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PubMed · 5798907

Equipment.

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E W Jones. Equipment.. https://pubmed.ncbi.nlm.nih.gov/5798907/

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Nicorandil accelerates recovery of neuromuscular block caused by vecuronium.

PURPOSE: To examine the effect of nicorandil, a K ATP channel agonist, on neuromuscular block caused by vecuronium in patients anesthetized with nitrous oxide, oxygen, isoflurane, and fentanyl. METHODS: Sixty adult patients were allocated to four groups of 15: nicorandil-post-tetanic count (N-PTC), nicorandil-train-of-four (N-TOF), control-post-tetanic count (C-PTC) or control-train-of-four (C-TOF) group. In the N-PTC and N-TOF groups, 0.1 mg kg nicorandil was given as a bolus followed by an infusion at 1 microg x kg(-1) x min(-1). Two minutes after the bolus, 0.1 mg x kg(-1) vecuronium was administered. In the C-PTC or C-TOF group normal saline was given instead of nicorandil. PTC and TOF responses were measured mechanically using a force displacement transducer. RESULTS: Time from the administration of vecuronium to the onset of neuromuscular block in the N-PTC or N-TOF group did not differ from that in the C-PTC or C-TOF group (241 +/- 33 vs 225 +/- 32 sec, mean +/- SD). Times from vecuronium injection to the return of PTC in the N-PTC and C-PTC groups, and those of T1, T2, T3, and T4 (first, second, third, and fourth stimulation of TOF) in the N-TOF and C-TOF groups did not differ. Recoveries of PTC in the N-PTC and C-PTC groups followed similar time course. T1/control twitch height and TOF ratio (T4/T1) in the N-TOF group were higher than those in the C-TOF group 80-120 min and 100-120 min after administration of vecuronium, respectively. CONCLUSION: Nicorandil accelerates recovery of neuromuscular block caused by vecuronium.

Anesthesia, Inhalation↗

Production of compound A under low-flow anesthesia is affected by type of anesthetic machine.

PURPOSE: The purpose was to compare the concentrations of compound A in inspired gas breathed by patients produced by different types of anesthetic machines under prolonged sevoflurane low-flow anesthesia. METHODS: The anesthetic machines tested were Excel 210 SE (Datex-Ohmeda, Louisville, CO), Cicero (Dräger, Lübeck, Germany), and AS/3 ADU (Datex-Ohmeda, Louisville, CO). Anesthesia expected to last more than four hours was maintained with 2.0% sevoflurane and nitrous oxide (0.5 L x min(-1))/oxygen (0.5 L x min(-1)). The concentrations of compound A, obtained from the inspiratory limb of the circle system, were measured using a gas chromatograph. RESULTS: When Excel and Cicero were used, concentrations of compound A increased steadily from the baseline values to 28 and 29 (mean) ppm, respectively, at two hours after exposure to sevoflurane and became constant. There was no significant difference between the concentrations of compound A produced by these anesthetic machines. In contrast, the new anesthetic machine AS/3 was associated with lower concentrations of compound A (6 ppm at one hour, P <0.05 compared with Excel and Cicero), and the concentration did not change significantly thereafter. CONCLUSION: In spite of the use of a conventional carbon dioxide (CO2) absorbent with strong bases, the anesthetic machine AS/3 with a small volume of canister/soda lime (900 ml/700 ml) produced lower concentrations of compound A than those produced by the other machines.

Anesthesia, Inhalation↗

[Epileptoform EEG activity: occurrence under sevoflurane and not during propofol application].

In a 62-year-old female patient without a history of epileptic seizures EEG monitoring (EEG monitor: Narcotrend) was routinely performed during propofol/remifentanil and during sevoflurane/remifentanil/nitrous oxide anaesthesia. In the first course of anaesthesia after a bolus of propofol 1% a continuous EEG slowing was followed by a burst suppression pattern without occurrence of epileptiform activity throughout this sequence. During the second course of anaesthesia the sevoflurane concentration was increased from 2 to 8 % by volume. After 5 min epileptiform activity appeared in the EEG at an endtidal concentration of 5.9% by volume.

Anesthesia, Inhalation↗