scholarly journals Use of a New Syringe Pump (Springfusor®) for Muscle Relaxant Infusion

1993 ◽  
Vol 21 (4) ◽  
pp. 444-446 ◽  
Author(s):  
C. C. P. Eagle ◽  
D. F. Capes
Keyword(s):  
Muscle Relaxant ◽  
Infusion Rate ◽  
Bolus Dose ◽  
Muscle Relaxants ◽  
Syringe Pump ◽  
Background Infusion ◽  
Continuous Background ◽  
Nominal Rate ◽  
The Mean ◽  
Initial Bolus

A new spring-driven syringe pump (Springfusor 10®, Go Medical Industries, Subiaco, W.A.) was evaluated for infusion of muscle relaxants in 50 surgical cases. After an initial bolus dose, atracurium was given at a rate of 25 to 37.5 mg/hour and vecuronium at a rate of 4 to 6 mg/hour. The mean infusion rate was found to be 4% above the nominal rate of 5 ml/hour and the accuracy in all cases was within ± 20%. The Springfusor was found to be rugged, cheap and easy to use. It lacks dose flexibility but is suitable for continuous background infusion of muscle relaxants during surgery.

RELATIONSHIP BETWEEN THE TIME TO BEGINNING OF RECOVERY AFTER THE INITIAL BOLUS OF MUSCLE RELAXANT AND THE INFUSION RATE REQUIREMENTS FOR MIVACURIUM AND SUCCINYLCHOLINE

1988 ◽  
Vol 69 (3A) ◽  
pp. A521-A521
Author(s):  
S. K. Woelfel ◽  
B. W. Brandom ◽  
D. R. Cook ◽  
B. Whitehead ◽  
L. M Borland
Keyword(s):  
Muscle Relaxant ◽  
Infusion Rate ◽  
Initial Bolus

scholarly journals A Comparison of Alfentanil Requirements in European and Asian Patients during General Anaesthesia

1988 ◽  
Vol 16 (4) ◽  
pp. 396-404 ◽  
Author(s):  
C. Aun ◽  
I. T. Houghton ◽  
K. Chan ◽  
R. H. Carley ◽  
N. P. Salmon ◽  
...  
Keyword(s):  
General Anaesthesia ◽  
Half Life ◽  
Infusion Rate ◽  
Plasma Concentrations ◽  
Muscle Relaxants ◽  
Spontaneous Ventilation ◽  
Asian Patients ◽  
Elimination Half ◽  
The Mean ◽  
Incremental Dose

Alfentanil requirements were compared in thirty-six Asian and forty-three European patients during general anaesthesia with muscle relaxants. Alfentanil infusion at 5 μg/kg/min was started immediately after induction with thiopentone and alcuronium. The infusion rate was reduced to 0.5 μg/kg/min after ten minutes. An incremental dose of 5 μg/kg/min for five minutes was given on each occasion when anaesthesia was clinically judged to be inadequate. Recovery parameters were recorded. Pharmacokinetics were also studied in five Europeans, four Chinese and four Nepalese. The dosage of alfentanil required was comparable in both Asian and European patients, but recovery was slower in the Asian patients. The elimination half-life in the Chinese and the Nepalese were both significantly shorter than that of the Europeans (P < 0.05), but at the time of recovery of spontaneous ventilation, the mean plasma concentrations were not significantly different.

scholarly journals A Method for Implementing Programmed Infusion of Thiopentone and Methohexitone with a Simple Infusion Pump

1989 ◽  
Vol 17 (4) ◽  
pp. 496-499 ◽  
Author(s):  
D. P. Crankshaw ◽  
F. Karasawa
Keyword(s):  
Infusion Rate ◽  
Infusion Pump ◽  
Drug Efflux ◽  
Syringe Pump ◽  
Plasma Drug ◽  
Drug Concentrations ◽  
Arterial Concentration ◽  
Initial Bolus

We have tabulated the series of steps in infusion rate required to maintain constant arterial levels of thiopentone and methohexitone. The tables are based on multiexponential equations for infusion rate, derived from plasma drug efflux studies. In each table an initial bolus is followed by nine steps in infusion rate over three hours. The tables provide rates suitable for delivery by a standard syringe pump to achieve and maintain an arterial concentration of 10 mg/l of thiopentone and 5 mg/l of methohexitone. Other desired drug concentrations can be derived from the table by simple multiplication.

scholarly journals Pancuronium Requirements during Hypothermic Cardiopulmonary Bypass in Man

