Juan César García: social medicine as project and endeavor / Juan César García: a medicina social como projeto e realização

This paper analyses some aspects of the trajectory of the Argentinian physician and sociologist Juan César García (1932-1984) in the field of Latin American Social Medicine. Three dimensions constituting his basic orientations are highlighted: the elaboration of systematic and reflective social thought; a critical attitude in questioning teaching and professional practices; a commitment to the institutionalization and dissemination of health knowledge.

O artigo analisa aspectos da trajetória de Juan César García (1932-1984), médico e sociólogo argentino, no campo da medicina social latino-americana. Destaca três dimensões que constituem as suas orientações básicas no campo da saúde: a elaboração de um pensamento sobre o social, sistemático e reflexivo; uma atitude crítica na problematização do ensino e das práticas profissionais; um compromisso com a institucionalização e divulgação do saber sanitário.

Hemodynamic and antiarrhythmic effects of lidocaine or amiodarone in dogs anesthetized with halothane / Efeitos hemodinâmicos e antiarrítmicos da lidocaína ou amiodarona em cães anestesiados com halotano

The effects of continuous rate infusion of lidocaine or amiodarone on hemodynamic and arrhythmias induced by epinephrine in dogs anesthetized with halothane were evaluated. Thirty dogs were distributed into three groups: amiodarone group (AG), lidocaine group (LG), or control group (CG). Anesthesia was induced with etomidate and maintained with halothane. Thirty minutes later a bolus and continuous rate infusion (CRI) of amiodarone in AG, lidocaine in LG and NaCl at 0.9% in CG was administered. After 10 minutes, arrhythmias were induced by epinephrine CRI at 0.0001mg/kg/minute, which was increased in 0.0001mg/kg/minute every ten minutes, until 0.0003mg/kg/minute. The measurements were performed 30 minutes after the induction of anesthesia (T0), 10 minutes after beginning the drug CRIs (T1), 10 minutes after beginning epinephrine administration (T2) and 10 minutes after increasing epinephrine CRI (T3 and T4). In CG, at T3 heart rate (HR) was greater than in LG, while at T4, HR in GC was higher than in LG and AG. In LG and CG, from T2, central venous pressure (CVP), cardiac index (CI), systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP), mean pulmonary arterial pressure (mPAP) increased. In AG, SAP, DAP and MAP it decreased from T1 to T3. The ventricular ectopic beats (VEB) were lower in AG. Amiodarone has better antiarrhythmogenic effects, although it was also associated with hypotension.

Avaliaram-se os efeitos da infusão contínua de lidocaína ou amiodarona sobre a hemodinâmica e as arritmias induzidas pela epinefrina em cães anestesiados com halotano. Trinta animais foram distribuídos em três grupos: grupo amiodarona (GA), grupo lidocaína (GL) ou grupo-controle (GC). A anestesia foi induzida com etomidato e mantida com halotano. Trinta minutos após, foram administrados bolus e infusão contínua (CRI) de amiodarona no GA, de lidocaína no GL e de NaCl a 0,9% no GC. Após 10 minutos, iniciou-se a CRI de epinefrina (0,0001mg/kg/minuto), aumentando-se 0,0001mg/kg/minuto a cada 10 minutos até 0,0003mg/kg/minuto. As mensurações foram realizadas 30 minutos após a indução anestésica (T0), 10 minutos após a CRI dos fármacos (T1), 10 minutos após a administração de epinefrina (T2) e a cada 10 minutos após o incremento na CRI de epinefrina (T3 e T4). A frequência cardíaca (FC) foi maior no GC que no GL em T3 e maior em GC que nos demais grupos em T4. A partir de T2, houve aumento na pressão venosa central (PVC), no índice cardíaco (IC), nas pressões arteriais sistólica (PAS), diastólica (PAD) e média (PAM) e na pressão média da artéria pulmonar (PAPm) no GL e no GC. No GA, PAS, PAD e PAM diminuíram de T1 a T3. Os batimentos ventriculares ectópicos (BVE) foram menores no GA. Amiodarona possui melhores efeitos antiarrítmicos, apesar de também estar associada com hipotensão.

