Administration of anticholinesterase drugs in the presence of beta-adrenergic blockade.
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Biomedical subjects
Publications and source records attributed to S S Moorthy.
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The possibility of enflurane-induced spike activity being related to a cholinergic mechanism was investigated. Thirty mongrel dogs were anesthetized with an inspired enflurane concentration of 3.5 +/- 0.09% (mean +/- SD) to obtain a sustained EEG spike activity. Scopolamine, in 0.04 mg/kg to 0.4 mg/kg IV doses, significantly decreased the spike activity (p less than 0.05). We speculate that a central cholinergic muscarinic mechanism is at least partly responsible for the EEG spike activity produced by enflurane.
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Left atrial catheters are used to measure left heart filling pressure in patients after open-heart surgery. It was observed that in some patients blood gases obtained from the left atrial catheters had a markedly higher PO2 as compared to PaO2 in the presence of severe hypoxemia. Twenty-five patients were studied consecutively; pulmonary venous admixture calculated from arterial blood was higher in 19 patients and lower in 5 as compared with that calculated from blood withdrawn from the left atrial catheter. These differences in venous admixture are due to regional changes in the lungs. This observation can be utilized in concentrating respiratory therapy to the regions of the lungs involved with significant therapeutic benefit to the patient.
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The 28-gauge catheter supplied by Kendall Healthcare Products Company (Mansfield, MA) for continuous spinal anesthesia has two important characteristics. The ink used for the centimeter calibration marks and to identify the tip of the catheter "washes off" while it is inserted in the patient. In addition, the catheter has a tendency to stretch while it is in the patient or being removed. These two characteristics produced a situation in which it was impossible to determine whether a catheter fragment had been left in a patient. This predicament had a serious impact on the postoperative management of the patient. A computerized tomographic scan and spine films were negative, while other evidence suggested that a fragment was left behind. When the patient developed a postdural puncture headache, the authors felt that an epidural blood patch was contraindicated. The patient's headache did resolve with 48 hours of conservative therapy.