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  • 1
    Electronic Resource
    Electronic Resource
    The clinical pharmacology of doxacurium in young adults and in elderly patients (1995)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 50 (1995), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Neuromuscular blockade induced by doxacurium 30 μg.kg-1 was compared in 21 young (18–55years) and 17elderly (65–85years) patients. Anaesthesia was induced with thiopentone and maintained with fentanyl, nitrous oxide in oxygen and isoflurane. Neuromuscular blockade was measured electromyographically (Datex Relaxograph) at the adductor pollicis using train-of-four stimuli at 20 s intervals. The depth of maximum neuromuscular blockade was similar in young and elderly patients (median 100% compared to 96%). However, the onset was significantly slower in the elderly: their mean (SD) time to 90% suppression of the first response of the train-of-four was 7.7 (1.8)min compared to 5.7 (1.7)min in the young (p = 0.002). Four min after doxacurium, the conditions for tracheal intubation were significantly poorer in the elderly (p 〈 0.001). Mean (SD) recovery of first response of the train-of-four to 25% of control was unaffected by age: young 79.0 (41.6)min; elderly 66.2 (32.1)min (p 〉 0.05). When the first response had reached 25% of control, neuromuscular blockade was antagonised with neostigmine 60 μg.kg-1. The mean time to first response to 90% of control was similar in the young and the elderly patients (9.1 min compared to 10.4 min). Recovery of the train-of-four ratio to 0.7 was significantly slower in the elderly: mean (SD) 17.1 (10.6) min compared to 10.1 (7.0) min (p = 0.03). Doxacurium was associated with clinically insignificant haemodynamic changes in both groups.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1995.tb06139.x
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  • 2
    Electronic Resource
    Electronic Resource
    Clinical and economic choices in anaesthesia for day surgery: A prospective randomised controlled trial (2003)
    Oxford, UK : Blackwell Science Ltd
    Anaesthesia 58 (2003), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary We compared the cost-effectiveness of general anaesthetic agents in adult and paediatric day surgery populations. We randomly assigned 1063 adult and 322 paediatric elective patients to one of four (adult) or two (paediatric) anaesthesia groups. Total costs were calculated from individual patient resource use to 7 days post discharge. Incremental cost-effectiveness ratios were expressed as cost per episode of postoperative nausea and vomiting (PONV) avoided. In adults, variable secondary care costs were higher for propofol induction and propofol maintenance (propofol/propofol; p 〈 0.01) than other groups and lower in propofol induction and isoflurane maintenance (propofol/isoflurane; p 〈 0.01). In both studies, predischarge PONV was higher if sevoflurane/sevoflurane (p 〈 0.01) was used compared with use of propofol for induction. In both studies, there was no difference in postdischarge outcomes at Day 7. Sevoflurane/sevoflurane was more costly with higher PONV rates in both studies. In adults, the cost per extra episode of PONV avoided was £296 (propofol/propofol vs. propofol/ sevoflurane) and £333 (propofol/sevoflurane vs. propofol/isoflurane).
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2044.2003.03125.x
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  • 3
    Electronic Resource
    Electronic Resource
    Suxamethonium—the relation between dose and response (1989)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 44 (1989), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: In a study which involved 120 adult patients, the ED95 of suxamethonium was shown to be 0.51 mg/kg, using an electromyographic technique. Marked individual variation in response was noted, for example a dose of 0.3 mg/kg produced a range of blockade from 4%–90%. Body surface area was shown to be more significantly related to blockade than lean body mass or total body weight.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1989.tb11089.x
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  • 4
    Electronic Resource
    Electronic Resource
    Pain on injection of propofol Methods of alleviation (1990)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 45 (1990), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: A controlled randomised double-blind design was used to study the effect of lignocaine on the pain produced by intravenous injection of propofol. Patients received a 2-ml pretreatment solution with temporary venous occlusion, followed by an induction solution. One hundred and three patients were assigned to one of five groups: saline pretreatment, followed by induction with propofol plus saline 2 ml; lignocaine 20 mg pretreatment, followed by induction with propofol plus saline 2 ml; lignocaine 40 mg pretreatment, followed by induction with propofol plus saline 2 ml; saline pretreatment, followed by induction with propofol plus lignocaine 20 mg; or saline pretreatment, followed by induction with propofol plus lignocaine 40 mg. Pain was reduced significantly in all groups in which lignocaine was used and a dose of 40 mg was more effective than 20 mg. There were no significant differences in the incidence of pain among the groups which received lignocaine as pretreatment and the groups which received lignocaine mixed with propofol. Sixty-eight percent of patients who experienced pain or discomfort recalled it in the postoperative period.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1990.tb14328.x
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  • 5
    Electronic Resource
    Electronic Resource
    Atracurium overdose in a small infant (1989)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 44 (1989), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: An error in setting a syringe driver caused a 2.75 kg infant to receive 37 mg atracurium over 75 minutes. Clinically full recovery of muscle power had returned spontaneously 135 minutes after the infusion was stopped. The child suffered no ill effects. Assay of blood and urine for atracurium and laudanosine conjirmed rapid clearance of the drug.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1989.tb11375.x