O efeito dos anestésicos inalatórios halotano e sevoflurano em um modelo experimental de lesão hepática / Effects of the inhalational anesthetics halothane and sevoflurane on an experimental model of hepatic injury

JUSTIFICATIVA E OBJETIVOS: A lesão hepática pós-anestesia inalatória ainda é controversa. Estudos sugerem que agentes inalatórios geram uma resposta imune que pode provocar lesões hepáticas. O objetivo deste estudo é analisar o efeito dos anestésicos inalatórios halotano e sevoflurano no fígado de ratos submetidos à hipóxia e à reperfusão. MÉTODO: Foram utilizados 30 ratos Wistar pré-tratados com fenobarbital 0,1 por cento por cinco dias, com suspensão da medicação 24 horas antes do experimento, a fim de provocar a lesão hepática. Os animais foram distribuídos em cinco grupos com seis ratos cada. O Grupo C foi o de controle, sem qualquer tipo de tratamento; o Grupo F foi aquele no qual se induziu lesão hepática com fenobarbital; o Grupo Hipóxia foi exposto a 14 por cento de oxigênio (O2); o Grupo H recebeu halotano 1 por cento e 14 por cento de O2; e o Grupo S recebeu sevoflurano 2 por cento e 14 por cento de O2. Contadas 24 horas após a exposição dos gases, realizaram-se coletas de sangue para avaliação de transaminases (AST e ALT) e de amostras de fígado para avaliação histológica. Foram usados os testes de Análise de Variância não paramétrica de Kruskal-Wallis e, para comparação de médias, os testes de Newman-Keuls. RESULTADOS: A atividade enzimática revelou que os valores de média amostral de AST (280,33 para halotano, 181 para sevoflurano) e ALT (235 para halotano e 48,33 para sevoflurano) não indicaram diferença estatística significativa; os grupos testados apresentaram valores elevados. O sevoflurano, quando comparado com o halotano à microscopia óptica, apresentou índices menores de alteração morfológica, com p = 0,045 para esteatose, p = 0,0075 para infiltrado inflamatório e p = 0,0074 para necrose. CONCLUSÕES: O Grupo sevoflurano, quando comparado ao Grupo halotano, não apresentou lesão no parênquima hepático quando avaliado por microscopia óptica.

BACKGROUND AND OBJECTIVES: Hepatic injury after inhalational anesthesia is controversial. Studies have suggested that inhalational agents generate an immune response that can provoke hepatic injury. The objective of this study was to analyze the effects of the inhalational agents halothane and sevoflurane on the liver of rats submitted to hypoxia and reperfusion. METHODS: Thirty Wistar rats, pretreated with 0.1 percent phenobarbital for 5 days, with discontinuation of the drug 24 hours before the experiment to cause hepatic injury, were used. Animals were distributed in five groups of six rats each. The control group (C) did not receive any treatment; in the F group, phenobarbital was used to induce hepatic injury; the Hypoxia group was submitted to 14 percent oxygen (O2); the H group received 1 percent halothane and 14 percent O2; and the S group received 2 percent sevoflurane and 14 percent O2. Twenty-four hours after exposure to the gases, blood samples were collected to evaluate transaminases (AST and ALT), and liver samples were collected for histological evaluation. Kruskal-Wallis Analysis of Variance and the Newman-Keuls test were used. RESULTS: Enzymatic activity mean values of AST (280.33, for halothane, 181, for sevoflurane) and ALT (235 for halothane, and 48.33, for sevoflurane) did not show significant differences, and all groups showed elevated values. Compared to halothane on optical microscopy, sevoflurane had lower indices of morphologic changes with p = 0.045, for steatosis, p = 0.0075, for inflammatory infiltrate, and p = 0.0074, for necrosis. CONCLUSIONS: Compared to the halothane group, sevoflurane did not show injuries of the liver parenchyma on optical microscopy.

