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PubMedDate not supplied

Interferon-alpha2b may impair myelinization of rat optic nerve.

This story investigated the effects of interferon-alpha-2b (IFN-alpha2b) on the optic nerves of 17 adult male Wistar albino rats. Animals were divided into 3 groups: 6 rats (group 1) received 7.5 units (5 mIU/m2) IFN-alpha2b-a normal treatment dose, and 6 (groups 2) received 30.0 units (20 mIU/m2)-a high dose; 5 rats (control group) received 0.5 mL saline. Test substances were delivered by intraperitoneal injection 3 times a week for 3 weeks with animals under inhalation anesthesia. After the rats were sacrificed, their optic nerves were dissected, sectioned, and examined under an electron microscope. The mean thicknesses of the basal membranes of blood vessels were 86.354 nm in the control group, 104.297 nm in group 1, and 140.181 nm in group 2. Basal membrane changes in IFN groups were dose dependent. Mitochondrial swelling, degeneration, increased diameter of vacuoles, and vacuolization in the cytoplasm of oligodendrocytes and astrocytes were also observed. IFN-alpha2b has histopathologic effects on blood vessels and cells of the optic nerve.

Animals↗
PubMed1975

The effects of morphine and halothane anaesthesia on urine norepinephrine during and after coronary artery surgery.

Urine concentrations and excretion rates of norepinephrine were measured in 28 patients anaesthetized with halothane or morphine before, during and for two hours after aortocoronary artery grafting procedures. All patients were paralyzed with d-tubocurarine, intubated and respiration was controlled. Urine was obtained for 90 minutes before induction, during induction, before, during and after bypass and postoperatively. In patients anaesthetized with halothane, urinary norepinephrine concentrations and excretion rates were not significantly different from preoperative values until the postoperative period. Patients anaesthetized with morphine did not have urine norepinephrine concentrations different from preoperative values until bypass, when they became significantly increased. All subsequent urine norepinephrine concentrations and excretion rates were significantly elevated when compared to preoperative values. These findings do not indicate a mechanism but they do demonstrate that morphine anaesthesia is associated with increased urinary and probably also increased plasma levels of norepinephrine during and after cardiopulmonary bypass in patients undergoing coronary artery operations.

Adjuvants, Anesthesia↗
PubMed1976

The effects of morphine and halothane anaesthesia on urine norepinephrine during surgery for congenital heart disease.

Urine excretion rates of norepinephrine were measured in 15 children with Tetralogy of Fallot and 25 with atrial septal secundum defects anaesthetized with halothane or morphine before, during and for two hours after surgical correction of their cardiac defects. All patients were paralyzed with d-tubocurarine, the tracheae were intubated and respiration was controlled. Urine was obtained for 90 minutes before induction, during induction, before, during and after bypass and postoperative. Patients with TF had significantly higher pre-operative urine norepinephrine excretion rates than patients with ASD. In TF children anaesthetized with halothane norepinephrine excretion was significantly decreased during induction and during operation but increased post-operatively. Children with ASD and anaesthetized with halothane did not have urine norepinephrine excretion rates that were significantly different from post-operative values until the postoperative period. ASD children anaesthetized with morphine had marked elevations in norepinephrine excretion during induction and all subsequent study periods. On the other hand, morphine anaesthetized TF children did not have a significant increase in urine norepinephrine excretion until bypass had been established. Increased norepinephrine excretion was maintained in these patients during all subsequent study periods. These data, when combined with our results in patients with acquired heart disease, demonstrate that disease can alter norepinephrine responses to morphine anaesthesia. In addition our results suggest that dosage of morphine and morphine blood levels might also modify norepinephrine excretion.

Anesthesia, Inhalation↗
PubMed1989

Anaesthesia for caesarean section in patients with uncontrolled hyperthyroidism.

The anaesthetic management of two patients with uncontrolled hyperthyroidism requiring Caesarean section is described. The first patient was diagnosed as hyperthyroid during pregnancy but was resistant to medical management with propylthiouracil (PTU). At 38 weeks' gestation, after optimizing her heart rate with intravenous propranolol, she received an epidural anaesthetic for the Caesarean section. The baby had manifestations of hypothyroidism immediately after birth but later became hyperthyroid. The second patient's hyperthyroidism was well controlled but she stopped her medication one week before delivery. The Caesarean section was performed under general anaesthesia for fetal distress. The baby died in the neonatal period of extreme prematurity. The anaesthetic management of the hyperthyroid parturient is discussed. Preoperative control of hyperthyroidism, bearing in mind pregnancy and time constraints, is essential. The use of PTU, propranolol, iodine, and glucocorticoids is described in the preparation of the parturient. Fetal and neonatal effects of these drugs are discussed.

Adult↗
PubMed1989

Denitrogenation in pregnancy.

