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Biomedical subjects

W C Stevens

Publications and source records attributed to W C Stevens.

At least 37 records · Page 2Linked to original sources
PubMed1981

Isoflurane: an anesthetic for the eighties?

The introduction of isoflurane to clinical practice follows the search for a nonflammable, potent inhalation anesthetic which, above all, is chemically stable so as to resist biodegradation or attack by other chemicals. These attributes characterize isoflurane (Table 2). The hoped for freedom from hepatic and renal toxicity and from carcinogenic and mutagenic properties is a reality with this drug. Other favorable characteristics include relatively low solubility in blood in relation to anesthetic dose, lack of arrhythmogenic effect, provision of good muscle relaxation, and the absence of central nervous system excitation. Its moderate pungency detracts slightly from the ease of inhaled induction. Disadvantages include respiratory depression, reduced arterial blood pressure, uterine relaxation, decreased uteroplacental blood flow, and likely ability to trigger malignant hyperpyrexia. The frequency and/or significance of tachycardia and dilation of muscle blood vessels in clinical practice remain to be established. We believe isoflurane is a significant improvement over earlier potent inhalation anesthetics.

Anesthesia, Obstetrical↗
PubMed1979

Sister chromatid exchanges induced by inhaled anesthetics.

There is sufficient evidence that anesthetics may cause cancer to justify a test of their carcinogenic potential. Baden, et al., using the Ames test, a rapid and inexpensive genetic indicator of carcinogenicity, have shown that among currently used anesthetics fluroxene alone caused bacterial mutations. The authors used the sister chromatid exchange (SCE) technique, another rapid assay of mutagenic-carcinogenic potential. The frequency of sister chromatid exchanges in Chinese hamster ovary cells increases when the cell cultures are exposed to mutagen-carcinogens, particularly in the presence of a metabolic activating system. With this test system a one-hour exposure to 1 MAC nitrous oxide, diethyl ether, trichloroethylene, halothane, enflurane, isoflurane, methoxyflurane, or chloroform did not increase SCE values. Divinyl ether, fluroxene and ethyl vinyl ether increased SCE values in the same circumstances. Results of this study of mammalian cells suggest that no currently used anesthetic is a mutagen-carcinogen. The results also suggest that anesthetics containing a vinyl moiety may be mutagen-carcinogens.

Anesthesia, Inhalation↗
PubMed1978

Hypotensive anesthesia for total hip arthroplasty: a study of blood loss and organ function (brain, heart, liver, and kidney).

The authors attempted to determine whether hypotensive anesthesia or the method of inducing hypotension has any effect on postoperative brain, liver, or kidney function and myocardial status following total hip arthroplasty. Thirty patients were anesthestized with halothane-nitrous oxide for total hip arthroplasty and randomly assigned to one of three groups. In two groups mean arterial blood pressure was decreased to 50 torr by high inspired concentrations of halothane (n = 90) or sodium nitroprusside (n = 12). In the third group (n = 9) mean blood pressure was maintained within 20% of control. Intraoperative blood losses decreased from 1,183 +/- 172 ml in the normotensive group to 406 +/- 102 ml and 326 +/- 41 ml in the halothane and nitroprusside hypotensive groups, respectively. Neither method of inducing hypotension nor hypertensive technique affected the results of postoperative tests of cerebral, hepatic, or renal function and myocardial status. These tests were performed before anesthesia and operation and at intervals in the postoperative course. In this small group of patients, deliberate hypotension for total hip arthroplasty added no morbidity and significantly shortened operating time, decreased blood loss, and decreased the number of blood transfusions needed.

Aged↗
PubMed1977

Comparative toxicities of enflurane, fluroxene and nitrous oxide at subanaesthetic concentrations in laboratory animals.

We compared the toxicities of subanesthetic concentrations of fluroxene, enflurane and nitrous oxide in mice, rats and guinea pigs which were in an active growth phase. Fluroxene produced a greater mortality and decrement in weight gain than enflurane and nitrous oxide despite administration of far lower concentrations. Enflurane, 0.1 MAC, resulted in a detrimental effect on weight and early mortality in mice but not in rats or guinea pigs. Nitrous oxide, 0.1 MAC, resulted in only a minor effect on weight gain in guinea pigs and an increased incidence of focal inflammatory liver changes in mice. No consistent injury to any organs other than liver or kidney were found.

Animals↗
PubMed1975

Species, strain, sex and individual differences in enflurane metabolism.

Species, sex and individual differences in serum inorganic fluoride concentrations were demonstrated in mice, guineapigs and rats exposed to either 0.07% or 0.2% enflurane for 35 days, suggesting differences in enflurane biotransformation. Exposure of Fischer 344 rats and Sprague-Dawley rats to 0.2% enflurane for 8 days resulted in enzyme induction as demonstrated by increasing serum inorganic fluoride and cytochrome P-450 concentrations. However, there was no difference in cytochrome P-450 concentrations between the strains despite differences in inorganic fluoride concentration. These results emphasize the multiplicity of factors and the lack of predictability in patterns of enflurane metabolism among species, strains and individuals.

Animals↗
PubMed1975

Comparative toxicities of halothane, isoflurane, and diethyl ether at subanesthetic concentrations in laboratory animals.

Effects of 35-day exposures to subanesthetic concentrations of halothane, isoflurane, and diethyl ether were measured in mice, rats, and guinea pigs which were in a phase of rapid body growth. Halothane produced a greater decrement in weight gain and a greater incidence of hepatic degenerative changes than isoflurane or diethyl ether despite its administration at lower anesthetic concentrations. Isoflurane results were intermediate between those of halothane and diethyl ether. No consistent injury to any organ other than the liver was found.

Anesthesia, Inhalation↗
PubMed1975

Psychological eff-cts of halothane and isoflurane anesthesia.

Psychological effects of halothane (16 subjects) and isoflurane (24 subjects) anesthesia on healthy young men were assessed prior to and 2,3,4,6,8, and 30 days after anesthesia. The results with each agent were compared with each other and with the results for 41 unanesthetized controls. Both agents altered psychological function. Changes in function were greatest 2 days after anesthesia; function had returned to near preanesthesia values 8 days after anesthesia. Only slight symptom and mood effects and no intellectual effect attributable to anesthesia remained 30 days after anesthesia. Halothane produced greater negative effects on moodds and symptoms and tended to produce greater negative effects on intellectural function than did isoflurane. The differences between the two anesthetics are consistent with differences in their solubilities and metabolism.

Adult↗