Comparative Study of Recovery From Short Anaesthesia With Thiopentone or Althesin, Appartus Used and Results

Dubois, Michael; Geddes, I.C.

doi:10.1093/bja/46.4.320-a

Cited by 3 publications

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“…Results from previous studies (Dubois and Geddes, 1974) have shown that patients who received single doses of thiopentone were impaired markedly on psychomotor tasks at 2 h after administration. The e.e.g.…”

Section: Anaesthetics Unit and Eeg Department The London Hospitalmentioning

confidence: 94%

Assessment of Long-Term Recovery From Short Duration Anaethesia, Using the Cerebral Function Monitor

Dubois

Savege

Scott

1977

British Journal of Anaesthesia

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Six patients, undergoing prolonged IPPV, were given single doses of pancuronium, followed some hours later by a series of incremental doses. Plasma pancuronium concentrations were determined at frequent intervals. In each instance an electrical analog model was used to construct a two-compartment open model for that patient which could be programmed to predict the effect of the ensuing increments (Hull and McLeod, 1976 former was a reasonable indicator of the development of lactic acidosis, probably resulting from tissue hypoxia. (7) SNP 1.5 mg/kg body weight is a safe maximum dose for an infusion of short duration. THE METABOLISM AND TOXICITY OF SODIUM NITROPRUSSIDE P. SIMPSON, L. ADAMS, P. COLE AND C. VESEY Department of Anaesthetics, St Bartholomew's Hospital, LondonSodium nitroprusside (SNP) breaks down in whole blood to yield free cyanide (HCN). The presence of sulphydryl groups is probably necessary for this reaction both in plasma (Vesey, Cole and Simpson, 1976a) and in red cells. The decomposition of SNP may occur in the erythrocytes and necessitates the free transfer of the intact nitroprusside molecule across the red cell membrane (Smith and Kruszyna, 1974). Two groups of anaesthetized dogs received either bolus doses of potassium cyanide 1.09 mg/kg body weight or bolus doses of SNP 1 mg/kg body weight. The increase and decrease of plasma and red cell cyanide concentrations in these two groups were compared in order to assess the rate of breakdown of SNP and the detoxication of HCN.A third group of anaesthetized dogs received SNP 1.5 mg/kg body weight at a steady rate for 1 h, in order to simulate the effects in patients receiving our maximum recommended dose (Vesey, Cole and Simpson, 1976b). Measurements of arterial base deficit and plasma lactate and pyruvate concentrations were made also to test the reliability of acid-base status measurements as an index of the development of tissue hypoxia. Our results may be summarized as follows:(1) The increase in plasma cyanide concentrations occurs before the increase in RBC cyanide concentration. (2) Ultimately, red cell cyanide concentrations reach 50-100 times those in the plasma. (3) In the bolus-dosed animals KCN produced plasma HCN values 10 times those produced by SNP, whereas RBC concentrations were similar. (4) Peak thiocyanate concentrations of 40-60 nmol/litre were attained 2 h following injection or infusion. (5) In the bolus SNP and infused SNP groups of dogs the calculated mean percentage of cyanide in the nitroprusside converted to thiocyanate was 63 and 64.5%, whereas the value for the bolus KCN dogs was 82%. (6) The correlation between arterial base deficit and lactate concentrations during SNP infusion showed that the

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