Systemic hypertension induced by aortic cross-clamping: detrimental effects of direct smooth muscle relaxation compared with ganglionic blockade.

PURPOSE: Infrarenal aortic cross-clamping performed during vascular reconstructive procedures is often accompanied by systemic supraclamp hypertension. Much of the disease and death that attend aortic cross-clamping centers around hypertension. Many different strategies have been developed to attenuate intraoperative hypertension, and a host of pharmacologic agents are regularly used to lessen the heart-related, cerebral, and systemic effects of clamp-induced hypertension. This study was performed to evaluate two such strategies; the intravenous administration of either trimethaphan camsylate or nitroprusside. METHODS: We used a highly controllable and reproducible model of aortic cross-clamping in which we have previously shown the hypertension associated with clamping to be an active process mediated by means of a reflex arc. Ten dogs, five treated with nitroprusside (NP group) and five treated with trimethaphan camsylate (TC group), underwent 90 minutes of aortic cross-clamping. During this 90-minute period each group received 30 minutes of antihypertensive therapy. RESULTS: Control mean arterial pressure +/- SEM was 80 +/- 5 mm Hg for both groups and increased to 140 +/- 5 mm Hg with clamp application. With antihypertensive treatment the elevation in mean arterial pressure produced by cross-clamping was reduced to preclamp levels in the TC group and only partially (52%) in the NP group, despite very high doses of nitroprusside. Cardiac output (CO) increased in the NP group by 115% and decreased by 36% in the TC group. This increase in CO translates into a large (101%) increase in cardiac minute work for the NP group. CONCLUSIONS: The attenuation of clamp-induced hypertension by nitroprusside is associated with a dramatic increase in CO and cardiac work whereas the use of trimethaphan camsylate is not. The use of this ganglionic blocker may be more appropriate in this setting.

Sphenopalatine ganglion blocks for the treatment of nicotine addiction.

The purpose of this study was to investigate the effects of sphenopalatine ganglion block upon the physical symptoms of nicotine withdrawal in a double-blind placebo-controlled study. Seventeen patients completed a course of treatment which involved daily intranasal application of local anesthetic (bupivacaine or cocaine) or saline over the sphenopalatine ganglion. The reported numbers of daily symptoms of physical discomfort were recorded during the preprocedure period. Analysis of variance results indicated that patients in all three groups experienced a significant decline in the number of symptoms of physical discomfort over the six-day withdrawal period. Further findings provided evidence of significantly fewer symptoms of discomfort for patients in the anesthetic treatment groups than in the placebo control group, though no statistically significant difference emerged between the two anesthetic treatment groups. Accelerated alleviation of discomfort during nicotine withdrawal may increase the success of smoking cessation.

[Evaluation of tiquizium bromide (HSR-902) as an antiulcer agent].

The effects of HSR-902, an antimuscarinic agent, on development of various gastric and duodenal lesions, gastric secretion, pupil size and salivation in rats were compared with those of pirenzepine.2HC1 (pirenzepine, antiulcer agent) and timepidium bromide (timepidium, antispasmodic). 1) HSR-902 (10-100 mg/kg), given orally, dose-dependently inhibited the developments of gastric lesions induced by water-immersion stress, aspirin, indomethacin, serotonin and reserpine and duodenal lesions induced by cysteamine and mepirizole. The activities of HSR-902 were almost equal or somewhat more potent than those of pirenzepine, and they were more potent than those of timepidium. 2) HSR-902 (30 and 100 mg/kg, p.o.), when examined using pylorus-ligated preparations, dose-dependently inhibited the gastric acid output, pepsin output, and gastric acid and pepsin concentrations, but did not inhibit the gastric volume (HSR-902, in a higher dose, slightly increased the gastric volume.). Pirenzepine (100 mg/kg, p.o.), like atropine sulfate, inhibited the gastric volume, acid output and pepsin output, but did not inhibit the gastric acid and pepsin concentrations. Timepidium (100 mg/kg, p.o.), however, hardly influenced these parameters except for increasing the gastric volume. 3) HSR-902 (100 mg/kg, p.o.) induced the mydoriasis and inhibited the pilocarpine-induced salivation, and its activities were less potent than those of pirenzepine. These results suggest that HSR-902 is a promising agent for the treatment of peptic ulcer.

[Effect of izoturon and its combination with ganglionic blockaders and alpha-adrenoblockaders on systemic hemodynamics in traumatic shock]. / Vliianie izoturona i ego kombinatsii s ganglioblokatorami i al'fa-adrenoblokatorami na sistemnuiu gemodinamiku pri travmaticheskom shoke.

Isoturone (5 mg/kg) administered in a single dose intravenously to unanesthetized cats in a torpid phase of traumatic shock increases arterial blood pressure (BP) and total peripheral vascular resistance (TPVR). The drug restores BP level mainly due to an increase of TPVR against background of neurovegetative blockade induced by pentamine, phentolamine and combinations of phentolamine with hexonium in the presence of a severe trauma. Vascular sensitivity to isoturone in traumatic shock is preserved and considerably increases during the use of the vasopressor in different types of neurovegetative blockade.

[Effect of quateron on the dopamine and DOPA content in the stomach tissues in experimental ulcer]. / Vliianie kvaterona na soderzhanie dofamina i DOFA v tkaniakh zheludka pri ego éksperimental'noi iazve.

Experimental neurogenous ulcer is accompanied by changes in the content of dopamin (DA) and dioxypyhenylalanine (DOPA) in the tissues of different functional regions of the stomach. Two hours following injury to the pyloroduodenal region, the content of DA rises, while that of DOPA declines. After 24 hours the content of the monoamine and especially that of the amino acid decreases along with emergence and development of morphological changes (hemorrhages, erosions, ulcers) in the gastric wall. The cholinolytic quateron administered prior to the injury prevents reliably the affection of the gastric mucosa and blocks to a certain measure DOPA depletion which is recorded 24 hours following exposure to the pathogenetic agent. The utiulcerous effect of quateron is potentiated by DOPA administration (100 mg/kg).