1983 ◽  
Vol 11 (3) ◽  
pp. 216-219 ◽  
Author(s):  
Malcolm E. Futter ◽  
David G. Whalley ◽  
J. Earl Wynands ◽  
David R. Bevan
Keyword(s):  
Cardiopulmonary Bypass ◽  
Neuromuscular Junction ◽  
Infusion Rate ◽  
Bolus Dose ◽  
Principal Agent ◽  
Hypothermic Cardiopulmonary Bypass ◽  
Train Of Four ◽  
The Mean

Eight patients were studied to determine the changes in pancuronium requirements during hypothermic cardiopulmonary bypass. They were anaesthetised with fentanyl as the principal agent, ventilated with oxygen and the neuromuscular junction was monitored using train-of-four stimulation. After a bolus dose of pancuronium an infusion was used to maintain the first twitch of the train-of-four at 5-15 per cent of control. Before bypass the mean pancuronium infusion rate was 0.52 (SD 0.16) μg/kg/min. There was a small, brief increase in requirement with the initiation of bypass to 0.62 (SD 0.38) μg/kg/min, which was followed by a decrease of more than 80 per cent during hypothermia to 0.08 (SD 0.03) μg/kg/min. Rewarming was associated with a rapid increase in requirement to 0.64 (SD 0.17) μg/kg/min, which decreased to 0.33 (SD 0.23) μg/kg/min when normothermia was re-established.

Aggressive atropinisation and continuous pralidoxime (2-PAM) infusion in patients with severe organophosphate poisoning: experience of a northwest Indian hospital

2001 ◽  
Vol 20 (1) ◽  
pp. 15-18 ◽  
Author(s):  
S Singh ◽  
D Chaudhry ◽  
D Behera ◽  
D Gupta ◽  
S K Jindal
Keyword(s):  
Methyl Parathion ◽  
Bolus Dose ◽  
Maximum Dose ◽  
Case Series ◽  
Assisted Ventilation ◽  
Organophosphate Poisoning ◽  
Sepsis Mortality ◽  
Respiratory Intensive Care Unit ◽  
The Mean ◽  
Initial Bolus

OBJECTIVE: The aim of the study was to find whether continuous pralidoxime (2-PAM) infusion along with aggressive atropinisation improves the outcome in patients with severe organophosphate poisoning who require assisted ventilation. METHODS: Sixteen patients admitted to the respiratory intensive care unit (RICU) with severe organophosphate poisoning and requiring assisted ventilation were included in the study. The compounds involved were phorate (six), dichlorvos (four), oxydimeton methyl (one), monocrotophos (one), methyl parathion (one) and in three it was unknown. After decontamination, they were given intravenous (iv) bolus atropine 5 mg at onset and then 2.5 mg every 5-10 min till atropinisation was achieved, and then maintained either by intermittent bolus doses or by continuous infusion if the required dose was large. They were also given continuous iv infusion of 2-PAM in dose of 7.5 mg/kg body weight/h (maximum 500 mg/h) after an initial bolus dose of 2 g. RESULTS: The mean (± S.D.) dose of atropine was 735.02 ± 742.98 mg (range 85-3000 mg) with maximum dose on day 1. The mean (± S.D) duration of2-PAM infusion was 96.4±49.4 h (range 10-216 h). The mean (±S.D) duration of mechanical ventilation (MV) was 131.5 ± 95.65 h (range 4-336 h). Fourteen patients could be successfully extubated and two died of bronchopneumonia and sepsis (mortality 12.5%6). CONCLUSION: Continuous 2-PAM infusion along with aggressive atropinisation after initial decontamination improved the outcome but notthe duration of MV in severely intoxicated patients with organophosphate compounds who required assisted ventilation in this case series.

Elimination of three doses of gentamicin over three consecutive days using a polyacrylonitrile-derived filter: An in vitro assessment

2021 ◽  
pp. 039139882110322
Author(s):  
Frédéric J Baud ◽  
Vanessa Seif ◽  
Pascal Houzé ◽  
Jean-Herlé Raphalen ◽  
Benoît Pilmis ◽  
...  
Keyword(s):  
Life Span ◽  
Bolus Dose ◽  
Central Compartment ◽  
Daily Session ◽  
Progressive Decrease ◽  
Time Dependency ◽  
Study Results ◽  
In Vitro Assessment ◽  
The Mean