This study measured nitrogen washout in ten pregnant and nine non-pregnant women to understand better how pregnancy effects denitrogenation. Nitrogen concentration was monitored continuously while the women breathed 100 per cent O2 for three minutes and took four deep breaths of 100 per cent O2 using a circle anaesthesia system and 8 L.min-1 fresh gas flow. Parturients achieved 95 per cent denitrogenation significantly (P less than 0.0005) faster than non-pregnant women (54.5 +/- 17.8 vs 110.8 +/- 35.7 sec). In parturients, denitrogenation for three minutes lowered expired N2 concentration to 1.0 +/- 0.2 per cent while four deep breaths lowered it to 5.1 +/- 1.7 per cent (P less than 0.0001). This difference, while statistically significant, is predicted to supply only 10-15 sec of extra protection against hypoxaemia, and thus is probably not clinically significant. The authors conclude that either two minutes of tidal breathing or four deep breaths of 100 per cent O2 provide adequate denitrogenation and similar protection against apnoeic hypoxaemia in normal parturients.

Adult↗
PubMed1990

Clinical assessment of the muscular response to tetanic nerve stimulation.

The study was undertaken in order to determine clinical tactile evaluation of tetanic nerve stimulation (50 Hz, 5 sec) as a means of detecting fade and possible residual curarization. Forty-four patients were studied and 128 clinical evaluations by eight different observers were performed at various levels of neuromuscular blockade. Tetanic fade was detected reliably by clinical evaluation only when high degrees of fade (tetanic fade ratio of 0.3 or less) were detected with a force-displacement transducer. We conclude that the clinical tactile assessment of the response to tetanic stimulation is not accurate except at very high degrees of fade and that its usefulness in monitoring neuromuscular recovery is doubtful.

Adult↗
PubMed1990

Atropine-induced heart rate changes: a comparison between midazolam-fentanyl-propofol-N2O and midazolam-fentanyl-thiopentone-enflurane-N2O anaesthesia.

Atropine-induced heart rate (HR) changes were studied in 19 patients (ASA physical status I) during anaesthesia-maintained predominantly with propofol-N2O or thiopentone-enflurane-N2O. Ten patients (Group A) received midazolam (0.07 mg.kg-1), fentanyl (1 microgram.kg-1), propofol (2 mg.kg-1) and succinylcholine (1 mg.kg-1). Following tracheal intubation, anaesthesia was maintained with propofol (6 mg.kg-1.hr-1), N2O (67 per cent) and O2 (33 per cent). In nine patients (Group B) thiopentone (4 mg.kg-1) was substituted for propofol and anaesthesia maintained with N2O (67 per cent) O2 (33 per cent), and enflurane (0.5 per cent inspired concentration). The study was non-randomised because Group B patients were only included if HR before administration of atropine less than 90 beats.min-1. IPPV was performed in all patients using a Manley ventilator (minute vol. 85 ml.kg-1; tidal vol. 7 ml.kg-1). Ten minutes after tracheal intubation, incremental doses of atropine (equivalent cumulative doses: 1.8, 3.6, 7.2, 14.4, 28.8 micrograms.kg-1) were administered at two-minute intervals and HR responses calculated during the last 45 sec of each intervening period. No differences were observed between the groups following 1.8 and 3.6 micrograms.kg-1 atropine, but propofol-N2O anaesthesia was associated with reduced responses (P less than 0.01) following 7.2, 14.4 and 28.8 micrograms.kg-1 atropine. These results suggest that there is a predominance of parasympathetic influences during propofol-N2O anaesthesia compared with thiopentone-enflurane-N2O anaesthesia.

Adult↗
PubMed1990

Visual evoked potentials during etomidate administration in humans.

The effects of etomidate on visual evoked potentials (VEP) were studied in 22 patients undergoing gynaecological procedures. They were divided into two groups: the etomidate group (12 patients) and the fentanyl-N2O-etomidate group (ten patients). In the etomidate group, etomidate 0.3 mg.kg-1 was given as a bolus injection during induction of anaesthesia which was followed by an infusion of etomidate 0.05 mg.kg-1.min-1. No significant changes were observed in the amplitudes of P100 or N70. Latencies of the P60, N70, and P100 were slightly increased. In the fentanyl-N2O-etomidate group, a bolus injection of 0.3 mg.kg-1 of etomidate was given during anaesthesia with 3-4 micrograms.kg-1 of fentanyl and 60 per cent nitrous oxide. The amplitude of the P100 was significantly decreased and the latencies of the P60 and N70 were significantly increased. In conclusion, interpretation of the VEP during etomidate administration alone was not hard to perform but, when given together with fentanyl-nitrous oxide anaesthesia, the VEP was affected significantly making its interpretation difficult.

Adult↗
PubMed1990

Pulmonary oedema in two parturients with hypertrophic obstructive cardiomyopathy (HOCM).

Two patients with hypertrophic obstructive cardiomyopathy (HOCM) presented for delivery. The first had a repeat Caesarean section with general anaesthesia and the second gave birth vaginally with epidural analgesia. Both patients developed pulmonary oedema in the peripartum period. These cases highlight the delicate fluid requirements of the pregnant patient with HOCM. The fluid management of the parturient is discussed with particular emphasis on the pathophysiology of HOCM. The indications for invasive monitoring are presented.

Adult↗