Variations in pancuronium requirement, plasma concentration, and urinary excretion induced by cardiopulmonary bypass with hypothermia.

Abstract:

:To determine the effects of cardiopulmonary bypass (CPB) and hypothermia on the neuromuscular blockade produced by pancuronium, this relaxant was infused intravenously into 10 anesthetized patients to produce and maintain 90% depression of the twitch tension of the adductor pollicis muscle following supramaximal ulnar nerve stimulation. Infusion rates, plasma concentration of pancuronium, and adductor pollicis temperature were measured every 15 min. During the normothermic period preceding the start of CPB, the pancuronium requirement, the pancuronium plasma concentration, and muscle temperature were mean (mean +/- SEM): 238 +/- 12 micrograms . m-2 . 15 min-1, 0.31 +/- 0.01 microgram/ml, and 33.9 +/- 0.1 degrees C, respectively. At the beginning of CPB, the pancuronium infusion rate increased to 362 +/- 32 micrograms . m-2 . 15 min-1 (P less than 0.001) despite a decrease in the muscle temperature to 29.2 +/- 0.9 degrees C (P less than 0.001) and in pancuronium plasma concentration to 0.22 +/- 0.02 microgram/ml. During sustained muscle hypothermia to 28.3 +/- 0.4 degrees C the pancuronium plasma concentration remained constant at 0.22 +/- 0.01 micrograms/ml (P less than 0.001) while the requirement decreased to 94 +/- 15 micrograms . m-2 . 15 min-1 (P less than 0.001). After the muscle temperature was returned to 34 +/- 0.6 degrees C, the plasma pancuronium concentration and requirements increased to 0.35 +/- 0.05 microgram/ml and 392 +/- 32 micrograms . m-2 . 15 min-1 (P less than 0.001), respectively. After CPB, these values were 0.39 +/- 0.04 microgram/ml and 239 +/- 25 microgram . m-2 . 15 min-1. These results demonstrate that pancuronium requirements are increased at the beginning of CPB because of circulatory volume changes and again during rewarming of the patient once muscle temperature reaches about 34 degrees C.

journal_name

Anesthesiology

journal_title

Anesthesiology

authors

d'Hollander AA,Duvaldestin P,Henzel D,Nevelsteen M,Bomblet JP

doi

10.1097/00000542-198306000-00004

subject

Has Abstract

pub_date

1983-06-01 00:00:00

pages

505-9

issue

6

eissn

0003-3022

issn

1528-1175

journal_volume

58

pub_type

杂志文章
  • Effects of desflurane in senescent rat myocardium.

    abstract:BACKGROUND:The myocardial negative inotropic effects of desflurane are less pronounced than those of other halogenated anesthetics, partly because of intramyocardial catecholamine store release. However, the effects of desflurane on aging myocardium are unknown, whereas aging is known to be associated with an attenuati...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200611000-00017

    authors: Rozenberg S,Besse S,Amour J,Vivien B,Tavernier B,Riou B

    更新日期:2006-11-01 00:00:00

  • Cell-based therapy for acute organ injury: preclinical evidence and ongoing clinical trials using mesenchymal stem cells.

    abstract::Critically ill patients often suffer from multiple organ failures involving lung, kidney, liver, or brain. Genomic, proteomic, and metabolomic approaches highlight common injury mechanisms leading to acute organ failure. This underlines the need to focus on therapeutic strategies affecting multiple injury pathways. Th...

    journal_title:Anesthesiology

    pub_type: 杂志文章,评审

    doi:10.1097/ALN.0000000000000446

    authors: Monsel A,Zhu YG,Gennai S,Hao Q,Liu J,Lee JW

    更新日期:2014-11-01 00:00:00

  • Echocardiographic Doppler assessment of pulmonary capillary wedge pressure in surgical patients with postoperative circulatory shock and acute lung injury.

