The effect of slightly warm temperature on work performance and comfort in open-plan offices - a laboratory study.

The aim of the study was to determine the effect of a temperature of 29°C on performance in tasks involving different cognitive demands and to assess the effect on perceived performance, subjective workload, thermal comfort, perceived working conditions, cognitive fatigue, and somatic symptoms in a laboratory with realistic office environment. A comparison was made with a temperature of 23°C. Performance was measured on the basis of six different tasks that reflect different stages of cognitive performance. Thirty-three students participated in the experiment. The exposure time was 3.5 h in both thermal conditions. Performance was negatively affected by slightly warm temperature in the N-back working memory task. Temperature had no effect on performance in other tasks focusing on psychomotor, working memory, attention, or long-term memory capabilities. Temperature had no effect on perceived performance. However, slightly warm temperature caused concentration difficulties. Throat symptoms were found to increase over time at 29°C, but no temporal change was seen at 23°C. No effect of temperature on other symptoms was found. As expected, the differences in thermal comfort were significant. Women perceived a temperature of 23°C colder than men.

Nebulized bupivacaine attenuates the heart rate response following tracheal intubation.

STUDY OBJECTIVE: To determine whether nebulized bupivacaine attenuates the acute hemodynamic response to laryngoscopy and intubation. DESIGN: Prospective, randomized, placebo-controlled study. SETTING: Operating room at a university medical center. PATIENTS: 40 health ASA physical status I and II patients scheduled for minor surgical procedures. INTERVENTIONS: Patients were randomized to receive 4 ml of a nebulized solution of either saline (n = 20) or 0.75% bupivacaine (n = 20) 15 minutes before induction of anesthesia. On completion of the aerosol treatment, fentanyl 1.5 micrograms/kg was given intravenously (i.v.), and 3 minutes later anesthesia was induced with thiopental sodium 5 mg/kg i.v. and succinylcholine 1.5 mg/kg i.v.. Laryngoscopy was begun 60 seconds after induction, and the trachea was intubated at 90 seconds. Anesthesia was maintained with 50% nitrous oxide in oxygen following intubation, and 1% isoflurane was administered at 180 seconds. MEASUREMENTS AND MAIN RESULTS: Heart rate (HR) and blood pressure were recorded automatically every 30 seconds for 5 minutes. Bupivacaine significantly attenuated HR (p < 0.05) but not the hypertensive response to laryngoscopy and intubation. CONCLUSION: Nebulized 0.75% bupivacaine was only partially effective in blunting the hemodynamic response to tracheal intubation.

Intravenous lidocaine does not cause shivering-like tremor or alter thermoregulation.

We tested the hypotheses that systemic absorption of epidural lidocaine: (1) contributes to the shivering-like tremor seen during epidural anesthesia by causing central nervous system disinhibition of spinal reflexes, or (2) activates or alters thermoregulatory mechanisms. In a double-blind, placebo, cross-over study, nine healthy volunteers were given intravenous lidocaine (or saline) to approximate the plasma levels of lidocaine achieved during epidural anesthesia for major abdominal surgery. Five volunteers were studied in a warm room (to test for nonthermoregulatory tremor), and four volunteers were studied in a cold room (to test the effects of lidocaine on normal thermoregulation). Central temperatures, peripheral vasoconstriction, tremor and clonus were unaffected by intravenous lidocaine. We conclude that the systemic absorption of epidural lidocaine does not contribute to tremor or shivering by these mechanisms.

Continuous infusion epidural analgesia during labor: a randomized, double-blind comparison of 0.0625% bupivacaine/0.0002% fentanyl versus 0.125% bupivacaine.

The analgesic efficacy of the continuous epidural infusion of 0.0625% bupivacaine/0.0002% fentanyl was compared with the infusion of 0.125% bupivacaine alone in a randomized, double-blind study of nulliparous women. Each patient received, in sequence: 1) 3 ml of 0.5% bupivacaine with 1:200,000 epinephrine; 2) 6 ml of study solution 1 (bupivacaine-fentanyl group: 0.125% bupivacaine/0.0008% fentanyl; bupivacaine-only group: 0.25% bupivacaine alone); and 3) a continuous epidural infusion of study solution 2 at a rate of 12.5 ml/h (bupivacaine-fentanyl group: 0.0625% bupivacaine/0.0002% fentanyl; bupivacaine-only group: 0.125% bupivacaine alone). The epidural infusion was discontinued at full cervical dilatation, but patients who lacked perineal anesthesia received one or two 5-ml boluses of study solution 3 (bupivacaine-fentanyl group: 0.0625% bupivacaine alone; bupivacaine-only group: 0.125% bupivacaine alone). During the first stage of labor, 36 of 41 (88%) women in the bupivacaine-fentanyl group, and 37 of 39 (95%) women in the bupivacaine-only group, had analgesia of excellent or good quality (P = NS). During the second stage, 22 of 37 (59%) women in the bupivacaine-fentanyl group, and 23 of 35 (66%) women in the bupivacaine-only group, rated their analgesia as excellent or good (P = NS). Women in the bupivacaine-only group were more likely to have motor block at full cervical dilatation (P less than .001). There was no significant difference between groups in duration of the second stage of labor, duration of pushing, position of the vertex before delivery, method of delivery, Apgar scores, or umbilical cord blood gas and acid-base values.(ABSTRACT TRUNCATED AT 250 WORDS)

The effect of vasopressor agents upon uterine artery blood flow velocity in the gravid guinea pig subjected to ritodrine infusion.

The purpose of the present study was to assess the effects of intravenously administered vasopressors upon uterine artery blood flow velocity (UBFV) in the gravid guinea pig subjected to ritodrine infusion. Fourteen experiments were performed in 14 chronically instrumented pregnant guinea pigs near term. Immediately following a 1-h intravenous infusion of ritodrine (0.05-0.20 mg.kg.min-1), each animal received an intravenous bolus of vasopressor solution: 1) epinephrine, 0.001 mg/kg; 2) phenylephrine, 0.01 mg/kg; 3) mephentermine, 1.0 mg/kg; 4) ephedrine, 1.0 mg/kg; or 5) placebo. The experimental sequence was performed five times, so that each animal received all five solutions. The vasopressor sequence was randomly altered between animals. Infusion of ritodrine increased maternal heart rate 18 +/- 1% (P less than .0001), decreased maternal mean arterial pressure (MMAP) 4 +/- 1% (P less than .01), and decreased UBFV 5 +/- 1% (P less than .001). The four active vasopressor solutions resulted in similar, though not equivalent, increases in MMAP. Further, the MMAP response to each active vasopressor differed from the response to placebo (P less than .0001). Epinephrine and phenylephrine each significantly decreased UBFV (P less than .002). Ephedrine clearly preserved UBFV, whereas mephentermine appeared to result in an intermediate response.