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1.
J Neurosurg Anesthesiol ; 27(1): 1-6, 2015 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-24633212

RESUMEN

BACKGROUND: The aim of this prospective, comparative, randomized study was to compare the inhalational anesthetics isoflurane, sevoflurane, and desflurane in pediatric patients undergoing craniotomy for excision of supratentorial tumors. We assessed early postoperative recovery outcome, intraoperative hemodynamics, and degree of brain swelling, as well as postoperative vomiting and shivering. METHODS: Sixty patients scheduled for supratentorial brain tumor excision, were randomly allocated into 1 of 3 groups (20 patients each); isoflurane, sevoflurane, and desflurane group. After IV induction of anesthesia, maintenance was achieved using the inhalational anesthetic according to the allocated group. Tracheal extubation time was the primary endpoint. The secondary endpoints included: emergence time and the interval time needed to reach Aldrete score ≥9, intraoperative degree of brain swelling, intraoperative heart rate and mean arterial blood pressure, as well as postoperative vomiting and shivering. RESULTS: The mean emergence time, extubation time, and the interval required to reach Aldrete score 9 were significantly shorter in the desflurane and sevoflurane groups than the isoflurane group. No statistically significant changes in the 3 groups regarding intraoperative brain swelling, hemodynamics, and postoperative shivering or vomiting were noted. CONCLUSIONS: Desflurane and sevoflurane can be used to facilitate early emergence from anesthesia in neurosurgical pediatric patients. Emergence times are shorter with desflurane or sevoflurane than with isoflurane. The patients who received desflurane or sevoflurane have similar intraoperative and postoperative incidence of adverse effects compared with those who received isoflurane. Thus, desflurane and sevoflurane can be considered as suitable for emergence in pediatric neurosurgical anesthesia.


Asunto(s)
Amidas , Anestesia Local/métodos , Anestésicos por Inhalación , Anestésicos Locales , Craneotomía/métodos , Isoflurano/análogos & derivados , Lidocaína , Éteres Metílicos , Bloqueo Nervioso/métodos , Cuero Cabelludo , Adulto , Amidas/farmacocinética , Anestesia General , Anestésicos por Inhalación/farmacocinética , Anestésicos Locales/farmacocinética , Presión Sanguínea/efectos de los fármacos , Desflurano , Combinación de Medicamentos , Femenino , Frecuencia Cardíaca/efectos de los fármacos , Humanos , Isoflurano/farmacocinética , Lidocaína/farmacocinética , Masculino , Éteres Metílicos/farmacocinética , Persona de Mediana Edad , Dolor Postoperatorio/epidemiología , Ropivacaína , Sevoflurano , Vigilia
2.
Lab Anim ; 46(2): 108-13, 2012 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-22238291

RESUMEN

Gabapentin has been used to treat a variety of conditions in both human and veterinary medicine, including seizures, neuropathies and chronic pain. However, little information is known about the effects of gabapentin on the minimum alveolar concentration (MAC) of volatile anaesthetics. In this study, we investigated the effect of intraperitoneal administration of gabapentin on isoflurane MAC in adult male rats and hypothesized that gabapentin would decrease MAC in a dose-dependent manner. Using a standard MAC study protocol, we compared five treatment groups (G) receiving 0 (G(0)), 30 (G(30)), 100 (G(100)), 300 (G(300)) and 1000 (G(1000)) mg/kg gabapentin intraperitoneally and compared post-drug MAC values among groups and with corresponding baseline MAC values determined in each group prior to drug testing. The average baseline isoflurane MAC value was 1.45 ± 0.17%, which did not differ significantly between groups (1.47 ± 0.23% [G(30)], 1.46 ± 0.23% [G(100)], 1.48 ± 0.18% [G(300)] and 1.42 ± 0.2% [G(1000)]). In the G(300) and G(1000) groups, the isoflurane MAC value decreased significantly by 19% and 18%, respectively, from corresponding baseline values (P< 0.05, when compared with G(0)). Linear regression analysis revealed a negative correlation between blood gabapentin concentration and percent change in MAC (R(2) = 0.43; P< 0.05) but not dose. In conclusion, high-dose intraperitoneal gabapentin decreased isoflurane MAC. However, the effect was small and not dose-dependent, and is unlikely to be clinically significant.


