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At least 397 records · Page 22Linked to original sources
PubMed1984

[Continuous blockade of the lumbar plexus ("3-in-1 block") in perioperative pain therapy].

This is a description of a technique for a continuous blockade of the lumbar plexus by means of a specially developed catheter set. The femoral nerve is located more or less atraumatically, on the basis of objective criteria, by the use of a nerve stimulator and a small-lumen puncture cannula. The catheter is subsequently inserted into the fascia surrounding the nerves by the Seldinger technique. The advantage of this catheter technique lies in the fact that the normal blockade period can be extended at will, without any great increase in the amount of time and material needed. Pain therapy for the patient during the operation does not involve the necessity of further punctures with the risk of neural lesion resulting from the fact that partial anaesthesia still exists. Individual dosage is possible because of the anatomical circumstances. The catheter technique we used enabled us in many cases to reduce the amount of local anaesthetic used. No disturbances in the functioning of the bladder or vasomotor system, as is the case with spinal conduction anaesthetics, were observed. In the pre-operative phase this 3-in-1 blockade procedure facilitates the treatment of patients with a fractured collum femoris in particular, and after an operation it makes it possible to mobilize the patient sooner, without the administration of additional analgetics.

Anesthesia, Spinal↗
PubMed1978

[Effect of neuroactivating amino acids on the system activating sympathetic preganglionic neurons].

In anesthetized cats, the bioelectrical responses were recorded in T3 white ramus during stimulation of intercostal nerve of the T3 segment and of descending pathways (dorsolateral funiculus) of the C5 segment. The effects of GABA, glycine (and its synaptic antagonists picrotoxin and strychnine), and of glutamic acid on different components of the responses were not identical which suggested different sites of the activity effects of glutamic acid and of the inhibitory effects of GABA and glycine in the central pathways for activation of the sympathetic preganglionic neurons.

Aminobutyrates↗
PubMed1978

Flushing.

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Blushing↗
PubMed1983

Maturation of central autonomic control of the circulation.

Postnatal maturation of central neural regulation of cardiovascular function is being examined in developing swine. Three major types of investigations have been undertaken: 1) alterations of inputs from visceral and somatic afferents, e.g., baroreceptor manipulation, stimulation of sciatic nerves; 2) stimulation of central vasoactive sites; 3) subjecting the animals to the stresses of hemorrhage, hypoxia, or hypercapnia. Our findings indicate that cardiovascular reflexes mature at different postnatal ages. For example, the J-receptor reflex had almost the adult pattern of response at birth, whereas the Bezold-Jarisch reflex had a markedly delayed postnatal maturation. Recordings of spontaneous discharge in a major efferent sympathetic supply, i.e., the greater splanchnic nerve, have indicated that neural innervation to the adrenal medulla and splanchnic vasculature is present at birth in piglets.

Animals↗
PubMedDate not supplied

[The adrenergic system].

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Adrenergic alpha-Agonists↗
PubMed1982

Diabetic autonomic neuropathy in the surgical management of the diabetic foot.

The onset of autonomic neuropathy can often be insidious and may be associated with somatic neuropathy. Whether the autonomic dysfunction has a primary role or simply serves as a marker for other disease processes remains unclear. There is no doubt, however, that autonomic neuropathy, once present, greatly complicates the diabetic state and the management of the diabetic patient in the perioperative period and also statistically increases the mortality risk. Hopefully the testing of diabetic patients for the presence of autonomic neuropathy will become more prevalent. The heightened awareness will serve to alert the podiatric physician of possible autonomic disease sequelae in the surgical management of such patients.

Autonomic Nervous System Diseases↗
PubMed1982

Reversible changes in norepinephrine extraction by the lungs in children with pulmonary hypertension.

Extraction of circulating vasoactive hormones by the lung may influence systemic vasomotor tone. Since this process occurs in the pulmonary microcirculation, we evaluated the effects of pulmonary artery hypertension (PAH) secondary to congenital heart disease (CHD) on this metabolic function of lung. Eleven patients with varying congenital cardiac lesions were studied preoperatively and postoperatively. Five had normal pulmonary artery pressure (PAP) (group I), and six had PAH with peak systolic PAP greater than 40 mm Hg (group II). PA and postpulmonary arterial blood samples were collected before and after surgery at the time of pressure measurements. Norepinephrine (NE) and epinephrine (EPI) levels were determined by radioenzymatic assay. Preoperatively, circulating NE levels were higher (P less than 0.05) and NE extraction measured was lower (P less than 0.01) in group II patients as compared with group I. Extraction increased in group II postoperatively after PA pressures were reduced, becoming equivalent to group I postoperative values. EPI extraction was negligible in either group at any time. These data demonstrate that lungs of children are capable of selective catecholamine uptake and that elevated PAP occuring with CHD is associated with a decrease in this capability and an increase in circulating NE levels. Additionally, the decrease in NE extraction observed with PAH is reversible once PAP is reduced by surgical repair of the cardiac defect.

