Alfentanil (0.175 mg/kg) and a combination of thiopental (3-4 mg/kg) and lidocaine (1.5 mg/kg) during anesthetic induction were compared. Each was administered rapidly to eight patients with cardiovascular disease (average age, 64 yr), followed by succinylcholine (1.5 mg/kg) for laryngoscopy and intubation. Chest wall rigidity or flexor spasm of arm and jaw were seen transiently in 7 of 8 patients receiving alfentanil. Both drugs led to decreases in mean arterial pressure averaging 31 mm Hg (P less than 0.01). In patients given thiopental-lidocaine, intubation led to a 28 mm Hg (P less than 0.01) increase over control in arterial pressure and a 10 beats . min-1 increase in heart rate (P less than 0.01). In patients given alfentanil, after intubation arterial pressure returned to levels no different from control and the heart rate remained stable. Five of the patients given alfentanil required a single dose of naloxone (0.08-0.15 mg) to achieve a PCO2 less than 50 torr at the end of surgery. Rapidly administered alfentanil blunted the cardiovascular response to intubation but decreased arterial pressure as much as thiopental-lidocaine.
Download full-text PDF |
Source |
|---|
Publication Analysis
Top Keywords
Similar Publications
Neuro-computational simulation of blood flow loaded with gold and maghemite nanoparticles inside an electromagnetic microchannel under rapid and unexpected change in pressure gradient.
Electromagn Biol Med
January 2025
Department of Mathematics, University of Gour Banga, Malda, India.
In cardiovascular research, electromagnetic fields generated by Riga plates are utilized to study or manipulate blood flow dynamics, which is particularly crucial in developing treatments for conditions such as arterial plaque deposition and understanding blood behavior under varied flow conditions. This research predicts the flow patterns of blood enhanced with gold and maghemite nanoparticles (gold-maghemite/blood) in an electromagnetic microchannel influenced by Riga plates with a temperature gradient that decays exponentially, under sudden changes in pressure gradient. The flow modeling includes key physical influences like radiation heat emission and Darcy drag forces in porous media, with the flow mathematically represented through unsteady partial differential equations solved using the Laplace transform (LT) method.
View Article and Find Full Text PDFIndividualized blood pressure regulation and acute kidney injury in older patients having major abdominal surgery: a pilot randomized trial.
Int J Surg
January 2025
Department of Anesthesiology, Xiangya Hospital, Central South University, Changsha, Hunan, China.
Background: Acute kidney injury (AKI) is a common postoperative complication, and hypotension may contribute. We therefore tested the primary hypothesis that individualized intraoperative blood pressure regulation reduces postoperative AKI in older surgical patients.
Methods: We enrolled patients ≥60 years old scheduled for elective major abdominal surgery with invasive arterial pressure monitoring.
The Clinical Course of Portopulmonary Hypertension and Outcomes With Endothelin Receptor Antagonist Treatment: Observational Study of Data From the US Organ Procurement and Transplantation Network.
Transplant Direct
March 2024
Actelion Pharmaceuticals Ltd, Janssen Pharmaceutical Company of Johnson and Johnson, Global Epidemiology, Allschwil, Switzerland.
Background: Portopulmonary hypertension (PoPH) occurs in patients with advanced liver disease and can be a contraindication to liver transplant (LT). Improvement of hemodynamic parameters with pulmonary arterial hypertension (PAH) therapies (including endothelin receptor antagonists [ERAs]) may help some patients to become eligible for LT.
Methods: We conducted a retrospective secondary data analysis to describe the clinical course and management of PoPH in patients on a US registry LT waitlist and outcomes in patients receiving an ERA.
Physiological arterial pressure improves renal performance during normothermic machine perfusion in a porcine kidney DCD model.
Heliyon
January 2025
Division of HPB and Transplant Surgery, Department of Surgery, Transplant Institute, Erasmus Medical Center, Rotterdam, the Netherlands.
Background: Normothermic machine perfusion (NMP) provides a platform for kidney quality assessment. Donation after circulatory death (DCD) donor kidneys are associated with great ischemic injury and high intrarenal resistance (IRR). This experimental study aims to investigate the impact of different perfusion pressures on marginal kidney function and injury during NMP.
View Article and Find Full Text PDFAdvantages and challenges of using arterial spin labelling MRI to monitor cerebral blood flow in multi-centre clinical trials of neurodegenerative disease: Experience from the RADAR study.
Cereb Circ Cogn Behav
January 2025
Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, University College London, London, UK.
Arterial spin labelling (ASL) enables non-invasive quantification of regional brain perfusion using MRI. ASL was used in the Reducing Pathology in Alzheimer's Disease through Angiotensin TaRgeting (RADAR) multi-centre trial to pilot the assessment of the effects of the anti-hypertension drug losartan on cerebral blood flow (CBF). In the multi-centre setting, disparities in ASL implementation on scanners from different manufacturers lead to inherent differences in measured CBF and its associated parameters (e.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!