Asunto(s)
Aminas/farmacología , Anestésicos por Inhalación/farmacocinética , Anticonvulsivantes/farmacología , Ácidos Ciclohexanocarboxílicos/farmacología , Isoflurano/farmacocinética , Alveolos Pulmonares/efectos de los fármacos , Ácido gamma-Aminobutírico/farmacología , Anestesia por Inhalación , Anestésicos por Inhalación/administración & dosificación , Animales , Relación Dosis-Respuesta a Droga , Gabapentina , Inyecciones Intraperitoneales , Isoflurano/administración & dosificación , Masculino , Alveolos Pulmonares/metabolismo , Ratas , Ratas Sprague-Dawley
3.
Magnes Res ; 24(4): 181-8, 2011 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-22064369

RESUMEN

BACKGROUND: In this study we aimed to analyze the effect of perioperative magnesium sulphate (MgSO(4)) on minimal alveolar concentration (MAC) of desflurane using bispectral index (BIS) monitoring. PATIENTS AND METHODS: Sixty patients undergoing abdominal surgery under general anesthesia were randomized into two groups: Mg - receiving perioperative MgSO(4) supplementation and C - control. Anesthesia was titrated to maintain the BIS value between 45-55. RESULTS: MAC values, tachycardia and hypertension during intubation was found to be lower in group Mg compared to group C (p<0.001). Time to extubation, verbal cooperation and eye opening was longer in patients receiving infusion of MgSO(4) (p<0.001). CONCLUSION: We concluded that perioperative MgSO(4) infusion may be used as an adjunct as it decreases MAC of desflurane and suppresses the hemodynamic response to intubation.


Asunto(s)
Monitores de Conciencia , Isoflurano/análogos & derivados , Sulfato de Magnesio/farmacología , Monitoreo Intraoperatorio/métodos , Periodo Perioperatorio , Alveolos Pulmonares/química , Adolescente , Adulto , Anestésicos por Inhalación/análisis , Anestésicos por Inhalación/farmacocinética , Desflurano , Femenino , Humanos , Isoflurano/análisis , Isoflurano/farmacocinética , Sulfato de Magnesio/uso terapéutico , Masculino , Persona de Mediana Edad , Concentración Osmolar , Alveolos Pulmonares/metabolismo , Factores de Tiempo , Adulto Joven
4.
Anesteziol Reanimatol ; (2): 58-62, 2011.
Artículo en Ruso | MEDLINE | ID: mdl-21692221

RESUMEN

The molecular theory of L. Poling is a genius example of scientific prediction, made in the middle of 20th century, when the studies about clathrates and methods of roentgen structured analysis were doing their first steps. The views expressed in this message are some additions on the structure of xenon clathrates, function-free xenon water associates and the use of cameras in the liberated associates of the water molecules, for the process of supramolecular detoxification and attempts to develop this theory more widely, to better understand the mechanisms of xenon anesthesia and treatment for further justification of its therapeutic features as well as for the use of other inert gases (Ar, Kr) in modern medicine.


Asunto(s)
Anestesia por Inhalación , Anestésicos por Inhalación/uso terapéutico , Fármacos Neuroprotectores/uso terapéutico , Xenón/uso terapéutico , Anestesia por Inhalación/métodos , Anestésicos por Inhalación/química , Anestésicos por Inhalación/farmacocinética , Anestésicos por Inhalación/farmacología , Cristalización , Humanos , Fármacos Neuroprotectores/química , Fármacos Neuroprotectores/farmacocinética , Fármacos Neuroprotectores/farmacología , Agua/química , Xenón/química , Xenón/farmacocinética , Xenón/farmacología
5.
Acta Anaesthesiol Scand ; 52(4): 509-13, 2008 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-18261199

RESUMEN

BACKGROUND: The fluid absorption that occurs during transurethral resection of the prostate (TURP) can be indicated and quantified by the ethanol method. Recently, nitrous oxide (N(2)O) was tested in animals and volunteers and seemed to be more accurate and safe. The present study compared these two methods in surgical patients. METHODS: Eighty-six TURPs were performed at two hospitals using an irrigating fluid that contained 3% mannitol, 1% ethanol and 0.004% N(2)O (40 ml/l). The ethanol concentration was measured by end-expiratory tests every 10 min. The N(2)O concentration was measured by a flared nasal cannula every second. Fluid absorption was calculated based on a regression equation (ethanol method) from the area under the curve based on the samples where CO(2) >median (N(2)O method). RESULTS: Thirteen patients (15%) absorbed >300 ml of fluid as indicated by the ethanol method. The median volume was 707 ml (range 367-1422). Ethanol yielded higher figures for fluid absorption up to 700-800 ml, whereafter the N(2)O method indicated that the absorption was larger. Over the entire range, the mean difference between the two methods at the end of any 10-min period of TURP was only +45 ml, although the 95% limits of agreement were quite separated (-479 to +569 ml). CONCLUSIONS: The N(2)O method does not require forced breath sampling and was successfully apply clinically. However, there was a dose-dependent difference in result between the ethanol and N(2)O methods, which markedly separated the limits of agreement for a wider range of fluid absorption events.


