ABSTRACT
Pharmacokinetic studies on atropine were performed in 52 patients under general or spinal anaesthesia. Age had a clinically significant effect on the kinetics of this alkaloid: in children under 2 years of age and in the elderly a prolonged elimination was found. This might explain, partly at least, the higher sensitivity of these age groups to the effects of atropine. Age had no effect on the serum protein binding of this alkaloid. Atropine was found in human CSF after a single i.m. administration, but not after a single i.v. administration. During anaesthesia after i.v. atropine administration, a diminished cardiovascular response was found in the elderly in comparison with healthy adult patients. This indicates changes also at the cholinergic receptor sites in the elderly.
Subject(s)
Aging , Atropine/metabolism , Adolescent , Adult , Aged , Atropine/pharmacology , Child , Child, Preschool , Female , Half-Life , Hemodynamics/drug effects , Humans , Infant , Injections, Intravenous , Kinetics , Male , Middle Aged , Time FactorsABSTRACT
Dioxonium (30, 40, and 60 microgram/kg i.v.), a new depolarizing agent, weas compared with pancuronium (0.05 and 0.1 mg/kg i.v.) as a muscle relaxant in combination anesthesia during general surgical operations in small children. Generally, the conditions during intubation, maintenance of anesthesia, and in the recovery room were comparable after both drugs. There were no differences in the cardiovascular responses either. However, a wider intra- and interindividual variation in the drug response was observed after dioxonium, especially after repeated administrations.
Subject(s)
Dioxolanes/pharmacology , Dioxoles/pharmacology , Neuromuscular Blocking Agents/pharmacology , Pancuronium/pharmacology , Pyrrolidines/pharmacology , Anesthesia , Cardiovascular System/drug effects , Child , Child, Preschool , Clinical Trials as Topic , Humans , InfantABSTRACT
The clinical effects of oxazepam and diazepam as oral premedicants were tested in a double-blind study of 60 children and 50 adults. The gas chromatographically measured concentrations of the active unconjugated forms of oxazepam and diazepam in the plasma were correlated to their clinical effects, as assessed both subjectively and objectively (sleep, sedation, apprehension, excitement, dizziness, emetic effect, headache, increase or decrease in systolic blood pressure, increase in pulse rate, venepuncture). No significant difference in the effects of these two benzodiazepine derivatives were observed, nor was there any obvious relationship between the plasma concentration and clinical effect.
Subject(s)
Diazepam/pharmacology , Oxazepam/pharmacology , Preanesthetic Medication , Adult , Biotransformation , Child , Clinical Trials as Topic , Diazepam/adverse effects , Diazepam/blood , Female , Humans , Male , Middle Aged , Oxazepam/adverse effects , Oxazepam/bloodABSTRACT
A comparision of a high dose of pentazocine (0.9 mg/kg), and moderate doses of pethidine (1 mg/kg) and diazepam (0.2 mg/kg) as pre-anaesthetic medication was carried out in a double-blind between-patient placebo-controlled trial in 200 children. The assessment of the drugs as pre-anesthetic medication was made by comparing the sedative effect before induction, the status of the patient at induction and the patient's behaviour in the recovery room. All the active drugs were superior to the placebo at induction of anaesthesia. Postoperatively the sedative effect of the high dose of pentazocine was superior to that of the other active drugs, presumably due to the strong analgesic effect at this dose. The rate of respiration was clearly lower after pentazocine than after the other two active drugs. Other side effects or complications did not differ between the groups. It is concluded that, in spite of its favourable sedative effect, a high dose of pentazocine should be used with caution in pediatric premedication because of the possibility of slight respiratory depression.
