Assuntos
Adenoma de Ducto Biliar/cirurgia , Carcinoma Hepatocelular/cirurgia , Neoplasias Hepáticas/cirurgia , Transplante de Fígado , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Teste de Histocompatibilidade , Humanos , Pessoa de Meia-Idade , Países Baixos , Opinião Pública , Doadores de Tecidos , Transplante HomólogoRESUMO
The effect of cross clamping the lower abdominal aorta on systemic blood pressure and right and left heart pressure was studied in 17 patients requiring surgical treatment for abdominal aortic aneurysm or aortic occlusive disease, in neuroleptanaesthesia. After cross clamping the systemic systolic blood pressure rose 24 mmHg (p is less than 0.01) and the systemic diastolic blood pressure 8 mmHg (p is less than 0.01). There was no influence of cross clamping on the right (CVP) and and left (PCWP) heart filling pressure even in patients with preexistent readings beyond the normal range.
Assuntos
Aorta Abdominal , Pressão Sanguínea , Hemostasia Cirúrgica/efeitos adversos , Idoso , Aorta Abdominal/cirurgia , Aneurisma Aórtico/fisiopatologia , Aneurisma Aórtico/cirurgia , Doenças da Aorta/fisiopatologia , Doenças da Aorta/cirurgia , Capilares/fisiopatologia , Pressão Venosa Central , Feminino , Frequência Cardíaca , Humanos , Masculino , Pessoa de Meia-Idade , Artéria Pulmonar/fisiopatologiaRESUMO
Experiences with the Swan-Ganz catheter in 'high risk' surgical intensive care patients are described. After description of the catheter and catheterization technique, normal values from the literature are presented. Attention is drawn to the occurrence of artefacts in the pressure curve, which can lead to the inference of faulty results from the measurements. Attention is also drawn to the effect of intrathoracic pressure on pulmonary vascular pressures. A review of possible complications is given, with recommendations how these may be avoided or at least reduced to a minimum. The authors' material is used to demonstrate the value of the catheter, showing that the CVP is not always a trustworthy parameter for hemodynamic monitoring. The conclusion is drawn that the 'high risk' patient on the surgical intensive care unit gains from the use of the Swan-Ganz catheter.
Assuntos
Determinação da Pressão Arterial/métodos , Circulação Pulmonar , Determinação da Pressão Arterial/instrumentação , Capilares/fisiologia , Cateteres de Demora/efeitos adversos , Pressão Venosa Central , Humanos , Pulmão/irrigação sanguínea , Pressão , Artéria Pulmonar/fisiologia , Procedimentos Cirúrgicos Operatórios , Tórax/fisiologiaRESUMO
The effects of droperidol and fentanyl on three samples of human bone marrow with regard to their colony forming in culture was studied in more than 256 multiple experiments. There was no evidence of any toxic effect of droperidol and fentanyl on the bone marrow cells.
Assuntos
Células da Medula Óssea , Medula Óssea/efeitos dos fármacos , Droperidol/farmacologia , Fentanila/farmacologia , Células Cultivadas , Células Clonais/efeitos dos fármacos , Humanos , Técnicas In VitroRESUMO
The authors' technique of balanced neuroleptanaesthesia with droperidol, fentanyl, nitrous oxide, pancuronium and nitroprusside is outlined. It is suggested that this is the anaesthetic method of choice for the surgical removal of catecholamine secreting tumours since it is associated with good operating conditions and an uneventful post-operative period.
Assuntos
Anestesia Geral , Feocromocitoma/cirurgia , Pressão Sanguínea/efeitos dos fármacos , Droperidol , Fentanila , Humanos , Neuroleptanalgesia , Nitroprussiato/farmacologia , Óxido Nitroso , Pancurônio , Medicação Pré-AnestésicaRESUMO
A case report is presented which illustrates the use of sodium nitroprusside to control blood pressure levels during neurolept anaesthetic technique for removal of phaeochromocytoma. In this case the evanescent action of nitroprusside was advantageous since when the drug was discontinued elevation of blood pressure gave rise to suspicion that further catecholamine-secreting tumour was present. In all, four such tumours were removed from this patient.