Introduction: Adsorption of gentamicin in a polyacrylonitrile filter was previously evidenced in a session lasting 6 h using the NeckEpur model. We extended the study over three consecutive days to mimic the 72-h life span of a filter. Methods: Prismaflex® monitor and ST150® filter were used in the continuous diafiltration (CDF) mode at a 2.5 L/h flowrate. The daily session started with a 6-h session of CDF. Thereafter, the 5-L central compartment was changed using a bag free of gentamicin to assess gentamicin release over the following 18 h. Experiments were repeated on Day 2 and stopped at the end of the 6-h session of CDF on Day 3. The experiment was performed in duplicate. Results: At a 2.5 L/h diafiltration flowrate, the mean daily clearances of gentamicin were 5.5, 4.0, and 3.3 L/h, respectively. The mean diafiltration and adsorption ratios in the daily elimination of gentamicin were 32/68%, 58/42%, and 88/12%, respectively. During days 1 and 2, the mean amount of gentamicin released from the ST150® filter were 14 and 34 mg, respectively. Conclusion: The pharmacokinetics of gentamicin over 3 days is strongly altered by adsorption in the same filter with a progressive decrease of elimination by adsorption, suggesting saturation of the filter. One limitation of our study results from the mode of administration using a bolus dose instead of an infusion over 30 min. Adsorption adds a clearance to those of diafiltration. The time-dependency of gentamicin clearance precludes using a constant dosage regimen over the filter’s life span.

scholarly journals Patient-Controlled Epidural Levobupivacaine with or without Fentanyl for Post-Cesarean Section Pain Relief

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Shin-Yan Chen ◽  
Feng-Lin Liu ◽  
Yih-Giun Cherng ◽  
Shou-Zen Fan ◽  
Barbara L. Leighton ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Epidural Analgesia ◽  
University Hospital ◽  
Control Regimen ◽  
Background Infusion ◽  
Continuous Background ◽  
American Society ◽  
Group B ◽  
Double Blinded ◽  
American Society Of Anesthesiologists

Purpose.The purpose of this study was to compare the analgesic properties of levobupivacaine with or without fentanyl for patient-controlled epidural analgesia after Cesarean section in a randomized, double-blinded study.Methods.We enrolled American Society of Anesthesiologists class I/II, full-term pregnant women at National Taiwan University Hospital who received patient-controlled epidural analgesia after Cesarean section between 2009 and 2010. Eighty women were randomly assigned into two groups. In group A, the 40 subjects received drug solutions made of 0.6 mg/ml levobupivacaine plus 2 mcg/ml fentanyl, and in group B the 40 subjects received 1 mg/ml levobupivacaine. Maintenance was self-administered boluses and a continuous background infusion.Results.There were no significant differences in the resting and dynamic pain scales and total volume of drug used between the two groups. Patient satisfaction was good in both groups.Conclusion.Our study showed that pure epidural levobupivacaine can provide comparative analgesic properties to the levobupivacaine-fentanyl combination after Cesarean section. Pure levobupivacaine may serve as an alternative pain control regimen to avoid opioid-related adverse events in parturients.

scholarly journals GAMBARAN LAMA KERJA ATRAKURIUM PADA PASIEN YANG MENJALANI ANESTESIA UMUM DI IBS RSUP PROF KANDOU MANADO NOVEMBER-DESEMBER 2013

e-CliniC ◽  
2014 ◽  
Vol 2 (2) ◽  
Author(s):  
Rosiana Lamerkabel ◽  
Harold Tambajong ◽  
Diana Lalenoh
Keyword(s):  
Muscle Relaxant ◽  
Acetylcholine Receptors ◽  
Average Length ◽  
Repeated Administration ◽  
Descriptive Study ◽  
Muscle Relaxants ◽  
Inclusion Criteria ◽  
Liver And Kidney ◽  
The Subject ◽  
Keywords Muscle