    abstract:BACKGROUND:In cardiac patients, pulmonary capillary wedge pressure (PCWP) is estimated using color M-mode Doppler study of left ventricular filling and Doppler tissue imaging. The goal of this study was to assess whether echocardiography accurately estimates PCWP in critically ill patients. METHODS:Sixty ventilated pa...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200305000-00011

    authors: Bouhemad B,Nicolas-Robin A,Benois A,Lemaire S,Goarin JP,Rouby JJ

    更新日期:2003-05-01 00:00:00

  • Pulsus alternans during general anesthesia with halothane: effects of permissive hypercapnia.

    abstract:BACKGROUND:Pulsus alternans is a classic type of abnormal pulse. It can be defined as a regular alternation of pulse amplitude in which runs of weak and strong beats follow each other alternatively without any change in cycle length. It may be a sign of severe decompensated congestive heart failure. The authors infrequ...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200007000-00017

    authors: Saghaei M,Mortazavian M

    更新日期:2000-07-01 00:00:00

  • Sedation using propofol induces similar diaphragm dysfunction and atrophy during spontaneous breathing and mechanical ventilation in rats.

    abstract:BACKGROUND:Mechanical ventilation is crucial for patients with respiratory failure. The mechanical takeover of diaphragm function leads to diaphragm dysfunction and atrophy (ventilator-induced diaphragmatic dysfunction), with an increase in oxidative stress as a major contributor. In most patients, a sedative regimen h...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0000000000000125

    authors: Bruells CS,Maes K,Rossaint R,Thomas D,Cielen N,Bergs I,Bleilevens C,Weis J,Gayan-Ramirez G

    更新日期:2014-03-01 00:00:00

  • Effect of antiemetic therapy on recovery and hospital discharge time. A double-blind assessment of ondansetron, droperidol, and placebo in pediatric patients undergoing ambulatory surgery.

    abstract:BACKGROUND:Postoperative nausea and vomiting continue to be a significant problem for pediatric ambulatory surgery patients. Although ondansetron has been demonstrated to be effective in the prophylactic treatment of postoperative nausea and vomiting (surrogate end point) no one has demonstrated a benefit of antiemetic...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-199511000-00007

    authors: Davis PJ,McGowan FX Jr,Landsman I,Maloney K,Hoffmann P

    更新日期:1995-11-01 00:00:00

  • Hepatic oxygen supply during halothane or isoflurane anesthesia in guinea pigs.

    abstract::The present study was designed to determine changes in hepatic oxygen supply in guinea pigs during halothane or isoflurane anesthesia. Twenty-seven guinea pigs were randomly divided into three equal groups: control (no anesthesia) group, and animals anesthetized with halothane or isoflurane to decrease mean arterial p...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198711000-00014

    authors: Hursh D,Gelman S,Bradley EL Jr

    更新日期:1987-11-01 00:00:00

  • Alveolar-to-arterial-to-venous anesthetic partial pressure differences in humans.

    abstract::To determine the correlation between the partial pressures of anesthetics in venous and arterial blood (Pv and Pa), and to assess whether this correlation was better than that between the partial pressure of anesthetic in alveolar gas (PA) and Pa, isoflurane (n = 4) or halothane (n = 4) was administered to eight patie...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198904000-00014

    authors: Carpenter RL,Eger EI 2nd

    更新日期:1989-04-01 00:00:00

  • 5-HT1A receptor agonist Befiradol reduces fentanyl-induced respiratory depression, analgesia, and sedation in rats.

    abstract:BACKGROUND:There is an unmet clinical need to develop a pharmacological therapy to counter opioid-induced respiratory depression without interfering with analgesia or behavior. Several studies have demonstrated that 5-HT1A receptor agonists alleviate opioid-induced respiratory depression in rodent models. However, ther...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0000000000000490

    authors: Ren J,Ding X,Greer JJ

    更新日期:2015-02-01 00:00:00

  • Neither xenon nor fentanyl induces neuroapoptosis in the newborn pig brain.