Asunto(s)
Anestésicos por Inhalación/farmacocinética , Monitoreo Intraoperatorio/métodos , Óxido Nitroso/farmacocinética , Resección Transuretral de la Próstata/métodos , Absorción , Anciano , Anciano de 80 o más Años , Anestésicos por Inhalación/administración & dosificación , Anestésicos por Inhalación/efectos adversos , Área Bajo la Curva , Pruebas Respiratorias/métodos , Depresores del Sistema Nervioso Central/administración & dosificación , Depresores del Sistema Nervioso Central/efectos adversos , Depresores del Sistema Nervioso Central/farmacocinética , Diuréticos Osmóticos/administración & dosificación , Relación Dosis-Respuesta a Droga , Etanol/administración & dosificación , Etanol/efectos adversos , Etanol/farmacocinética , Humanos , Masculino , Manitol/administración & dosificación , Óxido Nitroso/administración & dosificación , Óxido Nitroso/efectos adversos , Valor Predictivo de las Pruebas , Reproducibilidad de los Resultados , Irrigación Terapéutica/métodos , Factores de Tiempo
6.
Rev. esp. anestesiol. reanim ; 55(1): 26-31, ene. 2008. ilus, tab
Artículo en Es | IBECS | ID: ibc-71968

RESUMEN

OBJETIVOS: Evaluar los efectos electrofisiológicos delsevoflurano en niños con síndrome de Wolff-Parkinson-White (WPW) sometidos a ablación por radiofrecuencia(RF).MÉTODOs: Se estudiaron de forma prospectiva 15pacientes con síndrome de WPW, programados paraestudio electrofiosológico (EEF) y ablación por RF.La inducción anestésica se realizó con fentanilo (2 μkg–1), propofol (3 mg kg–1) y vecuronio (0,1 mg kg–1) y el mantenimiento con propofol (100 μ kg–1 min–1), bolus de fentanilo y vecuronio según necesidades. El EEF(EEFpropofol) se practicó mediante la introducción de cuatro electrocatéteres intracardiacos. Se determinaron la función del nodo sinusal, la conducción sinoatrial, períodos refractarios (auricular, nodo AV, anterógrado y retrógrado de la vía accesoria, ventricular)y características de la taquicardia ortodrómicainducida. Posteriormente, se intercambió propofol por sevoflurano (1 MAC según edad) repitiendo las mediciones(EEFsevoflurano). Los parámetros EEFpropofol y EEFsevoflurano se compararon mediante el test de Wilcoxon. RESULTADOS: La edad media fue de 9,3 ± 6 años. Trasla administración de sevoflurano se produjo un alargamiento del período refractario efectivo anterógrado de la vía accesoria (EEFpropofol 283 ± 22 ms; EEFsevoflurano 298 ± 25 ms; p = 0,004), y del ciclo mínimo de estimulación con conducción ventrículo-atrial 1:1 (EEFpropofol 244 ± 41 ms; EEFsevoflurano 273 ± 28 ms; p = 0,028). No hubo cambios significativosen el resto de los parámetros. En todos lospacientes se consiguió la ablación de la vía accesoria.CONCLUSIONES: El sevoflurano modificó parcialmentelas propiedades de la vía accesoria, aunque esto no impidióla ablación de la misma


