Significant Difference In Recovery Time Research Articles

Atracurium administration, as an infusion, to induce neuromuscular blockade in clinically normal and temporarily immune-suppressed cats

Summary Atracurium besylate, a nondepolarizing neuromuscular blocking agent, was administered by infusion to 10 cats that were anesthetized with isoflurane and oxygen to allow transplantation of a myocutaneous flap. Five of the cats were given cyclosporine (20 mg/kg of body weight, po, q 12 h in divided doses) for 2 days prior to anesthesia, and prednisolone (0.25 mg/kg, po) on the morning of surgery. The other 5 cats were not given either drug. Neuromuscular blockade was assessed, using the train-of-four stimulation, and throughout surgery, the infusion rate was adjusted to maintain the first-twitch response (T1) at 90 to 95% depression from baseline. At completion of surgery, atracurium was discontinued, and the infusion rate and the time for recovery (the time for the train-of-four ratio to increase from 50 to 75%) were recorded. Once the train-of-four ratio had been stable for 10 minutes, edrophonium (0.5 mg/kg), a cholinesterase inhibitor, was administered iv, and neuromuscular blockade was monitored for another 10 minutes. Mean (±sd) duration of the atracurium infusion was 302.1 ± 70.5 minutes for the control group and was 323.9 ± 61.7 minutes for the cats given cyclosporine and prednisolone. In the cats of the control group, the infusion rate required to induce 90 to 95% T1 depression from baseline was 3.7 ± 0.7 μg/kg/min. This rate was not significantly different from that of 2.8 ± 1.2 μg/kg/min in cats given cyclosporine and prednisolone. Significant difference in recovery time was not evident between the control group and the treated group (6.4 ± 4.5 minutes vs 6.2 ± 2.5 minutes). In this study, administration of atracurium by continuous infusion proved to be a suitable method of obtaining neuromuscular blockade for a prolonged period. Administration of cyclosporine and prednisolone did not affect the infusion rate of atracurium required to depress the first twitch by 90 to 95% and did not affect return of neuromuscular function.

Comparison of Bupivacaine-and Ropivacaine-Induced Conduction Blockade in the Isolated Rabbit Vagus Nerve

Ropivacaine (LEA-103) is a new amino-amide local anesthetic agent the chemical structure and anesthetic properties of which are similar to bupivacaine. Preliminary studies in animals indicate that the CNS toxicities of ropivacaine and bupivacaine are similar, but that ropivacaine may have less arrhythmogenic effects than bupivacaine. The current study arrhythmogenic effects than bupivacaine. The current study was designed to compare the in vitro potency, onset and recovery from block of ropivacaine and bupivacaine using an isolated rabbit vagus nerve model. The effect of varying concentrations of ropivacaine and bupivacaine on the compound action potential of A and C nerve fibers was assessed to determine whether motor and sensory fibers have different sensitivities to the two agents. The results showed that the depressant effect of bupivacaine was 16% greater than that of ropivacaine on motor fibers, but only 3% greater on sensory fibers. An analysis of variance indicated that this was a statistically significant difference (P = 0.028). Thus, at the concentrations tested, ropivacaine appears to produce relatively less blockade of motor fibers than does bupivacaine but with similar sensory blockade. The onset of this difference became significant as early as five minutes after the drug exposure was begun. No significant differences in recovery times were observed.

Total intravenous anaesthesia for laparoscopy

Two techniques of total intravenous anaesthesia for laparoscopy were compared in 80 patients. Group 1 received alfentanil, propofol and vecuronium, and Group 2 alfentanil, midazolam, ketamine and vecuronium. Haemodynamic stability after induction and the pressor response to tracheal intubation were significantly different. There was no significant difference in recovery times between the two groups and little difference in other postoperative sequelae.

Propofol anaesthesia in cats

ABSTRACTPropofol was administered to 49 cats to induce anaesthesia. The mean dose required was 6.8 mg/kg and this was not affected by prior administration of acepromazine maleate. In 27 cases, propofol was also used as the principal maintenance agent (mean dose rate 0.51 mg/kg/minute). Inductions were very smooth and problem free. Intubation was easily achieved in 15 cats with the aid of local desensitisation by lignocaine spray or neuromuscular relaxation by suxamethonium. Heart rate did not vary significantly during induction or maintenance of anaesthesia but respiratory rates did fall significantly. Recovery from anaesthesia was remarkably smooth in all cases and there was no significant difference in recovery times between the cats in which halothane was the principal maintenance agent and cats which received propofol alone. Side effects were seen during recovery in eight cats and included retching, sneezing and pawing of the face.

Treatment of the Alcohol Withdrawal Syndrome

SINCE THE PUBLICATION of Bumke's 1 paper in 1902, paraldehyde has been generally accepted as a useful drug in treatment of delirium tremens. With introduction of phenothiazines, these drugs have gained clinical acceptance, but there are few controlled studies reported in literature. Friedhoff and Zitrin 2 demonstrated that patients receiving paraldehyde recovered more quickly than those treated with chlorpromazine. Hart 3 found no significant difference in recovery time of delirium tremens patients treated with promazine compared to those treated with paraldehyde. In patients without delirium tremens, group treated with promazine showed a shorter duration of anxiety and agitation. Laties and colleagues, 4 in a double-blind study comparing promazine and chlorpromazine in delirium tremens, stated that the drugs were essentially indistinguishable in performance. Gruenwald and associates 5 concluded that patients with mild to moderate symptoms responded promptly to either promazine or triflupromazine, but patients in