    abstract:BACKGROUND:Some inhalation anesthetics increase apoptotic cell death in the developing brain. Xenon, an inhalation anesthetic, increases neuroprotection when combined with therapeutic hypothermia after hypoxic-ischemic brain injury in newborn animals. The authors, therefore, examined whether there was any neuroapoptoti...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0b013e318294934d

    authors: Sabir H,Bishop S,Cohen N,Maes E,Liu X,Dingley J,Thoresen M

    更新日期:2013-08-01 00:00:00

  • Respiratory Physiology for the Anesthesiologist.

    abstract::Respiratory function is fundamental in the practice of anesthesia. Knowledge of basic physiologic principles of respiration assists in the proper implementation of daily actions of induction and maintenance of general anesthesia, delivery of mechanical ventilation, discontinuation of mechanical and pharmacologic suppo...

    journal_title:Anesthesiology

    pub_type: 杂志文章,评审

    doi:10.1097/ALN.0000000000002666

    authors: Bigatello L,Pesenti A

    更新日期:2019-06-01 00:00:00

  • Antifibrinolytic therapy and perioperative blood loss in cancer patients undergoing major orthopedic surgery.

    abstract:BACKGROUND:Aprotinin has been reported to reduce blood loss and transfusion requirements in patients having major orthopedic operations. Data on whether epsilon amino-caproic acid (EACA) is effective in this population are sparse. METHODS:Sixty-nine adults with malignancy scheduled for either pelvic, extremity or spin...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-200302000-00011

    authors: Amar D,Grant FM,Zhang H,Boland PJ,Leung DH,Healey JA

    更新日期:2003-02-01 00:00:00

  • An Introduction to Causal Diagrams for Anesthesiology Research.

    abstract::Making good decisions in the era of Big Data requires a sophisticated approach to causality. We are acutely aware that association ≠ causation, yet untangling the two remains one of our greatest challenges. This realization has stimulated a Causal Revolution in epidemiology, and the lessons learned are highly relevant...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0000000000003193

    authors: Gaskell AL,Sleigh JW

    更新日期:2020-05-01 00:00:00

  • Electrocardiographic exercise stress testing for cardiac risk assessment in patients undergoing noncardiac surgery.

    abstract:BACKGROUND:The value of exercise electrocardiography in the prediction of perioperative cardiac risk has yet to be defined. This study was performed to determine the predictive value of exercise electrocardiography as compared with clinical parameters and resting electrocardiography. METHODS:A total of 204 patients at...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200101000-00011

    authors: Gauss A,Röhm HJ,Schäuffelen A,Vogel T,Mohl U,Straehle A,Meierhenrich R,Georgieff M,Steinbach G,Schütz W

    更新日期:2001-01-01 00:00:00

  • Bayesian modeling of muscle biopsy contracture testing for malignant hyperthermia susceptibility.

    abstract:BACKGROUND:Phenotyping malignant hyperthermia (MH) by contracture testing has a low but quantifiable degree of inaccuracy, measured by its sensitivity and specificity. Quantifying the limitations inherent in diagnostic testing for MH can help resolve issues in clinical practice, such as the interpretation of a negative...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199803000-00007

    authors: Loke JC,MacLennan DH

    更新日期:1998-03-01 00:00:00

  • Myocardial hypercarbic acidosis reduces cardiac resuscitability.

    abstract:BACKGROUND:The severity of spontaneous myocardial hypercarbic acidosis during cardiac arrest previously has been predictive of the likelihood of restoring spontaneous circulation. The present study investigated whether hypercarbia itself impairs cardiac resuscitation. Since coronary perfusion pressure is the overriding...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199302000-00019

    authors: Maldonado FA,Weil MH,Tang W,Bisera J,Gazmuri RJ,Johnson B,D'Alessio A

    更新日期:1993-02-01 00:00:00

  • Myocardial sensitization by thiopental to arrhythmogenic action of epinephrine in dogs.

