The Experts below are selected from a list of 138 Experts worldwide ranked by ideXlab platform

N. Anker - One of the best experts on this subject based on the ideXlab platform.

  • ANTICONVULSIVE PROPERTIES OF PREGNANOLONE EMULSION COMPARED WITH Althesin AND THIOPENTONE IN MICE
    2016
    Co-Authors: P. Carl, J Wagner, S. Hgskilde, N. Anker, H. R. Angelo, Bredgaard M. Srensen, M. John D. Wagner, M. Peder D. J Carl
    Abstract:

    Naturally occurring fluctuations in the concentra-tion of progesterone in the brain may decrease the frequency of seizures in patients with epilepsy [1]. Moreover, several of the metabolites of pro-gesterone (reduced in the 5 position on the steroid molecule) are considerably more potent than progesterone in their CNS depressant action [2-6], and it has been suggested that the effect of progesterone on brain excitability is mediated subsequent to a decrease in metabolism [2, 5, 7-9]. Thus it has been proposed that some of these progesterone metabolites could be used in the management of epilepsy [1]. Indeed, the administration of a mixture of two 5-ot reduced derivatives of progesterone, alphaxalone and alphadolone (Althesin), has been shown to be effective in the treatment of otherwise drug resistant status epilepticus [10-12]. Pregnanolone, a naturally-occurring 5-{ $ re-duced metabolite of progesterone [13], has now been prepared in a stable emulsion and may prove suitable for clinical use. The anaesthetic proper-ties of this preparation have been found to be similar to those of Althesin [14, 15]. The anticonvulsive profile of pregnanolone emulsion has been compared with the profiles of Althesin and thiopentone, using four standard experimental anticonvulsive test procedures

G. Mann - One of the best experts on this subject based on the ideXlab platform.

  • HISTAMINE RELEASE AFTER INTRAVENOUS APPLICATION OF SHORT-ACTING HYPNOTICS A Comparison of Etomidate, Althesin (CT1341) and Propanidid*
    2016
    Co-Authors: A. Doenicke, W. Lorenz, R. Beigl, H. Bezechy, G. Uhlig, L. Kalmar, B. Praetorius, G. Mann
    Abstract:

    The subject of histamine release was investigated in 16 volunteers by means of plasma histamine determination after the administration of etomidate, Althesin, propanidid, and Cremophor EL. Althesin and propanidid caused release of histamine in various degrees of frequency. Blood pressure changes were rather pronounced with both anaesthetic agents; tachycardia reached its mavimiim in the first and second minute, which seems to be an argument against histaminp release as the underlying cause of this reaction. Histamine was, indeed, only released to such an extent (with the exception of one borderline case) that no clinical symptoms other than secretion of gastric juice and erythema were to be expected. After the application of etomidate and Cremophor EL an increase in plasma histamine was not detectable. Changes in the differential Wood picture in terms of a decrease in basophils only occurred after Althesin and propanidid; not, however, after etomidate and Cremophor EL. Etomidate is, therefore, the first hypnotic drug for intravenous application which is unlikely to cause chemical histaminp release. The increasing incidence of anaphylactic and anaphy

T.e.j. Healy - One of the best experts on this subject based on the ideXlab platform.

  • EFFECT OF ANAESTHESIA ON THE QT INTERVAL
    2016
    Co-Authors: I. Mcconachie, T.e.j. Healy, J. P. Keaveny, S. Vohra, L. Million
    Abstract:

    The QT interval, which is measured from the start of the Q wave (or the R wave when no Q wave is present) to the completion of the T wave, reflects the duration of electrical ventricular systole. The duration of systole varies with heart rate and therefore the measured QT interval is often corrected for heart rate using the following formula, in which QTc represents the rate corrected value: QTc = Qt/VRR interval The QTc interval is normally less than 440 ms [1]. Increased serum concentrations of noradren-aline and a change in the balance between sympathetic and parasympathetic tone may be associated with prolonged QT interval [2, 3]; this may be controlled with either f}-block [4] or stellate ganglion block [5]. Hypomagnesaemia and, more commonly, hypokalaemia cause clinically significant prolongation which may be produced by effects on the repolarizing potassium current. Sleep (which is associated with a re-duction in sympathetic tone) prolongs QTc [6]. Induction of anaesthesia with thiopentone prolongs significantly the QT interval [7], whereas Althesin had no effect [8]. The most marked changes follow tracheal intubation facilitated with suxamethonium, but these changes may be reduced by pretreatment with tubocurarine [7] or by (3-block [9], suggesting mediation by the sympathetic nervous system. It has been reported also that the QT interval is significantly prolonged by enflurane [8, 10], but not by halothane an-aesthesia [8]. The mechanism underlying these differences has not been explained. It has been reported that these volatile agents and als

  • ANTAGONISM OF ALCURONIUM WITH EDROPHONIUM OR NEOSTIGMINE
    2016
    Co-Authors: N J N Harper, E. G. Bradshaw, T.e.j. Healy
    Abstract:

    The reversal of slcuronium by edrophonium 1 mgkg"1 or neostigmine 35.7figkg~l was compered in 23 patients undergoing elective ophthalmic sorcery. Neuromuscular transmission was assessed by measuring the force of contraction of the adductor pollkis muscle in response to train-of-four supramaximal stimuli (2 Hz, 0.2 ms duration) delivered via surface electrodes to the ulnar nerve every 10 s. Anaesthesia was induced and maintained with Althesin, and patient * were ventilated to oormocarbia with 67 % nitrous oxide in oxygen. Neuromuscular blockade was induced with alcuronium 0.2-0.3 mgkg"1 and antagoniimi was attempted when the train-of-four ratio had recovered spontaneously to 0.1. Recovery of the first contraction response of the train-of-four and of fade were more rapid after edrophonium. Although most patients were monitored for at least 30min no re-curarization was seen. Comparison of the relative rates of recovery of the first contraction, and the response to train-of-four stimuli, suggests that edrophonium has a greater prejunctional effect than neostigmine. Despite the frequent use of alcuronium, the ant-agonism of neuromuscular blockade produced by this agent has not been examined fully. Although neostigmine remains the most popular anticholines-terase, recent studies demonstrating the efficacy of large doses of edrophonium (Bevan, 1979; Kopman, 1979) have prompted a revival of interest in its pharmacological actions (Foldes et al., 1981; Morri

  • meptazinol as an analgesic adjunct to total intravenous anaesthesia in cystoscopy patients
    Anaesthesia, 2007
    Co-Authors: J Hargreaves, T.e.j. Healy
    Abstract:

    : Sixty-four unpremedicated patients undergoing cystoscopy received either intravenous meptazinol 2 mg/kg or saline in equivalent volume in a randomised, double-blind manner immediately before induction of anaesthesia with Althesin. Inclusion of meptazinol reduced the total dose of anaesthetic required, allowed a more rapid recovery and was associated with less movement in response to surgery. The patients in the control group tended to hyperventilate, and had lower end-tidal CO2 tension (p less than 0.001), and also higher pulse rates during surgery (p less than 0.01) than the meptazinol group. However, the patients who received meptazinol had a more frequent incidence of complications during induction and recovery (p less than 0.05).

S. Hgskilde - One of the best experts on this subject based on the ideXlab platform.

  • ANTICONVULSIVE PROPERTIES OF PREGNANOLONE EMULSION COMPARED WITH Althesin AND THIOPENTONE IN MICE
    2016
    Co-Authors: P. Carl, J Wagner, S. Hgskilde, N. Anker, H. R. Angelo, Bredgaard M. Srensen, M. John D. Wagner, M. Peder D. J Carl
    Abstract:

    Naturally occurring fluctuations in the concentra-tion of progesterone in the brain may decrease the frequency of seizures in patients with epilepsy [1]. Moreover, several of the metabolites of pro-gesterone (reduced in the 5 position on the steroid molecule) are considerably more potent than progesterone in their CNS depressant action [2-6], and it has been suggested that the effect of progesterone on brain excitability is mediated subsequent to a decrease in metabolism [2, 5, 7-9]. Thus it has been proposed that some of these progesterone metabolites could be used in the management of epilepsy [1]. Indeed, the administration of a mixture of two 5-ot reduced derivatives of progesterone, alphaxalone and alphadolone (Althesin), has been shown to be effective in the treatment of otherwise drug resistant status epilepticus [10-12]. Pregnanolone, a naturally-occurring 5-{ $ re-duced metabolite of progesterone [13], has now been prepared in a stable emulsion and may prove suitable for clinical use. The anaesthetic proper-ties of this preparation have been found to be similar to those of Althesin [14, 15]. The anticonvulsive profile of pregnanolone emulsion has been compared with the profiles of Althesin and thiopentone, using four standard experimental anticonvulsive test procedures

A. Doenicke - One of the best experts on this subject based on the ideXlab platform.

  • HISTAMINE RELEASE AFTER INTRAVENOUS APPLICATION OF SHORT-ACTING HYPNOTICS A Comparison of Etomidate, Althesin (CT1341) and Propanidid*
    2016
    Co-Authors: A. Doenicke, W. Lorenz, R. Beigl, H. Bezechy, G. Uhlig, L. Kalmar, B. Praetorius, G. Mann
    Abstract:

    The subject of histamine release was investigated in 16 volunteers by means of plasma histamine determination after the administration of etomidate, Althesin, propanidid, and Cremophor EL. Althesin and propanidid caused release of histamine in various degrees of frequency. Blood pressure changes were rather pronounced with both anaesthetic agents; tachycardia reached its mavimiim in the first and second minute, which seems to be an argument against histaminp release as the underlying cause of this reaction. Histamine was, indeed, only released to such an extent (with the exception of one borderline case) that no clinical symptoms other than secretion of gastric juice and erythema were to be expected. After the application of etomidate and Cremophor EL an increase in plasma histamine was not detectable. Changes in the differential Wood picture in terms of a decrease in basophils only occurred after Althesin and propanidid; not, however, after etomidate and Cremophor EL. Etomidate is, therefore, the first hypnotic drug for intravenous application which is unlikely to cause chemical histaminp release. The increasing incidence of anaphylactic and anaphy