolerance developing 2-3 weeks after start of treatment. Gabapentin and tricyclic antidepressants are efficacious in the treatment of painful diabetic neuropathy and postherpetic neuralgia.

Acetates↗
PubMed2000

[Paracetamol].

Explore the source record for details and available documents.

Acetaminophen↗
PubMed1991

Hemodilution during bone marrow harvesting in children.

Eight children (1-17 yr) underwent bone marrow harvesting while in cytostatic-induced remission of their disease (leukemia [n = 6], Ewing sarcoma, and non-Hodgkin lymphoma). After the induction of general anesthesia, all patients were loaded with 10 mL/kg of a 6% high-molecular dextran solution (Macrodex--Pharmacia), which resulted in a significant preoperative decrease in hematocrit (Hct) from 32% +/- 6% to 28% +/- 5% (hypervolemic hemodilution) and also allowed the procedure to be performed without systemic heparinization. The blood aspirated during the harvest (24 +/- 6 mL/kg; mean +/- SD) was replaced with a solution of 6% dextran and Ringer's acetate solution, and the Hct decreased from 28% +/- 5% to a minimum of 18% +/- 3%. Immediately after the harvest, 10 mL/kg of homologous packed red blood cells was transfused, increasing Hct to 25% +/- 3%. Oxygen saturation in the superior caval vein (ScvO2) decreased from 79% +/- 4% before the harvest to 70% +/- 3% (P less than 0.01) at the end of it, and then increased to 74% +/- 3% after the transfusion of homologous packed red blood cells. There was a strong linear correlation between mean values for Hct and ScvO2 during the various stages (r = 0.99). Mean heart rate decreased gradually during the procedure, from 106 +/- 10 to 86 +/- 7 beats/min. There was no significant change in arterial pressure, but cardiac output measured by impedance cardiography was about 30% greater during harvesting than during undisturbed anesthesia. Pulse oximetric saturation was 99% or 100% throughout. Caval venous blood lactate and pyruvate concentrations remained within normal limits in all children.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

Comparison of thumb acceleration and thenar EMG in a pharmacodynamic study of alcuronium.

We compared thumb acceleration (Acc) and thenar electromyography (EMG) techniques by evaluating the neuromuscular blocking properties of alcuronium in 14 ASA physical status I patients. The dose-response curves determined by the two techniques were parallel but the EMG-curve was shifted 25% to the right (P less than 0.001). Acc reflected 8-11% greater neuromuscular block than simultaneous EMG in every patients (P less than 0.05). Concurrently, the duration of greater than 90% neuromuscular block maintained by alcuronium 280 micrograms/kg was significantly longer when measured by the Acc transducer (30 vs. 19 min, P less than 0.001). Although the TOF ratios were in good correlation (r2 = 0.82), clinically significant differences existed between the two simultaneous techniques. The results underline the importance of the method of assessment of neuromuscular transmission when evaluating the action of neuromuscular blocking drugs.

Acceleration↗
PubMed1988

The acceleration transducer--an assessment of its precision in comparison with a force displacement transducer.

A new and simple acceleration transducer (ACT)-based system of neuromuscular monitoring has recently been introduced. The precision of this transducer has been evaluated as compared to a conventional force displacement transducer (FDT) in the present study. Ten progressions of spontaneous recovery from atracurium-induced block with simultaneous measurements using the ACT on one hand and the FDT on the other were studied. Five individuals undergoing elective surgery in modified neurolept anaesthesia and one ICU-patient requiring prolonged neuromuscular blockade, sedated with pentobarbital, were included. Measurements were carried out on the latter patient on 5 consecutive days. Train-of-four (TOF) stimulation was used, readings were given in twitch heights (TH) (T1/control value), and when four responses were obtained in TOF-ratios (T4/T1). Linearity was achieved after logit-transformation and the values regressed on time for each progression of recovery. Analysis of variance was applied to the regressions for the TH and TOF-ratio readings of each transducer. No significant differences were found, either between variation due to differences between slopes or variation due to technical error between the two transducers. The study indicates that the ACT is equal to the FDT with regard to precision in clinical recordings on atracurium-relaxed individuals.

Aged↗
PubMed1988

Assessment of neuromuscular transmission by the evoked acceleration response. An evaluation of the accuracy of the acceleration transducer in comparison with a force displacement transducer.

