Most previous studies which have assessed the depth of anaesthesia using the Bispectral Index (BIS) have used multi-agent anaesthetics with relatively slow induction and recovery times. Elevation of electroencephalographic (EEG) Beta/Alpha Ratio has been linked to onset of midazolam amnesia. Propofol anaesthesia for cardioversion in 19 patients enabled us to profile the changes in BIS and Beta/Alpha Ratio during a short, single-agent anaesthetic with a relatively rapid induction and recovery period.
OBJECTIVE: To compare their effects on cardiorespiratoy and recovery parameters and side effects. METHODS: This study was performed in The Ministry of Health Ankara Numune Research and Training Hospital, Ankara, Turkey, from January to May 2005. The 40 American Society of Anesthesiology II/III patients were randomized into 2 groups. All patients received remifentanil 0.75 microgram.kg(-1); and then received either etomidate 0.1 mg.kg(-1) (group E, n=20) or propofol 0.5 mg.kg(-1) (group P, n=20).
OBJECTIVE: To determine if earlier administration of epinephrine (adrenaline) in patients with non-shockable cardiac arrest rhythms is associated with increased return of spontaneous circulation, survival, and neurologically intact survival. DESIGN: Post hoc analysis of prospectively collected data in a large multicenter registry of in-hospital cardiac arrests (Get With The Guidelines-Resuscitation). SETTING: We utilized the Get With The Guidelines-Resuscitation database (formerly National Registry of Cardiopulmonary Resuscitation, NRCPR).
The beneficial effect of a beta-blocking agent (pindolol), given as an adjuvant to DC-shock and lidocaine therapy in a case of heart resuscitation is reported. A 65-year-old female patient was operated for an abdominal aortic aneurysm. At the conclusion of the operation, which was prolonged and difficult, the patient developed alternating ventricular tachycardia and fibrillation. Within a time interval of 50 min electrical defibrillation was performed 20 to 25 times, and as much as 1100 mg of lidocaine was administered.
Factors that may influence energy requirements for ventricular defibrillation include the duration of fibrillation and the mode of resuscitation. The present study assesses the effect of these influences on the energy needed for defibrillation. Dogs were anesthetized, and arterial blood pressure and Lead II of the ECG were continuously recorded. Ventricular fibrillation was electrically induced in each dog for a period of 1, 3, 5, or 9 min.
BACKGROUND: Patients with ischemic heart disease may require antianginal and/or antiarrhythmic regimes. These patients may also be candidates for implantable defibrillators. The effects of antiarrhythmics, such as bretylium, or calcium antagonists, such as verapamil, nifedipine, or diltiazem on internal defibrillation efficacy have been inconsistent or are unknown. METHODS AND RESULTS: The effects of bretylium and verapamil on the energy requirements for ventricular defibrillation threshold (DFT) were determined in 92 open-chest anesthetized pigs.
There is no information comparing the ability to reverse the cardiotoxic effects associated with incremental overdosage of bupivacaine (BUP) to levobupivacaine (LBUP), ropivacaine (ROP), or lidocaine (LIDO). Open-chest dogs were randomized to receive incremental escalating infusions of BUP, LBUP, ROP, and LIDO to the point of cardiovascular collapse (mean arterial pressure [MAP] < or = 45 mm Hg). Hypotension and arrhythmias were treated with epinephrine, open-chest massage, and advanced cardiac life support protocols, respectively.
Recent comments and amendments to routine algorithm of P. Safar's cardiopulmonary resuscitation, known as the ABCD principle, are critically analyzed. The primary mechanisms of thanatogenesis in sudden death in the majority of cases are not respiratory problems (requiring ABCD algorithm), but cardiac rhythm disorders.
At the end of the 19th century, there was both experimental and clinical evidence that coronary artery obstruction causes ventricular fibrillation and sudden death and that fibrillation could be terminated by electric shocks. The dominant figure at that time was McWilliam, who in 1923 complained that "little attention was given to the new view for many years." This remained so for many decades.