Adolescent↗
PubMed1981

[Changes in sympathetic activity in the renal and splenic nerves upon stimulation of bulbar nuclei during hypoxic hypoxia].

Microinjections of acetylcholine into the cat ventral reticular nucleus and nucleus of tractus solitarii in acute hypoxic hypoxia induce much lesser changes of efferent activity in renal and splenic nerves than in normoxia. Stimulation of the ventral reticular nucleus in hypoxia induces more obvious shifts of the efferent nerve activity than stimulation of the tractus solitarius nucleus. Bulbar reflex influences on cat's renal vascular bed are much more reduced in hypoxia than on the splenic one.

Acetylcholine↗
PubMed1995

Experimental studies on cortisol-induced hypertension in humans.

Studies in humans have shown that cortisol administration (200 mg/day) increases cardiac output, renal vascular resistance, glomerular filtration rate, plasma volume, extracellular fluid volume, exchangeable sodium, plasma glucose, insulin, renin substrate and atrial natriuretic peptide concentrations as well as urinary kallikrein excretion. Cortisol treatment decreases renin and angiotensin II concentrations while catecholamines and vasopressin are decreased or unchanged. We have clear evidence from a number of studies that cortisol-induced hypertension is modulated by, but not dependent on, exogenous sodium. The increase in cardiac output normally seen with cortisol administration is not essential for the blood pressure rise. The role of the increase in renal vascular resistance in the genesis of the hypertension is unclear. Studies using measurements of noradrenaline spillover and assessment of reflex function have not shown any increase in sympathetic nervous system activity but changes in vascular responsiveness, particularly to phenylnephrine and noradrenaline are marked. Cortisol is known to have a variety of effects on brain, heart, kidneys, blood vessels and body fluid volumes. To what extent the observed changes are epiphenomena, amplifiers or modulators, or are causal is unclear. Cortisol hypertension may reflect a complex interplay of these factors varying with the steroid concentrations achieved, underlying genetic factors and the particular experimental circumstances.

Extracellular Space↗
PubMed1994

Effect of smoking cessation upon circulatory responses to reactive hyperemia and cold pressor stress.

Local and sympathetic nervous system stress tests were administered prior to and following a 5-d smoking cessation program to determine the effects of short term smoking cessation upon peripheral circulation. Reactive hyperemia (RH) tests were performed on the forearm as a local dilatory stressor. Finger blood flow responses to cold pressor (CP) stresses were used to access stimulation of the sympathetic nervous system. Measures of heart rate and total forearm or finger blood flow, pulse volume and rate of blood delivery were obtained continuously during each stress test. Smoking cessation produced a significant decrease (0.01 < p < 0.05) in heart rate during both the RH and CP test sequences. Grouped mean peak forearm blood flow (Mean difference = 2.11 ml.100 ml-1.min-1; p < 0.05) and pulse volume (Mean difference = 0.04 ml.100 ml-1.pulse-1; p < 0.01) were both significantly greater following occlusion during the post-cessation RH tests than during the similar test before smoking cessation. Both finger pulse volume and rate of blood delivery were significantly greater (0.01 < p < 0.05) during the recovery portion of the post-cessation CP tests than during the same period of the pre-cessation tests. Thus, smoking cessation significantly altered both the locally mediated and central nervous system controlled responses to externally applied stressors.

Aged↗
PubMed1993

[Neurohormonal activity in heart insufficiency].

The maintenance of cardiac pumping ability in the presence of a primary disturbance of myocardial contractility and/or an excessive haemodynamic strain on the heart is dependent on several compensatory mechanisms. Particular attention has formerly been paid to the importance of the Frank-Starling mechanism and cardiac hypertrophy and dilatation in maintaining a blood supply sufficient to cover the metabolic needs of various tissues in heart failure. In recent years, however, it has been found that certain neurohormonal systems (the sympathetic nervous system, the renin-angiotensin-aldosterone system, atrial natriuretic peptide and several locally acting vaso-active substances) undergo considerable changes according to the degree of heart failure. These compensatory mechanisms support the circulation wholly or partially in acute heart failure, however sustained neurohormonal activation may be harmful in chronic heart failure, where several neurohormonal factors may be activated to ill-effect. The most significant neurohormonal systems and their importance in heart failure are reviewed on the basis of the available literature.

Atrial Natriuretic Factor↗