JUSTIFICATIVA Y OBJETIVOS: La lesión hepática postanestesia inhalatoria todavía es algo controversial. Algunos estudios sugieren que los agentes inhalatorios generan una respuesta inmune que puede provocar lesiones hepáticas. El objetivo de este estudio fue analizar el efecto de los anestésicos inhalatorios halotano y sevoflurano en el hígado de ratones que fueron sometidos a la hipoxia y a la reperfusión. MÉTODO: Fueron utilizados 30 ratones Wistar tratados previamente con fenobarbital al 0,1 por ciento durante cinco días, con suspensión de la medicación 24 horas antes del experimento para provocar la lesión hepática. Los animales fueron distribuidos en cinco grupos con seis ratones cada uno. El grupo C fue el de control, sin ningún tipo de tratamiento; el grupo F fue aquel en el cual se indujo la lesión hepática con fenobarbital; el grupo Hipoxia se expuso a un 14 por ciento de oxígeno (O2); el grupo H recibió halotano al 1 por ciento y al 14 por ciento de O2; y el grupo S recibió sevoflurano al 2 por ciento y al 14 por ciento de O2. Contadas 24 horas después de la exposición de los gases, se realizó la recolección de sangre para la evaluación de las transaminasas (AST y ALT), y de las muestras de hígado para la evaluación histológica. Fueron usados los test de Análisis de Variancia no paramétrica de Kruskal-Wallis, y para la comparación de los promedios se usaron los test de Newman-Keuls. RESULTADOS: La actividad enzimática arrojó valores de promedio de muestra de AST (280,33 para halotano, 181 para sevoflurano y ALT 235 para halotano y 48,33 para sevoflurano), que no indicaron diferencia estadística significativa: los grupos testados presentaron valores elevados. El sevoflurano, cuando fue comparado con el halotano a la microscopía óptica, presentó índices menores de alteración morfológica, con p = 0,045 para esteatosis, p = 0,0075 para infiltrado inflamatorio y p = 0,0074 para necrosis. CONCLUSIONES: El grupo sevoflurano, cuando se comparó con el grupo h...

[Comparison of remifetanil with halothane as the anesthesia maintenance method regarding endoscopic sinus surgery conditions]

Endoscopic surgery is a new standard method of treatment for chronic sinusitis. During this operation even small amount of bleeding may reduce the visual field of surgeon significantly and make the procedure troublesome. In this study we compared the operative conditions between patients who receive either remifentanil or halothane for general anesthesia. Endoscopic sinus surgery was performed in 60 patients. Pre- medication was done by fentanil and midazolam and induction was done by propofol and atracurium. The patients were divided into two groups and received either halothane or remifentanil for anesthesia maintenance. Monitoring was performed during anesthesia. Bleeding volume was measured and operation field condition was assessed by the surgeon. Patients' characteristics such as age and gender were the same in both groups. Intra- operative systolic blood pressure was significantly lower in the remifentanil group but diastolic and mean blood pressure and heart rate didn't change after induction and during maintenance in either group. Recovery time in the remifentanil group was also significantly shorter than the halothane group. Bleeding volume was also lower and the operation field condition was better in the remifentanil group. Remifentanil is a good choice to maintain an ideal anesthesia for endoscopic sinus surgery

Modelo experimental de indução de lesão oxidativa hepática em ratos por halotano / Experimental model of liver oxidative damage induction in rats by halothane

RACIONAL: O anestésico halotano pode ser metabolizado redutivamente a intermediários reativos que podem iniciar a lipoperoxidação acompanhada de injúria hepática. O tratamento prévio com hipóxia e fenobarbital em ratos aumenta o metabolismo do halotano e o estresse oxidativo e causa mudanças nas enzimas antioxidantes no fígado com dano hepático. MÉTODOS: Investigou-se o efeito do halotano na lipoperoxidação e histologia hepáticas após o aumento do metabolismo redutor do halotano induzido pela hipóxia e fenobarbital. Vinte e cinco ratos machos Wistar foram divididos em cinco grupos: Co (controle), HO14 (Halotano/Hipóxia), F (Fenobarbital), O14 (Hipóxia) e H (Halotano). Após 24 horas os ratos foram sacrificados, seus fígados foram retirados para determinar quimiluminescência, substâncias que reagem ao ácido tiobarbitúrico, enzimas antioxidantes, superóxido dismutase, catalase e amostras de sangue foram tomadas para determinar AST e a ALT. A avaliação histopatológica foi realizada pela técnica de hematoxilina-eosina. Os dados da avaliação histológica foram apresentados através de mediana e amplitude entre quartis. RESULTADOS E CONCLUSÕES: A exposição ao halotano/hipóxia causou lipoperoxidação hepática e mudanças significativas na atividade das enzimas antioxidantes. Além disso, provocou lesão histopatológica do fígado e aumento significativo dos níveis plasmáticos de AST e ALT.