Abstrak: Obat pelumpuh otot adalah obat yang digunakan selama anestesi dan memfasilitasi intubasi. Pelumpuh otot non depolarisasi merupakan antagonis dari fase I blok pelumpuh otot depolarisasi, karena ia menduduki reseptor asetilkolin sehingga depolarisasi oleh suksinilkolin sebagian dicegah. Atrakurium adalah salah satu obat pelumpuh otot non depolarisasi yang mempunyai struktur benziliquinolin yang berasal dari tanaman Leontice Leontopeltalum, keunggulan adalah metabolisme terjadi di dalam darah, tidak bergantung di pada fungsi hati dan ginjal, tidak mempunyai efek akumulasi pada pemberian berulang. Tujuan penelitian ini adalah untuk mengetahui gambaran lama kerja dari obat pelumpuh obat non depolarisasi atrakurium.Penelitian ini merupakan penelitian deskriptif prospektif yang dilakukan pada ruang pasca bedah Instalansi Bedah Sentral RSUP.Prof. DR. R. D. Kandou Manado dengan subjek berjumlah 10 orang yang telah memenuhi kriteria inklusi. Dapat disimpulkan bahwa rerata gambaran lama kerja adalah 35,6 menit. Kata kunci: pelumpuh otot non depolarisasi, atrakurium     Abstract: Muscle relaxant drugs are drugs used during anesthesia and facilitate intubation . Non- depolarizing muscle relaxants is an antagonist of the phase I block of depolarizing muscle relaxants , because it occupies the acetylcholine receptors so that depolarization by succinylcholine partially prevented . Atracurium is one of the non- depolarizing muscle relaxant drugs that have a structure that is derived from plants benziliquinolin LeonticeLeontopeltalum , excellence is metabolism occurs in the blood , does not depend on the function of the liver and kidney , had no effect on the accumulation of repeated administration . The purpose of this study is to describe the work of the old non- depolarizing paralytic drug drug atracurium . This study is a prospective descriptive study conducted on postoperative space Installation Central Surgical Hospital .Prof .DR . R. D. Kandou Manado with the subject of 10 people who have met the inclusion criteria . It can be concluded that the average length of employment was 35.6 overview minutes. Keywords: Muscle relaxants, Atracurium

P1860Unfractionated heparin dose and complication rate in catheter ablation of atrial fibrillation, a comparison between uninterrupted therapy with phenprocoumon and direct oral anticoagulants

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
N Poci ◽  
D Gjermeni ◽  
V Kuehlkamp
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Vitamin K Antagonists ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Bleeding Events ◽  
Anticoagulation Management ◽  
Significant Difference ◽  
The Mean ◽  
Initial Bolus

Abstract Background Catheter ablation of atrial fibrillation is known for the combining risks of thromboembolism (TE) and major bleedings. This urges a better understanding and optimization of the intraprocedural anticoagulation management. Differences in unfractionated heparin (UFH) requirements and anticoagulation time (ACT) levels between patients on different uninterrupted oral anticoagulation (OAC) agents have been studied. However, the clinical relevance, in terms of periprocedural TE and bleeding events, of UFH administration according to ACT monitoring among patients on different OAC agents, needs to be addressed. Objective To evaluate how the ACT monitoring and differences in intraprocedural UFH requirements among different anticoagulant agents, may translate to clinical outcome, in terms of periprocedural incidence of thromboembolic and bleeding events. Methods We retrospectively studied 1571 cases who underwent catheter ablation for atrial fibrillation between January 2011 and May 2017. Cases were on an uninterrupted oral OAC therapy of Vitamin K Antagonists (VKA)(713), Rivaroxaban (RG)(385), Dabigatran (DG)(260), Apixaban (AG)(192) and Edoxaban (EG)(21). First ACT measurements after the initial bolus of UFH (1ehz748.0610U), mean ACT measurements, total UFH doses/kg (Body Weight)/min (duration of procedure) and incidence of major periprocedural events were compared among the above OAC groups. Results The mean ACT (sec) was significantly lower in the AG and greater in the VKA (313,7±47 vs 340,5±49, p<0,001). Significantly lower UFH doses (U/kg/min) were required to reach the target ACT in VKA compared to RG, DG, AG and EG (0,69±0,4 vs 1,41±0,76; 1,42±0,7; 1,63±0,8; 1,37±0,4 respectively, p<0,001) The proportion of patients who achieved a target ACT value within 30 minutes after the fixed first UFH Bolus of 10 000 U was significantly lower in DG and AG compared to VKA, EG and RG group (51,5% and 49% vs 53%, 71,4%, and 61,8% respectively p=0,005). The incidence of periprocedural TE events and bleedings showed no significant difference among OAC groups. However, the 22 patients with a periprocedural TE event had significantly lower UFH doses (U)/ Duration of catheter ablation (min) compared to the ones without periprocedural TE (62,71±44,5 vs 94,4±66,4, p=0,026), despite equivalent mean ACT values between these two groups. Patients with a periprocedural TE had also a significantly older Age (69,6±10 vs 64±10 p=0,01, higher CHADSVASC Score (3,64±1,76 vs 2,63±1,7 p=0,006), longer duration of procedure (188,9±79,1 vs 144,9±57 p=0,0001) and higher pre-Ablation INR values (2,2±0,6 vs 1,7±0,6 p=0,002). Conclusions The average UFH doses required to reach the target ACT were lower in VKA than in NOAC- groups. The incidence of periprocedural TE events and bleedings was equivalent among OAC groups. Patients with TE showed a lower UFH requirement compared to no-TE group, with both groups having mean ACT ≥300 sec.

Sign in / Sign up

Export Citation Format

Share Document