ABSTRACT
The influence of anaesthesia on the peri-operative changes in acute phase protein concentrations was studied in 18 patients undergoing elective cholecystectomy. A standard anaesthetic technique was supplemented either by one of two different doses of fentanyl, or by halothane. Eleven proteins were studied but the acute phase response was significantly altered by the anaesthetic technique for only two, fibrinogen and antichymotrypsin. The concentration of these proteins tended to be lower with 2-3 micrograms/kg fentanyl than with either halothane or fentanyl 12 micrograms/kg. There was no evidence of variation in stress suppression between the three techniques. The mechanism of any anaesthetic influence on the acute phase response is uncertain and this study is too small to assess its clinical significance.
Subject(s)
Acute-Phase Proteins/blood , Anesthesia, General , Cholecystectomy , Fentanyl , Halothane , Blood Glucose/analysis , Female , Fibrinogen/analysis , Humans , Hydrocortisone/blood , Male , alpha 1-Antichymotrypsin/bloodABSTRACT
Three possible factors predisposing to Althesin hypersensitivity, namely total dose, method of administration, either by bolus dose or infusion, and pregnancy have been studied in patients receiving the drug for the first time. Of 137 patients given Althesin, four exhibited clinical signs of mild hypersensitivity, while C3 conversion alone, indicative of a subclinical reaction, was seen in a further six patients. No reactions were observed in two control groups in whom anaesthesia was induced with thiopentone. Neither the total dose nor method of administration appeared consistently to influence the incidence of reactions, but eight of the ten patients producing an altered response to Althesin were pregnant.
Subject(s)
Alfaxalone Alfadolone Mixture/adverse effects , Anesthesia, Intravenous/adverse effects , Drug Hypersensitivity/etiology , Pregnancy Complications/immunology , Alfaxalone Alfadolone Mixture/administration & dosage , Complement C3/analysis , Female , Humans , Pregnancy , Prospective StudiesABSTRACT
Sequential plasma samples from 30 patients showing clinical signs of hypersensitivity to Althesin were investigated to determine if a specific immune response to the drug was present (as measured by classical complement pathway activation) or if a non-antibody-dependent alternative complement pathway activation was taking place. The patients were classified as those reacting on first exposure to Althesin and those who reacted adversely only on a second exposure. The alternative complement pathway, but not the classical pathway, was activated in five of the 13 first-time reactors, while in the remaining eight no complement activation was detected. In contrast, classical complement pathway activation was demonstrated in the blood samples of all 17 patients reacting on repeat exposure. Severe reactions occurred in nine of the 17 previously exposed patients compared with only one of the 13 reacting on first exposure to Althesin.
Subject(s)
Alfaxalone Alfadolone Mixture/adverse effects , Drug Hypersensitivity/immunology , Adolescent , Adult , Anaphylaxis/immunology , Child , Complement C3/analysis , Complement C4/analysis , Complement Pathway, Alternative/drug effects , Complement Pathway, Classical/drug effects , Female , Humans , Immunoelectrophoresis, Two-Dimensional , Male , Middle AgedABSTRACT
The fibrinolytic effects of six different anaesthetic agents were studied in 36 patients undergoing abdominal hysterectomy. Fibrinolytic activity was measured by dilute whole blood and euglobulin clot lysis times. Concentrations of plasminogen, fibrinogen and fibrin degradation products were also determined. Significant enhancement of fibrinolytic activity, measured as a decrease in clot lysis time, was seen during anaesthesia and surgery with all agents studied. Halothane produced the least effect and the greatest increase in fibrinolytic activity was seen during trichloroethylene anaesthesia. Lumbar extradural anaesthesia also consistently produced enhancement of fibrinolysis. The reasons for these results and their clinical implications are discussed.
Subject(s)
Anesthesia/methods , Anesthetics/pharmacology , Fibrinolysis/drug effects , Adult , Blood Coagulation Tests , Enflurane/pharmacology , Female , Fentanyl/pharmacology , Halothane/pharmacology , Humans , Lidocaine/pharmacology , Middle Aged , Trichloroethylene/pharmacologyABSTRACT
When Vicia faba root tips are exposed for 2 h to clinically useful concentrations of halothane or methoxyflurane in air, or to halothane in 80% nitrous oxide/20% oxygen, there is a transient increase in mitotic index and then abnormal interphase cells are produced in proportion to the anaesthetic concentrations. After exposure there is a period of mitotic inhibition during which the cells become partially synchronised. When colchicine-metaphase cells collected 28 h after exposure are compared with controls and with metaphases collected only 4 h after exposure, they show a significant increase in the incidence of aneuploidy, tetraploidy and the results of chromosome breakage. It is suggested that all the abnormalities seen can be accounted for by the effects of the anaesthetics on spindle movements, and that at the concentrations used the anaesthetics have no mutagenic effects on chromosomes in interphase.