[Utilization of euthanatic agents; experience of physicians with 227 patients, 1998-2000]. / Toepassing van euthanatica; ervaringen van artsen bij 227 patiënten, 1998-2000.

OBJECTIVE: To determine the experiences of physicians in the application of euthanatics. DESIGN: Descriptive. METHOD: The report 'Toepassing en bereiding van euthanatica' [Use and Preparation of Euthanatics] prepared by the national pharmacists' association contains a questionnaire for physicians regarding the condition of the patient, the method followed and time till death. The report was sent on request 723 times. From August 1998 until May 2000, 227 questionnaires were returned by general practitioners. These questionnaires were analysed. RESULTS: In 73.1% of the cases the euthanatic substance was given intravenously, in 26.4% orally. Time until death varied from 0 to 30 min when applied intravenously and 8 minutes to 7 hours when applied orally. On 51 questionnaires problems were registered which may occur when euthanatics are applied: difficult intravenous injection, too large volume of solute for the thiopental, deposit in the syringe, too little time between the intravenous administration and decease, unpleasant taste of euthanatic drink, too large volume of euthanatic drink, and too much time between the oral intake of the drink and decease.

Comparison of intramuscular nalbuphine and nicomorphine in the treatment of post-operative pain.

Nalbuphine and nicomorphine were administered intramusculary in single doses for the relief of moderate to severe pain after abdominal surgery in a group of 40 patients to compare the analgesic effect and clinical tolerance during a 2 hour period. There was no statistically significant difference of the analgesic effect. In both groups SBP, DBP and RR decreased and HR increased significantly after injection but the tolerance of nalbuphine seems to be beter. Nalbuphine is a good choice for postoperative pain.

Enkephalinase inhibition prevented tolerance to nitrous oxide analgesia in rats.

Tolerance to nitrous oxide (N2O) antinociception was studied in rats in accordance with the Randall-Selitto pressure nociception test. Both N2O (70% in 30% O2) and the relatively selective enkephalinase inhibitor phosphoramidon (350 micrograms i.c.v.), which blocks the biotransformation of enkephalins, were administered. They both induced a significant analgesic effect which vanished within 45 min. The rapidly developed tolerance to N2O analgesia does not affect the anaesthetic state since the animals remained motionless for the duration of exposure lasting 3 h. In the animals treated with the enkephalinase inhibitor phosphoramidon, no development of tolerance to N2O-antinociception occurred during the exposure lasting 3 h. The results indicate that tolerance to N2O analgesia can be abolished by activation of the enkephalinergic system, which might suggest a possible insufficiency of this system during tolerance to N2O.

Effect of phosphoramidon - a selective enkephalinase inhibitor - on nociception and behaviour.

Phosphoramidon (100-350 micrograms i.c.v.), a selective enkephalinase inhibitor, induced in the rat a decrease of nociception to pressure stimulation without evident respiratory depression. In addition, intensive behavioural changes such as grooming (licking the fur, face washing and scratching), mounting behaviour and wet dog shakes were observed. Naltrexone pretreatment (1 mg/kg i.p.) caused a significant decrease in the phosphoramidon-induced nociception and behavioural changes. Puromycin (30 micrograms i.c.v. or 7.5 mg/kg i.p.) caused no changes in nociception or behaviour.