    abstract::This study examined the interaction between thiopental and epinephrine in inducing ventricular arrhythmias in dogs. The arrhythmogenic threshold of epinephrine was determined during anesthesia with either halothane alone, thiopental alone, etomidate plus different doses of thiopental, or halothane plus different doses...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198912000-00017

    authors: Hayashi Y,Sumikawa K,Yamatodani A,Tashiro C,Wada H,Yoshiya I

    更新日期:1989-12-01 00:00:00

  • Dextrose affects gravitational spread of epidural anesthesia.

    abstract::Chloroprocaine, 0.5 per cent, with physiologic saline solution, has a specific gravity of 1.007 and a osmolarity of 283 mOsm/l, which increase to a specific gravity of 1.025 and an osmolarity of 542 mOsm/l when chloroprocaine is prepared in dextrose, 5 per cent. Chloroprocaine, 2.7 per cent, shows similar increases in...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198005000-00014

    authors: Park YR,Eastwood DW

    更新日期:1980-05-01 00:00:00

  • Effects of oral clonidine premedication on plasma glucose and lipid homeostasis associated with exogenous glucose infusion in children.

    abstract:BACKGROUND:Oral clonidine may influence plasma glucose and lipid homeostasis by modulating endocrinologic responses to surgical stress. The effect of oral clonidine premedication on plasma glucose and lipid homeostasis associated with exogenous glucose infusion were investigated in children undergoing minor surgery. M...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-199804000-00011

    authors: Nishina K,Mikawa K,Maekawa N,Shiga M,Obara H

    更新日期:1998-04-01 00:00:00

  • Resting metabolic rate of the critically ill patient: measured versus predicted.

    abstract::Critically ill patients requiring mechanical ventilation are particularly susceptible to malnutrition. A knowledge of the energy requirements of these patients is essential in designing nutritional regimens. This study examines 45 resting energy-expenditure measurements performed in a group (n = 40) of postoperative, ...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198606000-00001

    authors: Weissman C,Kemper M,Askanazi J,Hyman AI,Kinney JM

    更新日期:1986-06-01 00:00:00

  • Intravenous anesthetic propofol inhibits multiple human cardiac potassium channels.

    abstract:BACKGROUND:Propofol is widely used clinically for the induction and maintenance of anesthesia. Clinical case reports have shown that propofol has an antiatrial tachycardia/fibrillation effect; however, the related ionic mechanisms are not fully understood. The current study investigates the effects of propofol on human...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0000000000000495

    authors: Yang L,Liu H,Sun HY,Li GR

    更新日期:2015-03-01 00:00:00

  • Bupivacaine-induced cardiac arrhythmias in sheep.

    abstract::Controversy persists about the cardiac toxicity of bupivacaine if accidentally administered intravenously during regional anesthesia. Using awake, unanesthetized sheep, we evaluated the cardiac effects of low and high equivalent doses of lidocaine and bupivacaine given intravenously over 10 s. All animals convulsed wi...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198401000-00004

    authors: Kotelko DM,Shnider SM,Dailey PA,Brizgys RV,Levinson G,Shapiro WA,Koike M,Rosen MA

    更新日期:1984-01-01 00:00:00

  • Volatile anesthetics differentially affect immunostimulated expression of inducible nitric oxide synthase: role of intracellular calcium.

    abstract:BACKGROUND:Nitric oxide released by inducible nitric oxide synthase (iNOS) plays an important role in immune responses and systemic vasodilation in septic shock. Volatile anesthetics have been reported to interfere with signal transduction and gene expression. We studied the effect of volatile anesthetics on activity a...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200004000-00028

    authors: Tschaikowsky K,Ritter J,Schröppel K,Kühn M

    更新日期:2000-04-01 00:00:00

  • Effects of a circulating-water garment and forced-air warming on body heat content and core temperature.

