scholarly journals Altered Drug Metabolism in Anaesthetists Exposed to Volatile Anaesthetic Agents

1978 ◽  
Vol 6 (3) ◽  
pp. 210-214 ◽  
Author(s):  
A. W. Harman ◽  
W. J. Russell ◽  
D. B. Frewin ◽  
B. G. Priestly

Antipyrine kinetics were measured on saliva in eight anaesthetists during a period when they were giving general anaesthetics and a period when they were working exclusively in intensive care. During the anaesthesia period there was a reduction in antipyrine half-life and the clearance of antipyrine increased. Analysis of the data in groups failed to detect these changes because of the wide variation in metabolism between subjects. Exposure to anaesthetic agents under non-scavenging operating theatre conditions appears to enhance hepatic metabolism.

1984 ◽  
Vol 2 (3) ◽  
pp. 551-575
Author(s):  
Michael J. Cousins ◽  
John L. Plummer ◽  
Pauline De La M. Hall

Author(s):  
Phillip E. Vlisides ◽  
Zhongcong Xie

As the elderly population increases, so will the number of surgical patients with dementia and other cognitive disorders. Laboratory evidence suggests that some commonly used anaesthetic agents may accelerate the Alzheimer’s disease (AD) process, but robust clinical research is still needed. This chapter discusses the need for peri-operative guidelines for patients with dementia, and the many opportunities for further research to inform such guidelines. It also covers postoperative delirium and its association with longer hospital and intensive care unit stays, cognitive decline after surgery, and higher mortality. Finally, it covers postoperative cognitive dysfunction (POCD), how standardized definitions and study methodology are lacking, and that studying cognitive trajectory after anaesthesia and surgery is often confounded by various clinical elements that cannot be accounted for methodologically.


1987 ◽  
Vol 15 (2) ◽  
pp. 212-216 ◽  
Author(s):  
D. G. Selby ◽  
A. H. Ilsley ◽  
W. B. Runciman

Five commercially available carbon dioxide analysers were assessed with respect to accuracy, response time, stability, the effect of water vapour and the effect of rebreathing. Two side-stream sampling analysers (Datex Normocap and Engstrom Eliza) and one main-stream sampling analyser (Hewlett-Packard Capnoshot) were found to be satisfactory for use both in the operating theatre and intensive care unit. The Instrumentation Laboratory (IL) 200, a side-stream monitor, performed satisfactorily but neither it nor the Siemens Sirecust 404, a main-stream monitor, has the facility to compensate for the presence of nitrous oxide. The Siemens analyser, in the form tested, could not be recommended for clinical use, as it was less accurate than the other monitors, could not detect rebreathing, and was subject to fluctuations when used with gas mixtures saturated with water vapour.


1980 ◽  
Vol 3 (5) ◽  
pp. 263-266 ◽  
Author(s):  
T.C. Marbury ◽  
L.H. Wang ◽  
C.S. Lee

The effect of the artificial kidney on the removal of acetaminophen was investigated in 6 chronic hemodialysis patients. Acetaminophen, 650 mg, was given orally 2 hrs prior to hemodialysis. Plasma and dialysate samples were collected periodically over 3 hours and analyzed by HPLC for acetaminophen content. Dialysis clearance was calculated by Arterial-Venous difference and simultaneous dialysate measurement. The extraction efficiency of the hollow-fiber dialyzers averaged 47.5%. The mean dialysis clearance of 112 ml/min measured with blood as the body fluid of reference was confirmed by calculation of clearance using dialysate measurement. A mean of 70.5 mg of acetaminophen or 11% of the administered dose was removed during the 3 hour dialysis period. The beta phase had a mean half-life of 1.6 hours in our patients on hemodialysis compared with 2.0 hours reported for both normal patients and uremic patients. Despite the favorable extraction ratio and dialyzer clearance, the artificial kidney is not very effective in competing with the liver for removal of the parent compound acetaminophen because of the drug's short half-life and rapid hepatic metabolism. Hence, the chronic hemodialysis patient may not need a dosage adjustment during or following hemodialysis.


2010 ◽  
Vol 1 (1) ◽  
pp. 2 ◽  
Author(s):  
Volkan Hanci ◽  
Fusun Cömert ◽  
Hilal Ayoğlu ◽  
Canan Kulah ◽  
Serhan Yurtlu ◽  
...  

Some anaesthetic agents may be contaminated with microorganisms during the process of preparing an infusion. For this reason, it is important to understand the antimicrobial effects of various anaesthetic agents, which have been investigated to some degree in previous studies. However, studies specifically focusing on antibacterial effects of neuromuscular blocking drugs (anaesthetic agents) are very rare. Herein, we analysed the antimicrobial effects of atracurium, rocuronium, and mivacurium, on four different microorganisms. The in vitro antimicrobial activities of atracurium, rocuronium and mivacurium were investigated using the broth microdilution method. The pH of the test solutions was determined using a pH meter. The test microorganisms included Staphylococcus aureus ATCC 29213, Enterococcus fecalis ATCC 29212, Escherichia coli ATCC 25922 and Pseudomonas aeruginosa ATCC 27853. The pH of the test solutions ranged between 7.20 and 7.32. The minimum inhibitory concentrations of atracurium, rocuronium and mivacurium for S. auereus, E. fecalis, E. coli and P. Aeruginosa were all found to be 512 µg/mL. Atracurium, rocuronium and mivacurium inhibit the growth of common intensive care unit pathogens at the same concentration (512 µg.mL–1). Thus, the neuromuscular blocking drugs, atracurium, rocuronium and mivacurium should be administered at a minimum concentration of 512 µg/mL in intensive care units to achieve this antibacterial effect. In our opinion, when used systemically, atracurium, rocuronium and mivacurium do not cause a systemic antibacterial effect. However, their antibacterial effects may be advantageous for inhibiting the spread of bacterial contamination during the preparation of the infusion solutions.


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