Effect of Vecuronium in different age group

Background: Muscle relaxants are adjuncts to good anesthesia. Neonates and infants are having less developed neuromuscular junction, larger distribution volume and poor hepatic and renal function. The aim of the present study was to define dose of Vecuronium in neonates and infants in comparison of other age groups, to observe cardiovascular effect of Vecuronium, to study adequacy of intubating condition and, Adequacy of intra-operative muscle relaxation, To observe completeness of recovery after reversal. Materials and methods: 100% patients belonging to physical status of A.S.A Group I and II for operative procedures from both routine and emergency surgeries were selected randomly for study to observe clinical Comparison of Vecuronium bromide in different age groups. Patients were divided into 4 groups each consists of 25 Patients: Group I - Patients of 0-1 year of Age, Group II - Patients of 1-5 year of Age, Group III - Patients of 6-15 year of Age, Group IV - Patients of 16-50 year of Age. Results: Mean pulse rate before induction in Group I patient was 143.92/min., it increased to 151.92 /min. after intubation and then maintained throughout the course of anesthesia between 143.68 to 146.28 / min. which was not significant. The mean arterial pressure in Group I patient was maintained between 74.32 mm of Hg, 77.24 mm of Hg in Group II from 84.21 of pre-induction value – small changes were there and MAP maintained between 79.9 to 89.3 mm of Hg. Pre-induction MAP in Group III was 87.95 mm of Hg, it maintained between 89.29 to 92.66 mm of Hg throughout and in Group IV pre-induction value of MAP was 94.62, where it was maintained between 91.78 – 98.5 mm of Hg. So, there was no any pulse rate or blood pressure changes reflecting cardiovascular stability of Vecuronium. Rajani B, Brahmbhatt H, Chaudhry H, Hiren Parmar H. Effect of Vecuronium in different age group. IAIM, 2016; 3(9): 210- 217. Page 211 Conclusion: Vecuronium is an excellent non-depolarizing muscle relaxant which is an intermediate duration of action in adult but of longer duration in neonates and infants (less than 1 year). It is having advantage of – Cardiostability, Lack of Ganglion blocking action, Lack of histamine release, Non cumulative property, Excellent conditions for intubation, Excellent muscle relaxation, Complete recovery without any complication

Cardiovascular activity of the n-butanol fraction of the methanol extract of Loranthus ferrugineus Roxb

We investigated the vascular responses and the blood pressure reducing effects of different fractions obtained from the methanol extract of Loranthus ferrugineus Roxb. (F. Loranthaceae). By means of solvent-solvent extraction, L. ferrugineus methanol extract (LFME) was successively fractionated with chloroform, ethyl acetate and n-butanol. The ability of these LFME fractions to relax vascular smooth muscle against phenylephrine (PE)- and KCl-induced contractions in isolated rat aortic rings was determined. In another set of experiments, LFME fractions were tested for blood pressure lowering activity in anesthetized adult male Sprague-Dawley rats (250-300 g, 14-18 weeks). The n-butanol fraction of LFME (NBF-LFME) produced a significant concentration-dependent inhibition of PE- and KCl-induced aortic ring contractions compared to other fractions. Moreover, NBF-LFME had a significantly higher relaxant effect against PE- than against high K+-induced contractions. In anesthetized Sprague-Dawley rats, NBF-LFME significantly lowered blood pressure in a dose-dependent manner and with a relatively longer duration of action compared to the other fractions. HPLC, UV and IR spectra suggested the presence of terpenoid constituents in both LFME and NBF-LFME. Accordingly, we conclude that NBF-LFME is the most potent fraction producing a concentration-dependent relaxation in vascular smooth muscle in vitro and a dose-dependent blood pressure lowering activity in vivo. The cardiovascular effects of NBF-LFME are most likely attributable to its terpenoid content.

Some arachnidan peptides with potential medical application

The search for new active drugs that can alleviate or cure different diseases is a constant challenge to researchers in the biological area and to the pharmaceutical industry. Historically, research has focused on the study of substances from plants. More recently, however, animal venoms have been attracting attention and studies have been successful in addressing treatment of accidents. Furthermore, venoms and their toxins have been considered good tools for prospecting for new active drugs or models for new therapeutic drugs. In this review, we discuss some possibilities of using different toxins, especially those from arachnid venoms, which have shown some potential application in diseases involving pain, hypertension, epilepsy and erectile dysfunction. A new generation of drugs is likely to emerge from peptides, including those found in animal venoms.