OBJECTIVE: To evaluate the electrophysiologicaleffects of sevoflurane in children with Wolff-Parkinson-White (WPW) syndrome undergoing radiofrequencyablation.METHODS: We performed a prospective study of 15patients with WPW syndrome who were scheduled foran electrophysiological study (EPS) and radiofrequencyablation.Anesthesia was induced with fentanyl (2 μg/kg),propofol (3 mg/kg), and vecuronium (0.1 mg/kg), andinitially maintained using propofol (100 μg/kg), withbolus administration of fentanyl and vecuronium asrequired. Four intracardiac catheters were introducedfor the EPSpropofol, which included measurements ofsinus-node function, sinoatrial-node conduction,refractory periods (atrial, AV-node, accessory pathwayanterograde and retrograde, and ventricular), and thecharacteristics of induced orthodromic tachycardia.The propofol was then replaced with sevoflurane (1MAC adjusted for age) and the measurements wererepeated (EPSsevoflurane). The EPSpropofol and EPSsevoflurane data were compared using the Wilcoxon signed-rank test.RESULTS: The mean (SD) age was 9.3 (6 ) years. Afteradministration of sevoflurane, the duration of the antegrade effective refractory period of the accessory pathway increased (EPSpropofol, 283 (22) ms; EPSsevoflurane, 298 (25) ms; P = .004), as did the duration of the minimum pacing cycle with 1:1 atrioventricular conduction (EPSpropofol, 244 (41) ms; EPSsevoflurane, 273 (28) ms; P = .028). No significant changes were observed in the other parameters. Ablation of the accessory pathway was achieved in all patients.CONCLUSIONS: Sevoflurane partially modified the properties of the accessory pathway but did not prevent ablation


Asunto(s)
Humanos , Masculino , Femenino , Niño , Síndrome de Wolff-Parkinson-White/fisiopatología , Propofol/farmacocinética , Técnicas Electrofisiológicas Cardíacas , Estudios Prospectivos , Ablación por Catéter , Arritmias Cardíacas/diagnóstico , Anestésicos por Inhalación/farmacocinética
7.
Br J Anaesth ; 100(1): 72-7, 2008 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-17998223

RESUMEN

BACKGROUND: The relationship between measures of drug effect such as bispectral index (BIS) and end-tidal (ET) levels of anaesthetic agents is described by the 'effect site equilibrium half-time', t(1/2)(ke0). There are limited data available on sevoflurane t(1/2)(ke0) during routine anaesthesia and surgery. Preliminary observations suggested t(1/2)(ke0) for the degree of hypnosis as estimated by BIS is different from that for burst suppression of the electroencephalograph, occurring at 'deep' levels of anaesthesia. This study aimed to determine and compare t(1/2)(ke0) for these two 'effects'. METHODS: Large changes in ET sevoflurane were produced in 13 subjects during surgery. ET sevoflurane, BIS, and burst suppression ratio (BSR) were recorded every 10 s. Data were divided into epochs with BIS>30 (BIS) or with BSR>10% (burst suppression). Using a non-parametric modelling technique, t(1/2)(ke0) was determined for each epoch. RESULTS: There were 36 'BIS' and 20 burst suppression zones. Mean (sd) t(1/2)(ke0) for BIS was 3.48 (1.12) min and for BSR 9.9 (6.4) min. In all subjects, t(1/2)(ke0) BIS

Asunto(s)
Anestésicos por Inhalación/farmacología , Electroencefalografía/efectos de los fármacos , Éteres Metílicos/farmacología , Adulto , Anciano , Anciano de 80 o más Años , Anestésicos por Inhalación/administración & dosificación , Anestésicos por Inhalación/farmacocinética , Femenino , Semivida , Humanos , Hipnosis Anestésica , Masculino , Éteres Metílicos/administración & dosificación , Éteres Metílicos/farmacocinética , Persona de Mediana Edad , Monitoreo Intraoperatorio/métodos , Sevoflurano , Procesamiento de Señales Asistido por Computador
8.
Am J Vet Res ; 66(8): 1364-70, 2005 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-16173479

RESUMEN

OBJECTIVE: To compare the effects of acupuncture (AP), electroacupuncture (EA), and transcutaneous cranial electrical stimulation (TCES) with high-frequency intermittent currents on the minimum alveolar concentration (MAC) of isoflurane and associated cardiovascular variables in dogs. ANIMALS: 8 healthy adult female Beagles. PROCEDURE: Each dog was anesthetized with isoflurane on 4 occasions, allowing a minimum of 10 days between experiments. Isoflurane MAC values were determined for each dog without treatment (controls) and after treatment with AP and EA (AP points included the Large Intestine 4, Lung 7, Governing Vessel 20, Governing Vessel 14, San Tai, and Baihui) and TCES. Isoflurane MAC values were determined by use of noxious electrical buccal stimulation. Heart rate, mean arterial blood pressure (MAP), arterial blood oxygen saturation (Spo2) measured by use of pulse oximetry, esophageal body temperature, inspired and expired end-tidal isoflurane concentrations, end-tidal carbon dioxide concentration, and bispectral index (BIS) were monitored. Blood samples were collected for determination of plasma cortisol concentration. RESULTS: Mean +/- SD baseline MAC of isoflurane was 1.19 +/- 0.1%. Acupuncture did not significantly change MAC of isoflurane. Treatments with EA and TCES significantly lowered the MAC of isoflurane by 10.1% and 13.4%, respectively. The Spo2, heart rate, MAP, BIS, esophageal body temperature, and plasma cortisol concentration were not significantly different after AP, EA, TCES, and control treatments at any time interval. CONCLUSIONS AND CLINICAL RELEVANCE: Use of EA and TCES decreased MAC of isoflurane in dogs without inducing adverse hemodynamic effects. However, the reduction in isoflurane MAC by EA andTCES treatments was not considered clinically relevant.


