ABSTRACT
The incidence of awareness was compared in three groups of patients undergoing elective or emergency Caesarean section, using pethidine alone or pethidine plus flunitrazepam (Rohypnol), as adjuvants to nitrous oxide: oxygen, muscle relaxant technique of general anaesthesia. The use of 0.03 mg/kg body weight of flunitrazepam was associated with a low incidence (4%) of awareness, cardiovascular stability, postoperative sedation and anterograde amnesia. The reduced incidence of awareness is probably due to increased depth of anaesthesia and anterograde amnesic effect produced by the drug.
Subject(s)
Anesthesia, Inhalation , Anesthesia, Obstetrical , Awareness/drug effects , Cesarean Section , Cognition/drug effects , Flunitrazepam/pharmacology , Adult , Female , Humans , Meperidine/pharmacology , PregnancyABSTRACT
The dose/response characteristics of lorazepam when administered parenterally as a premedicant drug were studied. The parameters studied included its' sedative and amnesic effects as well as effects on the cardiovascular and respiratory systems. Intramuscular and intravenous routes using doses 2 mg, 3 mg and 4 mg were compared. The findings suggest that lorazepam's sedative and amnesic effects were more pronounced with the intravenous route, and that in both routes the incidence and degree of sedation and of amnesia were dose dependant. There were minimal changes in arterial blood pressure, pulse rate or quality of respiration. We recommend that due to local logistic factors, the intravenous route might be more suitable, affording a more rapid onset of sedation before induction of anaesthesia, provided that close nursing observation is available. Furthermore, lorazepam 2 mg intravenously is just as effective as the larger doses with less incidence of nausea and vomiting associated with the larger doses.
Subject(s)
Lorazepam/administration & dosage , Premedication , Adult , Dose-Response Relationship, Drug , Female , Humans , Injections, Intramuscular , Injections, Intravenous , Mental Recall/drug effects , Random AllocationABSTRACT
We report our further anaesthetic experience with Etomidate in 100 patients. The cardiovascular and respiratory systems were not significantly affected but intraocular pressure was reduced. The occurrence of pain during injection of Etomidate was unaffected by analgesic premedication but was reduced by using a solution buffered to a higher pH and by choosing a big vein for injection. The myoclonic movements often seen with Etomidate anaesthesia were transient and have so far not created any major problem; they were reduced by a slower speed of injection but unaffected by diazepam premedication or pretreatment with low dose of a non-depolarizing muscle relaxant (pancuronium). Etomidate is a satisfactory alternative to thiopentone in situations where depression of the cardiovascular and respiratory systems are undersirable or where barbiturates are otherwise contraindicated and is a usefull addition to the induction agents in our anaesthetic practice.
Subject(s)
Anesthesia, General , Etomidate , Imidazoles , Adolescent , Adult , Aged , Child , Etomidate/pharmacology , Female , Humans , Imidazoles/pharmacology , Intraocular Pressure/drug effects , Male , Middle Aged , Myoclonus/chemically induced , Pain/chemically inducedABSTRACT
Etomidate, a new short-acting non-barbiturate hypnotic, was administered to 40 patients between the ages of 12 years and 65 years. Intra-ocular pressure was measured before and after etomidate injection using a Schiotz tonometer. A significant reduction of intra-ocular pressure was found to follow etomidate injection in spite of the often associated myoclonic movements. The mechanism of reduction of intra-ocular pressure has not been determined in this study. It is suggested that etomidate will be a useful intravenous induction agent where elevation of intra-ocular pressure is undesirable.