Aspectos fisiológicos del catión cinc y sus implicaciones cardiovasculares / Physiological aspects of Zn cathion and its cardiovascular implications

Introducción La versatilidad del catión cinc en la fisiología de diversos tipos celulares ha conllevado a una creciente atención de la comunidad científica sobre sus roles funcionales y la regulación a la que se encuentran sus niveles. Objetivos Presentar una revisión bibliográfica sobre el tema, con énfasis en las implicaciones cardiovasculares de este catión. Fuente de Datos El buscador Pubmed del Servicio Central de Información Biotecnológica de los Institutos Nacionales para la Ciencia, con el cual se localizaron y consultaron 52 artículos científicos. Resultados El catión cinc además de constituir un cofactor de numerosas enzimas (por ejemplo la anhidrasa carbónica) y consecuentemente estar implicado en diversos procesos metabólicos, participa como modulador de las sinapsis a través de su acción bloqueadora de diversos canales iónicos. Esto justifica que si bien su deficiencia puede acarrear trastornos en la fisiología del organismo, el exceso de este catión, incluso localmente, pudiera interferir con la actividad eléctrica de los tejidos excitables, entre ellos el miocardio. Conclusiones Es importante el estudio de los efectos cardioprotectores del cinc, pero a su vez, es necesario tener conocimiento de los mecanismos y las dosis mediante las cuales puede ejercer sus efectos nocivos.

Introduction Versatility of Zn+2 in the physiology of several cell types has led to growing attention by the scientific community on the functional roles and the regulation of this cation levels. Objectives To present a literature review on this topic, making emphasis on the cardiovascular implications of Zinc. Data source Pubmed from the Central Service of Biotechnological Information of the US National Institutes for Science (NCBI in English) from which 52 scientific articles were read. Results Cation Zinc is not only a co-factor for numerous enzymes (for example carbon anhydrase) and involved in several metabolic processes, but participates as modulator of synapses through its blocking action of various ion channels. This explains why, although the Zn deficiency may cause body physiology disorders, the excessive presence of this ion even locally could interfere in the electrical activity of excitable tissues such as the myocardium. Conclusions For these reasons, it is important to study the cardioprotective effects of Zinc, but at the same time, it is necessary to know the mechanisms and the doses through which it may have harmful impact.

Analysis of withdrawal of rofecoxib-cyclooxygenase-2 specific inhibitor / 中国临床药理学与治疗学

Rofecoxib, a COX-2 specific inhibitor, is approved for treatment of osteoarthritis, acute pain and primary dysmenorrhea. On September 30, 2004, Merck announced the voluntary worldwide withdrawal of rofecoxib (Vioxx). This paper reviewed the pharmacological actions of the COX-2 specific inhibitors and the characterization, premarket study, clinical application and side-effects of rofecoxib and analyzed the withdrawal of rofecoxib.

Echocardiographic evaluation of USAF pilots with Aortic Insufficiency(AI): Is the flying of High Performance Aircraft(HPA) detrimental to pilots with AI?

BACKGROUND AND METHOD: For decades, the presence of aortic insufficiency (AI) has been considered a potential hazard in military aviation and has generally excluded aircrew from high performance flight. The cardiovascular effect of repeated exposure of high +Gz forces associated with AI is largely unknown. To evaluate whether the flying of High Performance Aircraft (HPA) was detrimental to subjects with AI, we performed a retrospective review. we studied 32 asymptomatic patients in whom 16 of them had flying time with AI in HPA(Group I), others(GroupII, Control Gr.) in Low-G Aircraft(LGA). Among them, the data of 24 patients were available, 12 in group I., and 12 in group II. The two groups were matched for age, severity of AI, and flying time. RESULTS: Interval echocardiographic, and cineangiographic studies were obtained over a mean period of 4.6+/-2.6 years in group I and 5.9+/-4.2 years in group II (range, 0.9 to 12.7 years) and mean flying time with AI of 528.1+/-435.0 hours in group I and 865.0+/-816.1 hours in group II (range, 50 to 2290 hours). By paired-t test, there were no significant differences between both groups in left ventricular end-diastolic dimension (LVEDD), end-systolic dimension (LVESD), aortic dimension (Ao.D) and fractional shortening (FS) by echocardiography (p>0.05) and by multiple linear regression, there were no significant interval changes of above values in Gr. I according to increasing of flying time with AI (p>0.05). Visual grade by doppler echocardiography or aortic cineangiography increased 1 patient in Gr.I and 2 patients in Gr.II within no more than one grade. CONCLUSION: Thus, this study demonstrated that : 1) Quantitative echocardiographic measurements such as LEVDD, LVESD, Ao.D and FS didn't show significant interval change in Gr.I.2) A single subject with a minor increase in AI severity together with no difference between the HPA and LPA groups argue for a relatively chronic effect of high G exposure in aircrew with mild AI.

