RESUMO
The lower oesophageal sphincter plays an important role as a gastro-oesophageal blocker. Its proper function as a reflux barrier for the prevention of regurgitation and aspiration during anesthesia is very important. Therefore the effect of inhalation anesthetics upon the lower oesophageal sphincter is of great interest. In 10 healthy volunteers we studied the action of various inhalation anesthetics upon the lower oesophageal sphincter, the distal oesophagus and the stomach. The inhalation of nitrous oxide-oxygen alone or in combination with 2 Vol. % halothane or enflurane resulted in a highly significant pressure drop (p < 0.001) at the lower oesophageal sphincter. All three anesthetics (nitrous oxide-oxygen, nitrous oxide-oxygen-halothane and nitrous oxide-oxygen-enflurane) caused a pressure rise at the distal oesophagus and a pressure decrease at the stomach.
Assuntos
Anestesia por Inalação , Anestésicos/farmacologia , Junção Esofagogástrica/efeitos dos fármacos , Adolescente , Adulto , Enflurano/farmacologia , Esôfago/efeitos dos fármacos , Feminino , Halotano/farmacologia , Humanos , Masculino , Óxido Nitroso/farmacologia , Pressão , Estômago/efeitos dos fármacosRESUMO
The barrier function of the lower oesophageal sphincter is of great practical importance in the prevention of regurgitation and aspiration. The action of seven most commonly used premedicants upon the lower oesophageal sphincter was studied in ten healthy volunteers. The results were compared with a placebo injection in eight volunteers. Sodium pentobarbital, droperidol and triflupromazine increased the presenting pressure of the lower oesophageal sphincter. Decreases were observed after promethazine, pethidine, the combination of droperidol plus fentanyl and atropine.
Assuntos
Adjuvantes Anestésicos/farmacologia , Junção Esofagogástrica/efeitos dos fármacos , Medicação Pré-Anestésica , Adulto , Atropina/farmacologia , Droperidol/farmacologia , Feminino , Fentanila/farmacologia , Humanos , Masculino , Meperidina/farmacologia , Pentobarbital/farmacologia , Prometazina/farmacologia , Triflupromazina/farmacologiaRESUMO
Modern anesthetic techniques are superior to regional anesthesia for most operative procedures. Yet because of new advances in techniques and methods and sound pathophysiological knowledge, there are some operations for which regional anesthesia has distinct advantages over general anesthesia. This is the case, for example, in geriatric surgery. Here, the technical simplicity and short amount of time required give spinal anesthesia marked advantages over general anesthesia. Post-spinal headaches and slight falls in blood pressure have become rarer due to technical innovations and can reasonably be accepted.
Assuntos
Raquianestesia , Geriatria , Fatores Etários , Idoso , Raquianestesia/efeitos adversos , Raquianestesia/métodos , Anestésicos Locais/administração & dosagem , Humanos , Postura , Medicação Pré-AnestésicaRESUMO
In spite of the great advances in anesthesia, regional anesthesia has not lost its importance. The development of new, longer-acting local anesthetics has extended its indication still more. The causes of accidents lie mostly in ignorance ofthe pharmacology of local anesthetics and their adjuvants, in faulty technical performance of the nerve blockade and last but not least in inadequate knowledge of the therapy, of the side effects and complications. The various complications of regional anesthesia are reported on and the necessary therapy dealt with.