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  • 6
    Electronic Resource
    Electronic Resource
    Anaesthesia for the treatment of a giant cerebral aneurysm under hypothermic circulatory arrest (1990)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 45 (1990), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The anaesthetic management of a patient whose giant cerebral aneurysm was clipped is described. Profound hypothermia and thiopentone were used to provide cerebral protection during circulatory arrest. Atracurium was used to provide muscle relaxation; the level of neuromuscular block and plasma concentrations of atracurium and laudanosine were measured.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1990.tb14782.x
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  • 7
    Electronic Resource
    Electronic Resource
    Nitrous oxide anaesthesia and vomiting (1986)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 41 (1986), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Eighty-seven patients undergoing routine laparcscopy were divided randomly into two groups to study the effect of nitrous oxide anaesthesia on the incidence of postoperative vomiting. Patients in group A received nitrous oxide as part of their anaesthetic, while in group B nitrous oxide was omitted. Significantly fewer patients in group B vomited when compared with group A (17 percent and 49 percent respectively; p 〈 0.005). We suggest that an anaesthetic technique which avoids nitrous oxide may be especially indicated in patients undergoing laparoscopy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1986.tb12835.x
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  • 8
    Electronic Resource
    Electronic Resource
    A new APL valve hazard (2001)
    Oxford, UK : Blackwell Science Ltd
    Anaesthesia 56 (2001), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.2001.2331-9.x
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  • 9
    Electronic Resource
    Electronic Resource
    The infusion requirements and recovery characteristics of cisatracurium or atracurium in intensive care patients (1996)
    Springer
    Intensive care medicine 22 (1996), S. 694-698 
    Details
    ISSN: 1432-1238
    Keywords: Neuromuscular blocking agents ; Atracurium ; Cisatracurium ; Recovery ; Neuromuscular blockade ; Intensive care
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective To investigate the infusion requirements and recovery characteristics of cisatracurium compared with atracurium when both are administered by prolonged continuous infusion. Design A prospective, randomised, single-blind study. Settings The Intensive Care Unit of the Manchester Royal Infirmary. Patients 20 patients requiring a continuous infusion of a neuromuscular blocking agent to facilitate mechanical ventilation. 12 patients received cisatracurium and 8 received atracurium. Interventions Cisatracurium or atracurium was administered by continuous infusion for a minimum of 24h. The level of neuromuscular blockade was measured by recording the train-of-four responses using acceleromyography, the aim being to maintain 1–2 twitch responses of the adductor pollicis. At the end of the infusion period, the train-of-four was recorded until the ratio was greater than 0.7. Measurements and results The mean infusion rate of cisatracurium was 0.23 mgkg−1 h−1, compared to 0.62 mgkg−1 h−1. No time-related increase in infusion requirements was seen for either drug. The mean recovery time to a train-of-four ratio greater than 0.7 was the same (46 min). There was no correlation between recovery time and age, duration of infusion or mean infusion rate. Conclusions Cisatracurium provides a satisfactory level of neuromuscular blockade in adult ICU patients at approximately one-third the infusion rate of atracurium and with a similar recovery time.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01709749
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  • 10
    Electronic Resource
    Electronic Resource
    The infusion requirements and recovery characteristics of cisatracurium or atracurium in intensive care patients (1996)
    Springer
    Intensive care medicine 22 (1996), S. 694-698 
    Details
    ISSN: 1432-1238
    Keywords: Key words Neuromuscular blocking agents ; Atracurium ; Cisatracurium ; Recovery ; Neuromuscular blockade ; Intensive care
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract   Objective: To investigate the infusion requirements and recovery characteristics of cisatracurium compared with atracurium when both are administered by prolonged continuous infusion. Design: A prospective, randomised, single-blind study. Settings: The Intensive Care Unit of the Manchester Royal Infirmary. Patients: 20 patients requiring a continuous infusion of a neuromuscular blocking agent to facilitate mechanical ventilation. 12 patients received cisatracurium and 8 received atracurium. Interventions: Cisatracurium or atracurium was administered by continuous infusion for a minimum of 24 h. The level of neuromuscular blockade was measured by recording the train-of-four responses using acceleromyography, the aim being to maintain 1–2 twitch responses of the adductor pollicis. At the end of the infusion period, the train-of-four was recorded until the ratio was greater than 0.7. Measurements and results: The mean infusion rate of cisatracurium was 0.23 mg kg−1 h−1, compared to 0.62 mg kg−1 h−1. No time-related increase in infusion requirements was seen for either drug. The mean recovery time to a train-of-four ratio greater than 0.7 was the same (46 min). There was no correlation between recovery time and age, duration of infusion or mean infusion rate. Conclusions: Cisatracurium provides a satisfactory level of neuromuscular blockade in adult ICU patients at approximately one-third the infusion rate of atracurium and with a similar recovery time.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01709749
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