Anasthetics

Treatments facilitated by healthcare trusts are transformed into codes through which payments are organised. Accurate coding is essential for correct payment, inaccurate clinical coding results in significant loss of income. Our OMFS unit performs regular day-case procedures with data recorded in a standardised proforma. An audit was performed to determine the accuracy of ICD and OPCS codes generated by the OMFS department to identify factors contributing to inaccuracies leading to loss of income. All local anaesthetic and IV sedation cases were reviewed at two separate 3 monthly time frames within the OMFS department with 100 cases per cycle...

The stories of fluorinated inhalation anesthetics, including synthesis, physicochemistry and pharmacologies, were summarized in this review. Retrospecting the history of inhalation anesthetics revealed their increasing reliance on fluorine and ether structures. Halothane causes a rare but severe immune-based hepatotoxicity, which was resplaced by enflurane in the 1970s. Isoflurane took the place of enflurane in the 1980s, showing modest advantages (e.g., lower solubility, better metabolic stability, and without convulsive predisposition)...

INTRODUCTION: A variety of topical anesthetic creams are available to reduce pain associated with dermatological procedures. Pliaglis is a self-occluding eutectic mixture of lidocaine and tetracaine. STUDY OBJECTIVES: To evaluate the post-marketing safety profile of Pliaglis and efficacy in terms of pain reduction, product satisfaction, and daily practice use prior to pre-defined dermatological procedures. METHODS: A prospective, non-interventional study conducted at 44 sites in four European countries; 581 patients were treated prior to dermatological procedures such as pulsed-dye laser therapy, laser-assisted hair removal, non-ablative laser resurfacing, dermal filler injections, and vascular access...

Free radicals are highly reactive and unstable compounds. These highly reactive molecules cause oxidative damage to cellular components such as DNA, proteins and lipids. They play central role in the mechanism of cell injury and cell death. Free radical scavengers either prevent these reactive species from being formed, or remove them before they can damage vital components of the cell. Oxidative stress defines an imbalance in production of oxidizing chemical species and their effective removal by protective antioxidants and scavenger enzymes...

The aim of our study was assessment of efficacy of PLFT technique on ProstaLund CoreTHerm unit in nanagement of acute urine retention in patients with prostatic adenoma. We treated 31 patients with prostatic adenoma (age 58-97, mean age 74 years, volume of the prostatic gland from 32 to 188 ml); 11 patients had suprapubic fistula, 8 carried urethral catheter for acute urinary retention. All the patients were inoperable because of a high surgical-anasthetic risk. All of them were exposed to PLFT for 9-15 min...

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We considered data of samples collected in the period 1994-2001 in 83 operating rooms of 13 different public and private hospitals in Veneto Region. The anaestetic gases more used in operating rooms were nitrous oxide, isoflurane and, more recently, sevflurane. The mostly polluted positions were those in proximity of anaesthesiologic devices; the gases average concentrations were low in all hospitals examined, although some operating rooms demonstrated concentrations of anasthetic gases exceeding limit values...

OBJECTIVE: To investigate the changes of angiotensin II type 1 (AT1) receptor in the kidney of spontaneously hypertensive rats (SHR) with diabetes and the influence of endothelin receptor antagonist bosentan. METHODS: Streptozotocin-induced diabetic SHR were divided into four groups: groups treated by cilazapril, bosentan + amlodipine, and amlodipine rsspectively, and untreated group, 6 rats in each group. Six SHR rats and six WKY rats were used as hypertensive and normotensive controls respectively...

Sevoflurane induction of anasthesia has been examined extensively, but little is known about the usefulness of other drugs as adjuncts to hasten and smooth the process. Sixty patients, undergoing surgery of a type suitable for a spontaneous respiration, laryngeal mask airway anasthetic technique, were randomly allocated to receive 1.0 microgram.kg-1 intravenous fentanyl or the equivalent volume of normal saline, 30 s prior to triple-breath induction with sevoflurane. The study was double-blind. There were no differences between the groups for the times to loss of eyelash reflex, jaw relaxation, insertion of the laryngeal mask airway or regular settled breathing...

A patient with a known history of myotubular myopathy presented for surgery for insertion of a tibial nail. Anasthesia was induced and maintained using an intravenous anasthetic technique. Neuromuscular function was assessed using mechanomyography, which showed a profound reduction in muscle contractility. In view of this, the use of muscle relaxants was avoided altogether. Nerve conduction was normal but electromyography showed small motor units, with generalised distribution, suggesting mild to moderately severe myopathy...

