Some comparative biochemical effects of 5-substituted congeners of salicylic acid.
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Biomedical subjects
Publications and source records attributed to W C Petty.
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Two adult patients suffered postoperative delirium following administration of lorazepam, a new benzodiazepine sedative. Physostigmine was found effective in reversing all untoward central nervous system effects.
A double-blind comparison of lorazepam and placebo, lorazepam and pentobarbital, and a comparison of lorazepam IV drip versus lorazepam IV bolus as a premedicant showed this new agent to offer promise as a sedative premedicant. However, the potency of the drug demands caution, and its use for outpatient premedication is not recommended.
Correlation between plasma cholinesterase activity and duration of neuromuscular blockade following succinylcholine (SCh) was studied in 30 healthy women undergoing laparoscopic tubal coagulation and 20 pregnany women indergoing elective repeat cesarean section. All patients received N2O-thiopental anesthesia. Cholinesterase activity in nonpregnant patients was significantly greater than in pregnant patients. Time to 90 percent recovery of control twitch height following 40 or 80 mg/m2 BSA of SCh was not significantly different in pregnant versus nonpregnant patients. There also was no correlation between plasma cholinesterase activity and duration of paralysis from SCh. The authors conclude that pregnant patients have lower cholinesterase activity, but prolonged neuromuscular blockade from SCh should not occur unless the patient is grossly overdosed with SCh. Routine use of a peripheral nerve stimulator is recommended to avoid such overdosage.
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Operating tables evolved rapidly from 1860 through 1920. By 1920, the operating tables were well-designed for a wide variety of operations. Today, our operating tables resemble those developed in the early 20th century.
Consciousness during sedation has a long and well documented history. Awareness during anesthesia has been reported and is terrifying for the patient. Surgical staff must anticipate the possibility that the sedated patient is conscious.
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