Asunto(s)
Terapia por Acupuntura/veterinaria , Anestesia por Inhalación/veterinaria , Anestésicos por Inhalación/farmacocinética , Perros/cirugía , Isoflurano/farmacocinética , Estimulación Eléctrica Transcutánea del Nervio/veterinaria , Anestesia por Inhalación/métodos , Animales , Presión Sanguínea , Temperatura Corporal , Estudios Cruzados , Perros/metabolismo , Perros/fisiología , Electroacupuntura/veterinaria , Femenino , Frecuencia Cardíaca , Hidrocortisona/sangre , Alveolos Pulmonares/metabolismo
9.
J Vet Med Sci ; 65(1): 145-7, 2003 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-12576723

RESUMEN

The effect of electroacupuncture (EA) on minimum alveolar concentration (MAC) of isoflurane was evaluated in dogs. After determination of baseline MAC, EA was applied at each acupoints (LI-4, SP-6, ST-36 and TH-8) and nonacupoint for 30 min. MAC was determined again. EA at acupoints significantly lowered the MAC of isoflurane in dogs (17.5 +/- 3.1%, 21.3 +/- 8.0%, 21.2 +/- 7.5% and 15.4 +/- 3.1%, respectively). In control group and nonacupoint electrical stimulation group MAC were not decreased significantly. From these results, electroacupuncture at each acupoints used in the present study would have an advantage in isoflurane anesthesia with reducing its requirement.


Asunto(s)
Anestésicos por Inhalación/farmacocinética , Electroacupuntura/veterinaria , Isoflurano/farmacocinética , Alveolos Pulmonares/metabolismo , Anestesia por Inhalación/veterinaria , Animales , Perros , Masculino
10.
Minerva Anestesiol ; 68(6): 523-7, 2002 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-12105408

RESUMEN

BACKGROUND: The aim of this prospective, randomized study is to compare sevoflurane and isoflurane pharmacokinetics in morbidly obese patients. METHODS: With Ethical Committee approval and written informed consent, 14 obese patients (BMI >35 kg/m2), ASA physical status II, undergoing laparoscopic, silicone-adjustable gastric banding were randomly allocated to receive either sevoflurane (n=7) or isoflurane (n=7) as main anesthetic agents. General anesthesia was induced with 1 mg x kg-1 fentanyl, 6 mg x kg-1 sodium thiopental, and 1 mg x kg-1 succinylcholine followed by 0.4 mg kg-1 x h-1 atracurium bromide (doses were referred to ideal body weight). Intermittent positive pressure ventilation (IPPV) was applied using a Servo-900C ventilator with a nonrebreathing circuit and a 15 l x min-1 fresh gas flow (tidal volume: of 10 ml x kg-1; respiratory rate: 12 breaths/min; inspiratory to expiratory time ratio of 1:2) using an oxygen/air mixture (FiO2=50%), while supplemental boluses of thiopental or fentanyl were given as indicated in order to maintain blood pressure and heart rate values within +/-20% from baseline. After adequate placement of tracheal tube and stabilization of the ventilation parameters, 2% sevoflurane or 1.2% isoflurane was given for 30 min via a nonrebreathing circuit. End-tidal samples were collected at 1, 5, 10, 15, 20, 25 and 30 min, and measured using a calibrated infrared gas analyzer. General anesthesia was then maintained with the same inhalational agents, while supplemental fentanyl was given as indicated. After the last skin suture the inhalational agents were suspended, and the end tidal samples were collected at 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 4.5, and 5 min. Then the lungs were manually ventilated until extubation. RESULTS: No differences in age, gender and body mass index were reported between the two groups. Surgical procedure required 91+/-13 in the sevoflurane group and 83+/-32 min in the isoflurane group. The FA/FI ratio was higher in the sevoflurane group from the 5th to the 30th min. Also the washout curve was faster in the sevoflurane group during the observation period; however, the observed differences were statistically significant only 30 and 60 sec after discontinuation of the inhalational agents. CONCLUSIONS: The results of this prospective, randomized study confirmed that sevoflurane provides more rapid wash-in and wash-out curves than isoflurane also in the morbid obese patient.