Cardiovascular Effects of Growth Hormone Treatment in Idiopathic Short Stature

PURPOSE: An excess of GH causes various problems within the cardiovascular system including cardiac hypertrophy and abnormalities of left ventricle (LV) function. To evaluate the cardiovascular effects due to GH treatment in idiopathic short stature (ISS), we measured the cardiovascular function. METHODS: Twenty-two echocardiographic studies were performed in ISS who were admitted from Jan. 1994 through Jul. 1996, and they were divided into two groups which revealed in 11 children with GH treatment and in 11 children without GH treatment. RESULTS: The results obtained were as follows, 1) The mean HR in GH group was significantly lower than that of control group (79.9+/-12/min vs. 90.2+/-9/min) (p<0.05), and the mean BP was the GH group 81.6+/-10mmHg and control group 77.7+/-7mmHg. 2) The mean LV isovolumic contraction time (LICT) in GH group was significantly longer than that of control group (35.6+/-3 vs. 32.3+/-2) (p=0.01), but within normal limits. And in GH group, the mean shortening fraction (SF), mean velocity of circumferential fiber shortening (mVcf), and systolic time interval (STI) were 33.9+/-3%, 0.99+/-0.2cir/sec, and 0.15+/-0.04, respectively. In control group, the mean those values were 33.4+/-5%, 0.95+/-0.2cir/sec, and 0.15+/-0.04, respectively. 3) In GH group, the mean isovolumic relaxation time (IRT), peak E velocity (E), peak A velocity (A), and Ea/Aa ratio were 0.05+/-0.01sec, 113.5+/-18cm/sec, 60.5+/-14cm/sec, and 3.9+/-2, respectively. In control group, the mean those values were 0.06+/-0.01sec, 117+/-1.4 cm/sec, 56.8+/-13cm/sec, and 4.7+/-2, respectively. 4) In GH group, the mean cardiac index (CI) and systemic vascular resistance (SVR) were 4304+/-1660ml/min/m2 and 6330+/-764mmHg/ml. In control group, the mean those values were 3835+/-838ml/min/m2 and 6218+/-588mmHg/ml. CONCLUSIONS: These results suggest that the cardiovascular effects did not differ from those in the controls and remained within the normal range after a mean GH treatment duration of 6.2 months.

The Cardiovascular Effects of Rapid Sequence Induction and Slow Induction in Normotensive Patients / 대한마취과학회지

The circulatory stimulation accompanying laryngoscopy and tracheal intubation and its attendant potential hazards are well recognized. This study was perfomed to compare cardiovascular effects of rapid sequence induction with slow induction during induction of anesthesia and following tracheal intubation with laryngoscope. Eighty six adult patients ASA class I or II, ages 20-55, with no previous history of hypertension and pulmonary diseases that undergoing elective surgery requiring intubation, were admitted to the study. These patients were randomly divided into four groups. Group 1. Rapid sequence induction (n=20) Group 2. Slow induction for 7min. (n=20) Group 3. Slow induction for 10min. (n=21) Group 4. Slow induction for 15min. (n=25) Anesthesia was induced with lidocaine 1.5mg/kg and thiopental sodium 5mg/kg i.v. in a rapid sequence induction in group 1. Tracheal intubation with laryngoscope was facilitated with succinylcholine chloride 1mg/kg iv. Thereafter 50% nitrous oxide in oxygen, 2.0 vol% enflurane, and vecuronium bromide 0.1mg/kg was administered. Group 2, 3, 4 patients received thiopental sodium 5mg/kg iv, vecuronium bromide 0.1mg/kg iv, 2.0 vol% enflurane and 5096 nitrous oxide in oxygen with mask ventilation for 7 min, 10 min and 15 min before intubation with laryngoscope, respectively. After tracheal intubation inhalation of the anesthetic gases were administered. Blood pressure and heart rate measurements and electrocardiography were obtained throughout the study period. Slow induction (Group 2, 3, 4) significantly blunted the increase in heart rate and blood pressure caused by laryngoscopy and endotracheal intubation than rapid sequence induction (group 1). Less unwanted effects were observed in group 2 and 3. Therefore, the author suggests that 7-10 minute of slow induction with volatile anesthetics following thiopental sodium injection is more effective in attenuating cardiovascular responses to tracheal intubation and laryngoscopy.

Cardiovascular Effects of Propofol as an Induction Agent in Kidney Recipients / 대한마취과학회지

A need has been recognized for a safe and effective induction for patients undergoing elective renal transplantations. We have evaluated the effect of propofol (injection rate; 50 mg/min, average dosage; 2.28+/-0.08 mg/kg, n=10) on a cardiovascular stability compared with that of thiopental (injection rate; 100 mg/min, average dosage; 5.22+/-0.18 mg/kg, n=10) as an induction agent. Blood pressure and heart rate as cardiovascular parameters were checked before induction(control), one, two, three minutes after induction, before and after orotracheal spray of lidocaine, and immediately, one and two minutes after endotracheal intubation. The results were as follows: 1) There were no significant cardiovascular changes in the propofol group during the whole induction period. 2) In the thiopental group, diastolic blood pressures checked just after intubation, which were 120.20+/-7.79 mmHg, were significantly higher than those of one or two minutes after induction, which were 86.30+/-4.36, 88.40+/-3.85 mmHg, respectively. The above results suggest that intravenous propofol (2.0~2.5 mg/kg) is a safe and effective induction agent for renal recipients.

