Asunto(s)
Catéteres de Permanencia/efectos adversos , Bombas de Infusión Implantables/efectos adversos , Paraplejía/etiología , Estimulación Eléctrica Transcutánea del Nervio/efectos adversos , Anciano , Humanos , Imagen por Resonancia Magnética , Masculino , Morfina/administración & dosificación , Traumatismos de la Médula Espinal/etiología , Traumatismos de la Médula Espinal/patologíaAsunto(s)
Anestesia Intravenosa , Anestesia Local , Lidocaína/administración & dosificación , Animales , Perros , Cinética , Lidocaína/sangre , TráqueaRESUMEN
In baboons, lidocaine HCl was injected into the lingual (3 mg/kg), brachial (7 mg/kg), or femoral (7 mg/kg) arteries. Blood samples were taken from the internal carotid artery (ICA), internal jugular (IJV), external jugular (EJV), brachial (BV), or femoral (FV) vein, depending on the injection site, 6, 30, and 180 seconds after injection. Subsequently, radioactive microspheres (20 micron in diameter) were injected into the lingual artery, and the brains were obtained 48 hours later at postmortem to locate the microspheres. Six seconds after injection into the lingual artery, lidocaine concentration in ICA was 28 microgram/ml, whereas peak levels in IJV and EJV occurred at 30 seconds, being 51 and 25.7 microgram/ml, respectively. After injection into the brachial artery, peak average ICA levels were 105.5 microgram/ml at 6 seconds, while only 20.6 microgram/ml concentration was noted in ICA after injection into the femoral artery. Seventy-four precent of the Sr90 labeled microspheres were found lodged in the ipsilateral cerebral hemisphere. Local anesthetic drugs accidentally injected into arteries may reach the cerebral circulation following a centripetal pathway and thus produce central nervous system toxic responses.
Asunto(s)
Anestesia Local , Arterias , Circulación Sanguínea/efectos de los fármacos , Lidocaína/efectos adversos , Animales , Haplorrinos , Modelos Biológicos , PapioRESUMEN
Salpingectomy by laparoscopy in 200 healthy outpatients employed local analgesia and "pentazepam" (pentazocine 90 mg and diazepam 30 mg in 250 ml of 5% D/W) as anesthesia. Patients received no premedication, ventilated spontaneously, without tracheal intubation, but were given nasal O2 at 3 L/min throughout the procedure. N2O was used for abdominal insufflation, and the abdominal pressure and Trendelenburg position were restricted to less than 20 cm H2O pressure and 30 degrees, respectively. Changes in arterial blood gases measured in 12 patients were unremarkable. Prolonged recovery, unsatisfactory surgical conditions, tachycardia, nausea and vomiting were infrequent.