Asunto(s)
Anestesia , Anestésicos por Inhalación/farmacocinética , Éteres Metílicos/farmacocinética , Obesidad Mórbida/complicaciones , Adulto , Método Doble Ciego , Femenino , Humanos , Isoflurano/farmacocinética , Masculino , Persona de Mediana Edad , Obesidad Mórbida/metabolismo , Estudios Prospectivos , Sevoflurano
11.
J Vet Sci ; 3(3): 193-201, 2002 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-12514331

RESUMEN

The effects of electroacupuncture (EA) on the minimum alveolar concentration (MAC) and on the cardiovascular system were evaluated with dogs under isoflurane anesthesia. Eight healthy male beagles were randomly assigned to six study groups (five heads/group) with washout intervals of 7 ~ 31 days between experiments for recovery and anesthetic clearance. MAC of isoflurane and cardiovascular parameters were determined after EA at nonacupoint and and at acupoints LI-4, SP-6, ST-36 and TH-8. Electroacupuncture for 30 minutes at LI-4, SP-6, ST-36 and TH-8 acupoints lowered the MAC of isoflurane by 17.5 +/- 3.1%, 21.3 +/- 8.0%, 20.5 +/- 8.2% and 15.6 3.1%, respectively (p < 0.05). However, electrical stimulation of nonacupoint did not induce a significant change in MAC of isoflurane. In the cardiovascular system, the ST-36 group did not induce any significant change in cardiovascular parameters. In the TH-8 group, the mean and diastolic arterial pressure and the systemic vascular resistance were decreased. In the LI-4 group, cardiac output and cardiac index decreased after EA. These results indicate that EA at LI-4, SP-6 and ST-36 have advantages in isoflurane anesthesia in terms of reducing the dose of anesthetics and minimizing cardiovascular side effects.


Asunto(s)
Anestesia por Inhalación/veterinaria , Anestésicos por Inhalación/farmacocinética , Perros/metabolismo , Electroacupuntura/veterinaria , Isoflurano/farmacocinética , Alveolos Pulmonares/metabolismo , Anestesia por Inhalación/efectos adversos , Anestésicos por Inhalación/farmacología , Animales , Presión Sanguínea/efectos de los fármacos , Gasto Cardíaco , Perros/fisiología , Frecuencia Cardíaca/efectos de los fármacos , Isoflurano/farmacología , Masculino , Presión Esfenoidal Pulmonar/efectos de los fármacos , Distribución Aleatoria , Resistencia Vascular/efectos de los fármacos
12.
Artículo en Inglés | WPRIM | ID: wpr-22473

RESUMEN

The effects of electroacupuncture (EA) on the minimum alveolar concentration (MAC) and on the cardiovascular system were evaluated with dogs under isoflurane anesthesia. Eight healthy male beagles were randomly assigned to six study groups (five heads/group) with washout intervals of 7 ~ 31 days between experiments for recovery and anesthetic clearance. MAC of isoflurane and cardiovascular parameters were determined after EA at nonacupoint and and at acupoints LI-4, SP-6, ST-36 and TH-8. Electroacupuncture for 30 minutes at LI-4, SP-6, ST-36 and TH-8 acupoints lowered the MAC of isoflurane by 17.5 +/- 3.1%, 21.3 +/- 8.0%, 20.5 +/- 8.2% and 15.6 +/- 3.1%, respectively (p < 0.05). However, electrical stimulation of nonacupoint did not induce a significant change in MAC of isoflurane. In the cardiovascular system, the ST-36 group did not induce any significant change in cardiovascular parameters. In the TH-8 group, the mean and diastolic arterial pressure and the systemic vascular resistance were decreased. In the LI-4 group, cardiac output and cardiac index decreased after EA. These results indicate that EA at LI-4, SP-6 and ST-36 have advantages in isoflurane anesthesia in terms of reducing the dose of anesthetics and minimizing cardiovascular side effects.