A project to perform surgical correction of cleft lips and palates was carried out in Uganda in 1998. Twenty centres were visited and 336 cleft lips and 41 cleft palates were repaired. The age of the patients ranged from 2 weeks to 60 years. Many of the centres visited were remote and lacked even the most basic equipment. Patients were anasthetised using ketamine, ether or halothane according to a protocol that we developed. There was no anasthetic mortality and only one case of significant morbidity. We report our experience and discuss recommendations regarding the provision of anasthesia in remote circumstances based on our outcome...

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The aim of this study was to investigate in rabbits the diastolic arterial blood pressure, plasma glucose and plasma lactate responses to salbutamol (a selective beta-2 adrenoceptor agonist) and BRL 37344 (a selective beta-3 adrenoceptor agonist) in comparison with CGP 12177 (a potent beta-1 and beta-2 adrenoceptor antagonist which also acts as a partial beta-3 agonist), isoprenaline (a non-selective beta-1, beta-2 and beta-3 adrenoceptor agonist) and adrenaline (a non-selective beta and alpha adrenoceptor agonist)...

The influence of constant current passing through the spinal cord cross-section on the antidromic discharges in afferent nerves caused by intraspinal stimulation of central afferent terminals was studied in experiments on anasthetized cats. The current flowing through the spinal cord in the dorso-ventral direction produced an increase or antidromic discharges. The current flowing in the ventro-dorsal direction produced an opposite effect. Facilitation of antidromic discharges evoked by conditioning stimuli decreased with an increase of constant current of both directions...

Phencyclidine (PCP), discovered in Germany during the 1920s, has become over the past four decades the number one drug of abuse in the United States. While briefly showing promise as being the "ultimate" anasthetic agent during the late 1950s, it very quickly fell into disfavor because of untoward side-effects during post-anesthetic emergence (1960s). Some few years later (1970s), PCP began its ascent in the illicit drug market. PCP is a drug with a broad range of pharmacological activity. It has been implicated as a major cause of psychiatric decompensation and has a number of clinical syndromes described in the literature...

The effect of nitrous oxide on the minimum alveolar concentration of enflurane required to prevent movement in response to skin incision in 50% of subjects (MAC) has been investigated in two groups of 16 patients. The end-tidal enflurane concentration was held constant for 25-36 min in order to equilibrate the brain with the alveolar anasthetic partial pressure. When nitrous oxide (30%) was present in the inspired mixture the MAC of enflurane was 1.17%; the value decreased to 0.57% when 70% nitrous oxide was used...

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Having confirmed the development of cephalea in a large number of patients undergoing saphenectomy under subarachnoidal anasthetic, the authors wanted to research its probable causes. With this in mind, they observed a group of patients who had varices of the lower limbs which they had operated. They present their study methodology, and then examine and discuss the results. The conclude that many factors are responsible for the aetiology of the symptoms of cephalea. The sex, age, and conditions of venous hypertension in the posterior tibial vein are particularly determining factors...

One hindleg of an anasthetized rat (n = 15) was isolated from systemic blood circulation. The preparation was connected to the body only by nerve and bone. A. and V. femorales were cannulated and perfused with normoxic (PO2 = 530 mm Hg) or hypoxic (PO2 = 60 mm Hg) Tyrode solutions. Static contractions of the muscle were elicited by electrical stimulation on the sciatic nerve (2 x motor threshold, 400-800 mV, 50 s-1). A 1 s stimulus was followed by a 2 s rest period. Total test time amounted to 40 min. It was proceeded and succeeded by 20 min periods of control perfusions without stimulation...

Evidence is presented that marked changes in the electromyographic (EMG) activity of single motor units often occur during a fatigue-test paradigm (12) widely used for the classification of mammalian motor units into fast-fatigable (FF), fast-intermediate-fatigable, fast-fatigue-resistant and slow categories (11), particularly in type FF units. Force output and EMG activity were measured in single motor units of the tibialis posterior muscle of anasthetized cats, while each unit was subjected to a fatigue test consisting of 4 min of motor-axon stimulation, using 1 Hz 330 ms trains of 0...