BACKGROUND: The anesthetic halothane can be reductively metabolized to reactives intermediates that may initiate lipid peroxidation accompanied by hepatic injury. Hypoxia and phenobarbital pretreatment in rats increases metabolism of halothane, the oxidative stress, cause liver antioxidant enzymes changes and tissue damage. AIMS: We investigated the effect of halothane on hepatic lipid peroxidation and on hepatic histology after increases reductive metabolism of halothane caused by hypoxia and phenobarbital pretreatment. METHODS: Twenty-five male wistar rats were divided in five equals groups: CO (Control), HO14 (Halothane/Hypoxia), F (fenobarbital alone), O14 (Hypoxia alone) and H (Halothane alone). After 24 hours the rats were killed, their livers removed to determine chemoluminescence, thiobarbituric acid-reactive substances, catalase, superoxide dismutase, and blood samples were taken to determine AST and ALT. The histopathologic evaluation was performed with hematoxylin and eosin staining. Histopathologic scores are presented as 25th-75th percentile/range values and median ± range. RESULTS/CONCLUSION: Halothane-hypoxic exposure resulted in a significant changes in the activities of antioxidant enzymes, and induced hepatic lipoperoxidation. Moreover it resulted in histopathologic liver injury as well as significant increase of serum activity of AST and ALT.

Efeitos do halotano, isoflurano e sevoflurano sobre a função renal em cães sob pinçamento aórtico infra-renal / Effects of halothane, isoflurane and sevoflurane on renal function in dogs under infra-renal aortic cross-clamping

JUSTIFICATIVA E OBJETIVOS: O pinçamento infra-renal da aorta abdominal pode produzir alterações renais. O objetivo do estudo foi avaliar os efeitos do halotano, isoflurano e sevoflurano sobre a função renal, em cães submetidos a pinçamento aórtico infra-renal. MÉTODO: O estudo aleatório foi realizado em 30 cães, distribuídos em três grupos, de acordo com o anestésico halogenado utilizado durante a anestesia, em concentrações equipotentes de 0,75 CAM: GH (n = 10) - halotano a 0,67 por cento; GI (n = 10) - isoflurano a 0,96 por cento; e GS (n = 10) - sevoflurano a 1,8 por cento. Em todos os animais foi realizada ligadura infra-renal da aorta, por período de 30 minutos. Os atributos renais foram estudados nos momentos: C (controle), após 15 (Ao15) e 30 (Ao30) minutos de pinçamento aórtico, e após 15 (DAo15) e 30 (DAo30) minutos do despinçamento aórtico. RESULTADOS: A depuração de água livre foi menor nos grupos GI e GS, em relação ao GH, após o despinçamento aórtico (p < 0,05). Durante o pinçamento aórtico, nos três grupos, houve aumento do débito urinário, da excreção urinária de sódio e da depuração de sódio, e diminuição da osmolaridade urinária (p < 0,05). A resistência vascular renal e a fração de filtração aumentaram somente em GS (p < 0,05), enquanto a excreção fracionária de sódio aumentou em GH e GI (p < 0,05). Após o despinçamento aórtico, houve normalização dos atributos que haviam se alterado, com exceção da osmolaridade urinária, que continuou em níveis menores do que os do controle em todos os grupos (p < 0,05). A resistência vascular renal e a fração de filtração continuaram mais elevadas em GS, acompanhadas por diminuição do fluxo sangüíneo renal e da depuração de para-aminohipurato de sódio (p < 0,05)...

