RESUMO
The effect of pancuronium 0.1 mg/kg i.v. on heart rate (HR) and mean arterial blood pressure were investigated in two groups of eight patients, each receiving inhalational anaesthesia with either halothane or cyclopropane. A more pronounced effect on HR in the cyclopropane group with a mean increase of 104% occurred. The mean increase in the halothane group was 54%. There was a statistically significant difference (P less than 0.05) between the HR increases The vagolytic effect of pancuronium and the influence of halothane and cyclopropane on the autonomic nervous system are discussed.
Assuntos
Anestesia , Ciclopropanos , Halotano , Hemodinâmica/efeitos dos fármacos , Pancurônio/farmacologia , Adulto , Arritmias Cardíacas/induzido quimicamente , Pressão Sanguínea/efeitos dos fármacos , Feminino , Frequência Cardíaca/efeitos dos fármacos , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
In a patients with severe pulmonary hypertension, haemodynamic observations, including cardiac output and pressure measurement in the systemic and the pulmonary circulation, were performed during vaginal delivery under selective segmental epidural block from T9 to L1 combined with bilateral pudendal blocks. No hypotensive episodes were observed in connection with the epidural block, but a gradual increase in the pulmonary pressures was observed during the stages of delivery. After perineal analgesia was achieved with bilateral pudendal blocks, a 2100 g girl with an Apgar score of 9 at 1 min was delivered by vacuum extraction. The patient died 9 days after the delivery because of intractable cardiac failure.
Assuntos
Anestesia Epidural , Anestesia Obstétrica , Hipertensão Pulmonar , Complicações Cardiovasculares na Gravidez , Pressão Sanguínea , Débito Cardíaco , Feminino , Humanos , Hipertensão Pulmonar/fisiopatologia , Gravidez , Complicações Cardiovasculares na Gravidez/fisiopatologia , Circulação Pulmonar , Fatores de TempoRESUMO
The effects of induction of anaesthesia by ketamine 2 mg.kg-1 were studied in six patients with valvular heart disease before tracheal intubation and operation. Cardiac index was unaffected because a mean decrease in stroke index was compensated for a mean increase in heart rate. A significant increase was found in mean arterial pressure, pulmonary arterial mean pressure, pulmonary capillary wedge pressure and central venous pressure. Systemic vascular resistance increased, but not significantly, whereas pulmonary vascular resistance increased significantly by more than 150 per cent. Right ventricular minute work index increased in all patients, and the increase was as much as 400 per cent. Left ventricular minute work index increased in four of the six patients, but the magnitude of the increase was not so marked. It is therefore concluded that ketamine causes pronounced pulmonary vasoconstriction and an undesirable strain on the myocardium. Such effects could prove deleterious in patients with limited functional reserve of the right ventricle.
Assuntos
Anestesia Geral , Doenças das Valvas Cardíacas/fisiopatologia , Hemodinâmica/efeitos dos fármacos , Ketamina/farmacologia , Idoso , Feminino , Próteses Valvulares Cardíacas , Humanos , Masculino , Pessoa de Meia-Idade , Circulação Pulmonar/efeitos dos fármacosRESUMO
The haemodynamic effects of the induction of anaesthesia with Althesin 0.1 ml.kg-1 were studied in eight patients with valvular heart disease before tracheal intubation and surgery. A 20 per cent reduction in stroke index was compensated for by an increase in heart rate of similar magnitude. Cardiac index, mean arterial, pulmonary arterial, central venous and pulmonary capillary wedge pressures and systemic vascular resistance were unaffected. Pulmonary vascular resistance declined by nearly 30 per cent. It is therefore conclude that Althesin causes only minimal cardiovascular depression in patients with valvular heart disease.