RESUMO
In 10 patients after mitral or/and aortic valve replacement, terbutaline was given intramuscularly (10 mcg/kg body wt.) to see what cardiovascular and respiratory effects were produced. A marked cardiovascular effect was seen. Increase in heart rate (20%) was of sinus or atrial origin, no ventricular arrhythmias were seen. Cardiac index rose (46%) left and right stroke work increased (18%, 31%); systemic and pulmonary vascular resistance decreased (32%, 19%); Arterial oxygen tension decreased from 134 to 102 mmHg (24%); O2-consumption remained unchanged. Except for an increase in compliance no changes in respiratory dynamics occurred in the total respiratory system. Terbutaline's cardiovascular effects, its low toxicity, lack of ventricular arrhythmias and unchanged oxygen consumption, indicate that it could be useful to patients where an increase in cardiac output and improvement in peripheral circulation is needed.
Assuntos
Doenças das Valvas Cardíacas/cirurgia , Hemodinâmica/efeitos dos fármacos , Respiração/efeitos dos fármacos , Terbutalina/uso terapêutico , Adulto , Idoso , Feminino , Humanos , Complacência Pulmonar/efeitos dos fármacos , Masculino , Pessoa de Meia-Idade , Oxigênio/sangue , Circulação Pulmonar/efeitos dos fármacosAssuntos
Clordiazepóxido/efeitos adversos , Insuficiência Respiratória/induzido quimicamente , Doença Aguda , Adulto , Idoso , Clordiazepóxido/uso terapêutico , Drenagem , Feminino , Humanos , Inalação , Intubação Intratraqueal , Masculino , Pessoa de Meia-Idade , Psicoses Alcoólicas/tratamento farmacológico , Respiração Artificial , Insuficiência Respiratória/mortalidade , Insuficiência Respiratória/terapiaAssuntos
Anestesia Geral , Transplante de Coração , Adulto , Humanos , Masculino , Doadores de Tecidos , Transplante HomólogoRESUMO
This is a report of anaesthesia in one year in The Gambia. The problems related to the development of an anaesthetic service are described and the important function of nurse anaesthetists is emphasised. Recommendations are made about future developments of the specialty.
Assuntos
Serviço Hospitalar de Anestesia/organização & administração , Anestesia , Departamentos Hospitalares/organização & administração , Criança , Países em Desenvolvimento , Feminino , Gâmbia , Humanos , Masculino , Enfermeiros Anestesistas/estatística & dados numéricos , Gravidez , Recursos HumanosRESUMO
The haemodynamic effects of nitroprusside (SNP) were studied in six patients undergoing surgery for intracranial aneurysm under controlled hypotension in endotracheal anaesthesia with halothane-nitrous oxide during hypocapnia. Mean arterial pressure was reduced with SNP from mean 12.25 kPa to mean 8.29 kPa (32%). There were concomitant statistically significant decreases in systemic vascular resistance (-21%), cardiac index (-17%), stroke index (-23%), pulmonary arterial mean pressure (-27%) and pulmonary capillary wedge pressure (-27%). Heart rate, central venous pressure and pulmonary vascular resistance did not change significantly. After the infusion of SNP was discontinued all parameters, except cardiac index and heart rate, returned to values not significantly different from the control values. The hypotension induced by SNP resulted from reductions in cardiac index and systemic vascular resistance. The reduction in cardiac index did not reach a critical level in any of the patients.