BACKGROUND AND OBJECTIVES: Infra-renal aortic cross-clamping is associated to renal effects. This study aimed at analyzing halothane, isoflurane and sevoflurane effects on renal function of dogs submitted to infra-renal aortic cross-clamping. METHODS: This study involved 30 mixed-breed dogs randomly distributed in three groups, according to equipotent anesthetic doses (0.75 MAC) of inhaled anesthetics: GH (n = 10) - 0.67% halothane; GI (n = 10) - 0.96% isoflurane; and GS (n = 10) - 1.8% sevoflurane. All animals were submitted to infra-renal aortic cross-clamping for 30 minutes. Renal parameters were evaluated at control (C), 15 (Ao15) and (Ao30) minutes after aortic cross-clamping, and 15 (DAo15) and 30 (DAo30) minutes after aortic unclamping. RESULTS: Free water clearance was significantly lower in GI and GS as compared to GH (p < 0.05) after aortic unclamping. Urinary output, sodium urinary excretion and sodium clearance have significantly increased during aortic cross-clamping, while urinary osmolarity has decreased in all groups (p < 0.05). Renal vascular resistance and filtration fraction have increased during aortic cross-clamping in GS only, while sodium fractional excretion increased in GH and GI (p < 0.05). All renal parameters had returned to control levels after aortic unclamping, with the exception of urinary osmolality which has remained below control levels in all groups (p < 0.05). Renal vascular resistance and filtration fraction have remained higher in GS, followed by renal blood flow and PAH clearance decrease (p < 0.05)...

JUSTIFICATIVA Y OBJETIVOS: El pinzamiento infra-renal de la aorta abdominal puede producir alteraciones renales. La finalidad del estudio fue evaluar los efectos del halotano, isoflurano y sevoflurano sobre la función renal, en canes sometidos a pinzamiento aórtico infra-renal. MÉTODO: El estudio aleatorio fue realizado en 30 canes, distribuidos en tres grupos, de acuerdo con el anestésico halogenado utilizado durante la anestesia, en concentraciones equipotentes de 0,75 CAM: GH (n = 10) - halotano a 0,67%; GI (n = 10) - isoflurano a 0,96%; y GS (n = 10) - sevoflurano a 1,8%. En todos los animales fue realizada ligadura infra-renal de la aorta, por un período de 30 minutos. Los atributos renales fueron estudiados en los momentos: C (control), después 15 (Ao15) y 30 (Ao30) minutos de pinzamiento aórtico, y después 15 (DAo15) y 30 (DAo30) minutos del despinzamiento aórtico. RESULTADOS: La depuración de agua libre fue menor en los grupos GI y GS, en relación a la GH, después del despinzamiento aórtico (p < 0,05). Durante el pinzamiento aórtico, en los tres grupos, hubo aumento del débito urinario, de la excreción urinaria de sodio y de la depuración de sodio, y diminución de la osmolaridad urinaria (p < 0,05). La resistencia vascular renal y la fracción de filtración aumentaron solamente en GS (p < 0,05), en cuanto la excreción fraccionaria de sodio aumentó en GH y GI (p < 0,05). Después del despinzamiento aórtico, hubo normalización de los atributos que se habían alterado, con excepción de la osmolaridad urinaria, que continuó en niveles menores que los del control en todos los grupos (p < 0,05). La resistencia vascular renal y la fracción de filtración continuaron más elevadas en GS, acompañadas por diminución del flujo sanguíneo renal y de la depuración de para-aminohipurato de sodio (p < 0,05)...