    abstract:BACKGROUND:Forced-air warming is sometimes unable to maintain perioperative normothermia. Therefore, the authors compared heat transfer, regional heat distribution, and core rewarming of forced-air warming with a novel circulating-water garment. METHODS:Nine volunteers were each evaluated on two randomly ordered study...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-200405000-00005

    authors: Taguchi A,Ratnaraj J,Kabon B,Sharma N,Lenhardt R,Sessler DI,Kurz A

    更新日期:2004-05-01 00:00:00

  • Pharmacokinetics, neuromuscular effects, and biodisposition of 3-desacetylvecuronium (Org 7268) in cats.

    abstract::The pharmacokinetics, biodisposition, and neuromuscular blocking properties of 3-desacetylvecuronium were studied in 17 adult cats. Animals were divided into three groups: five cats with kidney failure induced by bilateral ligation of the renal pedicles, six cats with galactosamine-induced fulminant hepatitis, and six...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199106000-00013

    authors: Segredo V,Shin YS,Sharma ML,Gruenke LD,Caldwell JE,Khuenl-Brady KS,Agoston S,Miller RD

    更新日期:1991-06-01 00:00:00

  • Morphine inhibits spontaneous and cytokine-enhanced natural killer cell cytotoxicity in volunteers.

    abstract:BACKGROUND:Opioids are used by patients who have conditions ranging from the acute pain of surgery and chronic cancer pain to substance abuse. Despite their widespread use and considerable experimental data about them, little is known about how opioids may alter in vivo immunity in humans. This study was designed to ev...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199509000-00008

    authors: Yeager MP,Colacchio TA,Yu CT,Hildebrandt L,Howell AL,Weiss J,Guyre PM

    更新日期:1995-09-01 00:00:00

  • Tissue factor and platelet glycoprotein Ib-alpha alleles are associated with age at first coronary bypass operation.

    abstract:BACKGROUND:Age is a known risk factor for postoperative complications, but the genetic factors that account for variability in age at presentation for surgery have not been characterized. Because thrombosis is a critical process in the development of coronary syndromes, the authors hypothesized that patients bearing th...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200312000-00009

    authors: Donahue BS,Byrne DW,Gailani D,George AL Jr

    更新日期:2003-12-01 00:00:00

  • α2δ-1-Bound N-Methyl-D-aspartate Receptors Mediate Morphine-induced Hyperalgesia and Analgesic Tolerance by Potentiating Glutamatergic Input in Rodents.

    abstract:BACKGROUND:Chronic use of μ-opioid receptor agonists paradoxically causes both hyperalgesia and the loss of analgesic efficacy. Opioid treatment increases presynaptic N-methyl-D-aspartate receptor activity to potentiate nociceptive input to spinal dorsal horn neurons. However, the mechanism responsible for this opioid-...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0000000000002648

    authors: Deng M,Chen SR,Chen H,Pan HL

    更新日期:2019-05-01 00:00:00

  • Prothrombin Complex Concentrate Is Effective in Treating the Anticoagulant Effects of Dabigatran in a Porcine Polytrauma Model.

    abstract:BACKGROUND:In the event of trauma, emergency reversal of anticoagulation therapy may be required. However, no specific reversal agents are routinely available for the direct oral anticoagulants such as dabigatran. The authors investigated four-factor prothrombin complex concentrate (PCC) for treating dabigatran-induced...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0000000000000863

    authors: Honickel M,Braunschweig T,van Ryn J,Ten Cate H,Spronk HM,Rossaint R,Grottke O

    更新日期:2015-12-01 00:00:00

  • Signaling pathways involved in desflurane-induced postconditioning in human atrial myocardium in vitro.

    abstract:BACKGROUND:Isoflurane and sevoflurane have been shown to elicit myocardial postconditioning, but the effect of desflurane remain unknown. The authors studied the mechanisms involved in desflurane-induced myocardial postconditioning. METHODS:Contracting isolated human right atrial trabeculae (34 degrees C, stimulation ...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0b013e31818d6b09

    authors: Lemoine S,Beauchef G,Zhu L,Renard E,Lepage O,Massetti M,Khayat A,Galera P,Gérard JL,Hanouz JL

    更新日期:2008-12-01 00:00:00