Asunto(s)
Animales , Masculino , Anestesia por Inhalación/efectos adversos , Anestésicos por Inhalación/farmacocinética , Presión Sanguínea/efectos de los fármacos , Gasto Cardíaco , Perros/metabolismo , Electroacupuntura/veterinaria , Frecuencia Cardíaca/efectos de los fármacos , Isoflurano/farmacocinética , Alveolos Pulmonares/metabolismo , Presión Esfenoidal Pulmonar/efectos de los fármacos , Distribución Aleatoria , Resistencia Vascular/efectos de los fármacos
13.
IEEE Trans Biomed Eng ; 48(8): 874-89, 2001 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-11499525

RESUMEN

A model-based closed-loop control system is presented to regulate hypnosis with the volatile anesthetic isoflurane. Hypnosis is assessed by means of the bispectral index (BIS), a processed parameter derived from the electroencephalogram. Isoflurane is administered through a closed-circuit respiratory system. The model for control was identified on a population of 20 healthy volunteers. It consists of three parts: a model for the respiratory system, a pharmacokinetic model and a pharmacodynamic model to predict BIS at the effect compartment. A cascaded internal model controller is employed. The master controller compares the actual BIS and the reference value set by the anesthesiologist and provides expired isoflurane concentration references to the slave controller. The slave controller maneuvers the fresh gas anesthetic concentration entering the respiratory system. The controller is designed to adapt to different respiratory conditions. Anti-windup measures protect against performance degradation in the event of saturation of the input signal. Fault detection schemes in the controller cope with BIS and expired concentration measurement artifacts. The results of clinical studies on humans are presented.


Asunto(s)
Anestesia por Circuito Cerrado/métodos , Anestésicos por Inhalación/farmacología , Electroencefalografía , Isoflurano/farmacología , Monitoreo Fisiológico/métodos , Adulto , Anestésicos por Inhalación/administración & dosificación , Anestésicos por Inhalación/farmacocinética , Electrodos , Diseño de Equipo , Femenino , Hemodinámica , Humanos , Isoflurano/administración & dosificación , Isoflurano/farmacocinética , Masculino , Persona de Mediana Edad , Modelos Teóricos , Análisis de Regresión , Procesamiento de Señales Asistido por Computador
14.
Am J Ther ; 8(4): 237-41, 2001.
Artículo en Inglés | MEDLINE | ID: mdl-11441322

RESUMEN

The objective of this study was to predict minimum alveolar concentration (MAC) of inhalational anesthetics in humans from animal data. The MAC of 10 anesthetics was obtained from the literature. At least three animal species (excluding humans) were used in the scaling. Interspecies scaling of MAC was performed in two ways: (1) using the traditional allometric approach, the MAC of each drug was plotted against the body weight of the species on a log-log scale, and MAC in humans was predicted from the resultant equation; and (2) MAC in each species was multiplied by a correction factor obtained by adjusting the lung weight of the species based on per kg body weight. The product of the correction factor and the MAC was then plotted against body weight as described in the traditional approach. Predicted MAC values in humans from animal data using simple allometry produced comparatively more error than the prediction made by incorporating the correction factor into the scaling. The results of this study indicate that MAC may not be predicted in humans from animal data using simple allometry; however, applying a correction factor may significantly improve the prediction of MAC in humans from animal data.


Asunto(s)
Anestésicos por Inhalación/farmacocinética , Pulmón/anatomía & histología , Modelos Animales , Alveolos Pulmonares/metabolismo , Anestésicos por Inhalación/administración & dosificación , Animales , Peso Corporal , Perros , Evaluación Preclínica de Medicamentos , Haplorrinos , Ratones , Tamaño de los Órganos , Valor Predictivo de las Pruebas , Conejos , Ratas , Especificidad de la Especie
15.
Anesthesiology ; 91(6): 1770-9, 1999 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-10598621