Comparative study of desflurane, isoflurane and halothane [as a part of Blanced Anaesthesia] for ambulatory anaesthesia

This study was done on 60 adult patients of both sexes between 18-45 years old undergoing ambulatory surgery. All of them were ASA I and II and categorized into three groups, each including 20 patients: Group I maintained on halothane, group II maintained on isoflurane and group III maintained on desflurane. Using bispectral index [BIS], all maintenance drugs were titrated to keep BIS monitor value around 40-60. The vital signs measured were heart rate and MAP with no statistically significant difference between the three groups. The modified Aldrete score showed significantly high scores for desflurane group as compared with the other two groups. As regard to the post- anesthesia discharge scoring system [PADSS] and time to home discharge, there were no statistical significant differences between all groups

Açäo antimicrobiana de solventes de guta-pecha / Antimicrobial action of gutta-percha solvents

Estudou-se a açäo antimicrobiana de solventes de guta-percha (halotano, óleo de laranja, eucaliptol e xilol) sobre os microrganismos Staphylococcus aureus, Enterococcus faecalis, Pseudomonas aeruginosa, Bacillus subtilis, Candida albicans e uma mistura destes. Duzentos e quarenta cones de papel contaminados foram mantidos em contato com os solventes por períodos de 5, 10, 15 e 30 minutos e, a seguir, transportados para 7mL de Brain Heart Infusion e incubados a 37ºC por 48 horas. Posteriormente, foi analisada a presença ou ausência de turvaçäo, indicativa ou näo de crescimento e multiplicaçäo dos microrganismos. Para a confirmaçäo dos resultados, empregou-se a coloraçäo de Gram. O halotano mostrou efetividade antimicrobiana em todos os tempos de análise para a C. albicans; a partir de 10 minutos para o E. faecalis e P. aeuruginosa; a partir de 15 minutos para o S. aureus e foi inefetivo para o B. subtilis e sobre a mistura. Os demais solventes foram enefetivos sobre todos os microrganismos testados, em todos os períodos de observaçäo

Middle ear pressure changes during different inhalation anesthesia comparative study by tympanometry between modern and old inhalational anesthetic agents

This investigation examined the effect of modern inhalant anesthesia [isoflurane and sevoflurane] in comparison with older inhalational agent [halothane] with or without nitrous oxide on middle ear pressure [MEP]. Tympanometry was used to measure MEP variations. Seventy-six subjects were examined with tympanometry prior to inhalant anesthesia and baseline tympanometry was performed. This study found that the changes of MEP are significantly greater when nitrous oxide added to any of modern or older inhalational agents. The results have shown that administration of nitrous oxide with these agents should be used with great care during tympanic membrane grafting, ossiculoplasty or ossicular replacement prosthesis

Utilizaçäo de alfentanil, sufentanil e fentanil em cäes anestesiados com halotano / Use of alfentanil, sufentanil and fentanyl in dogs anesthetized with halothane

Os analgésicos opióides promovem analgesia intensa, possibilitando o emprego de concentraçöes reduzidas dos anestésicos inalatórios, minimizando assim a depressäo cardiovascular que ocorre durante a anestesia. Vários opióides podem ser empregados na anestesia, sendo que dentre os mais potentes, o fentanil, sufentanil e alfentanil säo os mais freqüentemente administrados no transoperatório. No presente estudo, comparou-se a açäo no sistema cardiovascular desses três agentes durante a anestesia inalatória em cäes, submetidos a procedimentos ortopédicos, bem como, avaliou-se a possibilidade de se manter a anestesia com baixas concentraçöes de halotano. Foram usados três grupos, de dez animais cada, que receberam, após estabilizaçäo da anestesia, doses equipotentes de um dos três agentes analgésicos - grupo I - 5µg/kg de fentanil IV, grupo II - 1µg/kg de sufentanil IV e grupo III - 25µg/kg de alfentanil IV. Os parametros cardiovasculares e respiratórios foram avaliados em diferentes tempos de observaçäo. Os resultados obtidos foram analisados através de análise estatística (ANOVA seguida de Dunnett e Bonferroni). Os três agentes promoveram bradicardia importante durante o decorrer do estudo, sendo que apenas o alfentanil promoveu hipotensäo significativa após sua administraçäo. Apenas um animal tratado com fentanil apresentou aumento da pressäo arterial e freqüência cardíaca durante a anestesia. Na recuperaçäo da anestesia, um número maior de animais tratados com alfentanil apresentou sinais de excitaçäo. Através dos resultados obtidos, pode-se concluir que a administraçäo de analgésicos opióides possibilita de fato o emprego de menores concentraçöes de halotano, promovendo anestesia estável com a manutençäo da pressäo arterial dentro dos valores normais para a espécie. Dos agentes empregados, o alfentanil é o que promove efeitos cardiovasculares mais pronunciados.