The Dose-related Effects of Alfentanil on Respiratory and Cardiovascular Function / 대한마취과학회지

To evaluate the effects of a1fentanil doses on cardiovascular and respiratory function, changes in mean arterial pressure (MAP), heart rate (HR), respiratory rate(RR) and PaCO2 induced by alfentanil (5 and 10 ug/kg) after intravenous administration over 10 s were measured in 20 young adult male patients (ASA physical status 1) who were scheduled for lower extremity operations under spinal anesthesia. After fixation of spinal anesthesia level and stabilization of vital signs, control measurements were done. MAP and HR were measured at 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 15, 20, 25, 30 min and, RR and PaCO2 were measured at 5, 10, 15, 20, 30 min after alfentanil administration. While there were no significant changes in MAP or HR in either of the two groups after alfentanil administration, RR and PaCO2 showed significant changes and returned to control values by 10 and 20 min, respectively, with low doses of alfentanil and by 30 and 30 min, respectively, with high doses of alfentanil. These results suggest that 5 or 10 ug/kg of alfentanil has no influence on cardiovascular function but, as the administered dose is increased, RR and minute ventilation decrease more profoundly and recovery is delayed.

Clinical Effects of Propofol According to Dosage / 대한마취과학회지

Propofol(Diprivan, England ICI) is a new intravenous anesthetic agent chemically unrelated to barbiturates or other intravenous anesthetic agents. It was found to produce rapid onset of anesthesia and early recovery similar to that Obtained with pentothal sodium. The purpose of the present study is to compare the cardiovascular and respiratory effect of propofol with the cardiovaseular and respiratery effeet of pentothal sodium. Sixty patients of ASA class l or 2 scheduled to undergo gynecological, orthopedic and abdominal procedures were classified randomly into 3 Groups. Group A were injected with pentothal sodium 5.0 mg/kg and Group B, C received propofol 2.0 mg/kg, 2.5 mg/kg respectively. The results were as follows, 1) Change of the systolic arterial pressure. Propofol 2.5 mg/kg produced the greatest decrease in systolic blood pressure when compared with other groups. 2) Change of the heart rate. Change of the heart rate was minimal after both doses of prepofol when compared with pentothal sodium. 3) Respiratory effect. Respiratory measurement in 20 unpremedicated surgical patients who received an induction dose of propofol 2.5 mg/kg showed significant respiratory depression. 4) Side effect. Excitatory effects and pain on injection were more frequent in propofol group than pentothal sodium group. Nausea, vomiting were more frequent in pentothal sodium group than propofol group.

Cardiovascular Effect of Lidocaine in Patients under Halothane , Enflurane and Diazepam Anesthesia / 대한마취과학회지

To evaluate the cardiovascular effect of lidocaine and serum electrolytes during inhalational or intravenous anesthesia, thirty-two healthy patients were randomly divided into three groups and measured systolic pressure, diastolic pressure, mean pressure, heart rate and serum K+ and Na+ level were measured at 30 sec, l, 3, 6, 12 minutes after intravenous injection of lidocaine(1.5 mg/kg) during halothane-N2O-O2 or enflurane-N2O-O2 or diazepam-N2O-O2 anesthesia. In all 3 groups, the values of hemodynamic and serum electrolytes were not changed by 2% lidocaine. These results indicate that intravenous injection of lidocaine(1.5 mg/kg) to prevent undesirable reflexes and to prevent intracranial hypertension is a safe method without depression of hemodynamics.

Cardiovascular Effects of Isoflurane in Korean Dogs / 대한마취과학회지

7 Korean dogs were anesthetized with oxygen and isoflurane in different concentrations (1 vo1.%, 2 vo1.%, 3 vo1.%). Cardiovascular effects of isoflurane in different concentrations were investigated. The results were as follow: 1) Heart rate was decreased significantly (p<0.05) following increase of isoflurane concentrations. 2) Mean arterial blood pressure was decreased significantly (p<0.05) following increase of isoflur- ane concentrations. 3) Cardiac index was decreased significantly (p<0.05) following increase of isoflurane concentra- tions. 4) Left ventricular stroke work index was decreased significantly (p<0.05) following increase of isoflurane concentrations. 5) Pumonary artery pressure and pumonary artery wedge pressure were decreased significantly (p<0.05) following increase of isoflurane, but there were no significant changes in central venous pressure, systemic vascular resistance and pulmonary vascular resistance.