RESUMEN

BACKGROUND: Anesthetics, including isoflurane, depress the electroencephalogram (EEG). Little is known about the quantitative effects of isoflurane on EEG and subcortical electrical activity responses to noxious stimulation. The authors hypothesized that isoflurane would depress the results of EEG and subcortical response to noxious stimulation at concentrations less than those needed to suppress movement. Furthermore, determination of regional differences might aid in elucidation of sites of anesthetic action. METHODS: Ten goats were anesthetized with isoflurane, and minimum alveolar concentration (MAC) was determined using a noxious mechanical stimulus. Depth electrodes were inserted into the midbrain reticular formation and thalamus. Needle electrodes placed in the skull periosteum measured bifrontal and bihemispheric EEG. The noxious stimulus was applied at each of four anesthetic concentrations: 0.6, 0.9, 1.1, and 1.4 MAC. RESULTS: At an isoflurane concentration of 0.6 MAC, the noxious stimulus activated the midbrain reticular formation, thalamic, and bifrontal-hemispheric regions, as shown by decreased high-amplitude, low-frequency power. For all channels combined (mean +/- SD), total (-33+/-7%), delta (-47+/-12%), theta (-23+/-12%), and alpha (-21+/-6%) power decreased after the noxious stimulus (P < 0.001); beta power was unchanged. At 0.9 MAC, total (-35+/-5%), delta (-42+/-7%), theta (-35+/-8%), and alpha (-23+/-11%) power decreased after the noxious stimulus (P < 0.001); beta power was unchanged. At 1.1 MAC only one site, and at 1.4 MAC, no site, had decreased power after the noxious stimulus. CONCLUSIONS: Isoflurane blunted EEG and midbrain reticular formation-thalamus activation response to noxious stimulation at concentrations (1.1 MAC or greater) necessary to prevent movement that occurred after noxious stimulation. It is unknown whether this is a direct effect or an indirect effect via action in the spinal cord.


Asunto(s)
Anestesia por Inhalación , Anestésicos por Inhalación/farmacología , Electroencefalografía/efectos de los fármacos , Isoflurano/farmacología , Formación Reticular/efectos de los fármacos , Tálamo/efectos de los fármacos , Anestésicos por Inhalación/farmacocinética , Animales , Corteza Cerebral/efectos de los fármacos , Sincronización Cortical/efectos de los fármacos , Femenino , Cabras , Isoflurano/farmacocinética , Movimiento/efectos de los fármacos , Dolor/fisiopatología , Estimulación Física , Alveolos Pulmonares/metabolismo , Formación Reticular/fisiología , Tálamo/fisiología
16.
Anesth Analg ; 88(4): 867-76, 1999 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-10195540

RESUMEN

UNLABELLED: The Meyer-Overton hypothesis predicts that the potency of conventional inhaled anesthetics correlates inversely with lipophilicity: minimum alveolar anesthetic concentration (MAC) x the olive oil/gas partition coefficient equals a constant of approximately 1.82 +/- 0.56 atm (mean +/- SD), whereas MAC x the octanol/gas partition coefficient equals a constant of approximately 2.55 +/- 0.65 atm. MAC is the minimum alveolar concentration of anesthetic required to eliminate movement in response to a noxious stimulus in 50% of subjects. Although MAC x the olive oil/gas partition coefficient also equals a constant for normal alkanols from methanol through octanol, the constant (0.156 +/- 0.072 atm) is one-tenth that found for conventional anesthetics, whereas the product for MAC x the octanol/gas partition coefficient (1.72 +/- 1.19) is similar to that for conventional anesthetics. These normal alkanols also have much greater affinities for water (saline/gas partition coefficients equaling 708 [octanol] to 3780 [methanol]) than do conventional anesthetics. In the present study, we examined whether fluorination lowers alkanol saline/gas partition coefficients (i.e., decreases polarity) while sustaining or increasing lipid/gas partition coefficients, and whether alkanols with lower saline/gas partition coefficients had products of MAC x olive oil or octanol/gas partition coefficients that approached or exceeded those of conventional anesthetics. Fluorination decreased saline/gas partition coefficients to as low as 0.60 +/- 0.08 (CF3[CF2]6CH2OH) and, as hypothesized, increased the product of MAC x the olive oil or octanol/gas partition coefficients to values equaling or exceeding those found for conventional anesthetics. We conclude that the greater potency of many alkanols (greater than would be predicted from conventional inhaled anesthetics and the Meyer-Overton hypothesis) is associated with their greater polarity. IMPLICATIONS: Inhaled anesthetic potency correlates with lipophilicity, but potency of common alkanols is greater than their lipophilicity indicates, in part because alkanols have a greater hydrophilicity--i.e., a greater polarity.


Asunto(s)
Anestésicos por Inhalación/química , Alveolos Pulmonares/química , Alcoholes/química , Alcanos/química , Anestésicos por Inhalación/análisis , Anestésicos por Inhalación/farmacocinética , Animales , Encéfalo/metabolismo , Flúor/química , Gases/química , Masculino , Estructura Molecular , Aceite de Oliva , Aceites de Plantas/química , Alveolos Pulmonares/metabolismo , Ratas , Ratas Sprague-Dawley , Cloruro de Sodio/química , Solubilidad , Organismos Libres de Patógenos Específicos
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