Halothane effect on formalin-induced paw edema and flinching in rat

The formalin test is a model of injury-produced inflammatory pain. Anesthetics, in clinically relevant concentrations, affect neutrophils and immune suppression. This study was to determine whether halothane reliably inhibits inflammatory reaction and formalin induced pain behavior or does not. Rats were exposed to 100% oxygen (control) or halothane, respectively for 30 min and then 24 hr later five percent formalin test was assessed. The base values of the paw's diameter were obtained earlier, and then formalin induced edema was assessed by measuring diameters of the injected paws at 5 min, 1 hr, 4 hr and 24 hr after the injection. Nociceptive behavior was quantified by counting the number of times with the paw flinched at 5 min intervals for 60 min. The diameters of edema in the halothane group lessened more than those in the oxygen group at 1 and 24 hr in each following of the injection (p<0.05). The rats pre-administered with oxygen or halothane were similar appearances in nociceptive behaviors. It suggests that halothane anesthesia might inhibit slightly the inflammatory reaction with the formalin-induced edema but might not inhibit the formalin-induced pain behavior in the event of pre-administration halothane 24 hr earlier before the formalin test of rat.

Rapid inhalation induction in children: a comparative study between 8% sevoflurane and 5% halothane

In a randomized study, the induction characteristics of maximum initial inspired concentration of 8% sevoflurane and 5% halothane was compared using conventional vaporizers in children aged 3-7 years. It was found that sevoflurane had significantly a shorter mean loss of consciousness time compared with halothane and it had also a shorter mean end of induction time compared with halothane. A small number of complications was noted in both groups, although none interfered with the induction of anesthesia. It was concluded that with this technique, induction was rapid in both groups, but it was more faster with sevoflurane than with halothane with a less respiratory cardiovascular effects and with less struggling scores, which made the inhalation induction with sevoflurane more pleasant than with halothane

Comparison of induction and recovery characteristics of sevoflurane and halothane in children

Forty ASA I or II children undergoing adenoidectomy with bilateral myringotomy with the insertion of tubes were included in the study. The clinical profile of sevoflurane was compared with that of halothane. Intubating conditions were assessed and the quality of tracheal intubation was graded according to the easiness of laryngoscopy, position of vocal cords, coughing, jaw relaxation and movement of limbs. This study suggested that the intubating conditions were better in the halothane group than in the sevoflurane group. Sevoflurane provided a superior clinical profile to halothane in pediatric patients, including a smoother and more rapid induction of anesthesia, a significantly more rapid emergence and recovery from anesthesia and a lesser propensity for postoperative nausea and vomiting

Comparative study of the haemodynamic effects of sevoflurane and halothane in children

This study was designed to compare between halothane and sevoflurane in pediatric patients regards hemodynamic response to inhalational induction. The study was carried out on 40 patients [ASA physical status I or II] scheduled for elective surgery and divided into 2 groups, each 20 patients. The results showed that sevoflurane is as safe as halothane for rapid inhalational induction in children. Also, sevoflurane provided hemodynamic stability during induction with maintenance of blood pressure, mildly increasing heart rate and lack of arrhythmogenicity

Study of cytokines and postoperative outcome after laparoscopic and open cholecystectomy

