ABSTRACT
Atropine and glycopyrrolate were compared in a mixture with neostigmine for reversal of neuromuscular blockade in patients undergoing open heart surgery. In patients not receiving beta-blocking drugs, glycopyrrolate was shown to possess advantages over atropine in terms of a lower initial increase in heart rate, better protection against the muscarinic effects of neostigmine, and smaller increases in rate-pressure product. The concomitant administration of beta-adrenergic blocking therapy significantly attenuated the effect of reversal on heart rate and the differences between atropine and glycopyrrolate were not significant. There was no difference in the incidence of arrhythmias between patients who received beta-blocking drugs and those who did not.
Subject(s)
Atropine/pharmacology , Glycopyrrolate/pharmacology , Neostigmine/pharmacology , Neuromuscular Junction/drug effects , Pyrrolidines/pharmacology , Adrenergic beta-Antagonists/therapeutic use , Blood Pressure/drug effects , Cardiac Surgical Procedures , Drug Combinations , Heart Rate/drug effects , Humans , Middle Aged , Pancuronium/antagonists & inhibitors , Time FactorsABSTRACT
Hypocapnia was induced in dogs lightly anaesthetized with nitrous oxide and fentanyl. Measurements were made of estimated renal plasma flow (ERPF), glomerular filtration rate, vascular resistance and urine production. During the (short) duration of the experiments hypocapnia was found to be associated with ERPF twice that during normocapnia. Glomerular filtration rate and urine output were increased by hypocapnia in an approximately similar proportion, whilst renal vascular resistance halved. Though some of the experimental animals had a degree of metabolic acidosis this was thought not to have greatly influenced the results.
Subject(s)
Anesthesia, General , Carbon Dioxide/blood , Kidney/physiology , Acid-Base Equilibrium , Animals , Blood Pressure , Dogs , Glomerular Filtration Rate , Kidney/blood supply , Partial Pressure , Regional Blood Flow , Time Factors , Urine , Vascular ResistanceABSTRACT
A patient suffering from chronic carbon dioxide retention with persistent pneumothorax, following spontaneous rupture of an emphysematous bulla, underwent thoracotomy. The surgical and anaesthetic management are reported.