This paper presents preliminary observations on an acceleration-responsive transducer designed to monitor neuromuscular transmission. Simultaneously evoked acceleration and tension responses of the adductor pollicis muscles were studied. Registrations were obtained during recovery from atracurium-induced block in 29 individuals in neurolept II anaesthesia (Group I) and in 4 ICU patients (Group II) sedated with pentobarbital or midazolam. Regression analysis of 1567 train-of-four (TOF) registrations, in regard to TOF-ratio (T4/T1) and first twitch ratio (T1/T0), demonstrated regression coefficients (b) and correlation coefficients (r) in the range 0.91-1.06 and 0.89-0.98, respectively. During 1 Hz single twitch stimulation and post-tetanic count stimulation, b and r were in the range 0.85-1.03 and 0.77-0.90, respectively. Following administration of edrophonium (n = 6, Group I) a deviation of T1/T0 regression values was observed in four individuals, i.e. 0.48 (b) and 0.56 (r). This investigation proved a good level of accuracy of the acceleration transducer compared to the force displacement transducer during spontaneous and neostigmine-induced recovery from atracurium block. The acceleration transducer-based system does not require a rigid suspension and seems to have a good monitoring potential in clinical assessment of neuromuscular transmission.

Adult↗
PubMed1988

Midazolam combined with paracervical blockade compared to general anaesthesia for curettage of the uterus.

Two anaesthetic techniques were compared in a randomized trial of 60 ASA I and II women admitted for diagnostic dilatation and curettage of the uterus. Group I had fentanyl 2.5 micrograms/kg and thiopentone 2 mg/kg i.v. Supplementary thiopentone 50 mg was given every 15 s until loss of the eyelid reflex. Anaesthesia was maintained with nitrous oxide in oxygen 2/1 together with supplementary thiopentone 50 mg as required. Group II had midazolam 0.1 mg/kg i.v. and a supplementary 0.025 mg/kg every second min until sleep or dysarthria, followed by paracervical blockade with 1% mepivacaine 10 ml on each side of the portio. There was no significant depression of the cardiovascular system. The working conditions for the gynaecologist were good in both groups. The midazolam technique gave just as good amnesia as did general anaesthesia, and there was a high degree of patient satisfaction in both groups. In the thiopentone group there was a significant depression of the respiratory rate and a significantly higher frequency of adverse effects (nausea and vomiting) as compared to the midazolam group. It is concluded that paracervical blockade combined with midazolam, titrated i.v., until sleep or dysarthria, is a recommendable anaesthetic technique for diagnostic dilatation and curettage.

Anesthesia, General↗
PubMed1986

A fatal case of malignant hyperthermia following isoflurane anaesthesia.

To date, only two cases of malignant hyperthermia following isoflurane anaesthesia have been reported, neither of which were fatal. This case describes a very malignant form of hyperthermia after isoflurane, in which the laboratory values were grossly abnormal, and with multi-organ failure and death finally supervening.

Adult↗
PubMedDate not supplied

Effects of gabapentin in acute inflammatory pain in humans.

BACKGROUND AND OBJECTIVES: The aim of the study was to examine the analgesic effects of the anticonvulsant, gabapentin, in a validated model of acute inflammatory pain. METHODS: Twenty-two volunteers were investigated in a double-blind, randomized, placebo-controlled cross-over study. Gabapentin 1,200 mg or placebo was given on 2 separate study days. Three hours after drug administration, a first-degree burn injury was produced on the medial aspect of the nondominant calf (12.5 cm(2), 47 degrees C for 7 minutes). Quantitative sensory testing (QST) included pain ratings to thermal and mechanical stimuli (visual analog scale [VAS]), assessments of thermal and mechanical detection thresholds, and areas of secondary hyperalgesia. Side effects drowsiness and postural instability were assessed by subjective ratings (VAS). RESULTS: The burn injury induced significant primary and secondary hyperalgesia (P <.0001). Gabapentin diminished the decrease in mechanical pain threshold in the burn area (P =.04) and reduced secondary hyperalgesia, but the reduction was not significant (P =.06). Heat pain thresholds, pain during the burn, and mechanical pain in the area of secondary hyperalgesia were not significantly changed by gabapentin (P <.2). Ratings of drowsiness and unsteadiness during walking were significantly higher for gabapentin than for placebo (P <.05). CONCLUSIONS: The study indicates that gabapentin has no analgesic effect in normal skin, but may reduce primary mechanical allodynia in acute inflammation following a thermal injury. These observations suggest a clinical potential of gabapentin in the treatment of postoperative pain.

Acetates↗