To investigate stress response and postoperative outcome in laparoscopic and open cholecystectomy. In addition, to compare between two anesthetic techniques for laparoscopic cholecystectomy as regards serum cytokines changes and postoperative outcome. Thirty patients scheduled for elective cholecystectomy for gall stone disease were classified into 3 equal groups. Group I: underwent open cholecystectomy under halothane anesthesia; Group II : underwent laparoscopic cholecystectomy under halothane anesthesia; Group III : underwent laparoscopic cholecystectomy under isoflurane anesthesia. All patients were subjected to the following : [1] Measurements of IL-6, IL-1 before anesthesia, I hour and 24 hours postoperatively; [2] Recordings the time to eye opening and orientation to persons and place; [3] Evaluation of postoperative pain at 1, 6, 12, 24 h and 48 h postoperatively; [4] Frequency of nausea and vomiting; [5] Length of the hospital stay, IL-6 and IL-I increased significantly in the-three groups at 1 hour postoperatively, then decreased significantly at 24 hours postoperatively. The differences between group I and group II or III was significant, but there was no significant difference between group II and group III. Laparoscopic groups [II and III] were associated with less postoperative pain and narcotic requirements compared with open group [I] while no significant difference between laparoscopic group [II and III]. Nausea and vomiting were encountered more frequent in laparoscopic groups than in open group, but the difference was not significant. Hospital stay was significantly short in laparoscopic group than in open group. Time to eye opening and time to orientation to place and person were significantly short in isoflurane laparoscopic cholecystectomy group than halothane laparoscopic cholecystectomy group. [1] Laparoscopic cholecystectomy is associated with less tissue injury and less stress response as indicated by lower serum levels of IL-6 and IL-1 compared to open cholecystectomy; [2] Laparoscopic cholecystectomy is associated with better postoperative outcome as indicated by less postoperative narcotic requirements and short hospital stay; [3] Apart from early eye opening and early orientation associated with isoflurane anesthesia, it exerts minor influence on postoperative outcome compared to fluthane anesthesia for laparoscopic cholecystectomy

Volatile cardioplegia: fast normothermic cardiac arrest induction and recovery with halothane in isolated rat hearts

To study the effect of halothane as a cardioplegic agent, ten Wistar rats were anesthetized by ether inhalation and their hearts were perfused in a Langgendorff system with Krebs-Henseleit solution (36 graus Celsius; 90 cm H2O pressure). After a 15-min period for stabilization the control values for heart rate, force (T), dT/dt and coronary flow were recorded and a halothane-enriched solution (same temperature and pressure) was perfused until cardiac arrest was obtained. The same Krebs-Henseleit solution was reperfused again and the parameters studied were recorded after 1,3,5,10,20 and 30 min. Cardiac arrest occurred in all hearts during the first two min of perfusion with halothanebubbled solution. One minute after reperfusion without halothane, the following parameters reported in terms of control values were obtained: 90.5 percent of control heart rate (266.9 + 43.4 to 231.5 + 71.0 bpm), 20.2 percent of the force (1.83 + 0.28 to 0.37 + 0.25 g), 19.8 percent of dT/dt (46.0 + 7.0 to 9.3 + 6.0 g/s) and 90.8 percent of coronary flow (9.9 + 1.5 to 9.4 + 1.5 ml/min). After 3 min of perfusion they changed to 99.0 percent heart rate (261.0 + 48.2), 98.9 percent force (1.81 + 0.33), 98.6 dT/dt (45.0 + 8.2) and 94.8 percent coronary flow (9.3 + 1.4). At 5 min 100.8 percent (267.0 + 40.6) heart rate, 105.0 percent (1.92 + 0.29) force and 104.4 percent (48.2 + 7.2) dT/dt were recorded and maintained without significant differences (P>0.01) until the end of the experiment. These data demonstrate that volatile cardioplegia with halothane is an effective technique for fast induction of and prompt recovery from normothermic cardiac arrest of the rat heart.

Surgical, histopathological and electron microscopic research aspects of hepatic regeneration following major hepatic resection using halothane

Twenty dogs had major hepatic resection and were re-explored two- eighteen months later were included in this study. Biopsies were taken for histopathological and electron microscopic studies which showed that the hepatocytes pass into a state of hyperactivity after resection which returns to normal when the liver reached its full original size. Mortality rate following the initial surgery was 15%. The liver resumed its full pre-resection size in fifteen dogs of the seventeen which survived the initial resection. It could be also postulated that what is known as hepatic regeneration is in fact a state of hypertrophy and hyperplasia of liver cells rather than re- growth from the line of resection. All the research data were analyzed to obtain a better understanding of this unique phenomenon