Continuous Intravenous Thiopentone‐flaxedil*

Evans, Frankis T.; Gray, P. W. Spencer

doi:10.1111/j.1365-2044.1953.tb12310.x

Cited by 6 publications

(3 citation statements)

References 3 publications

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“…Sustained muscular relaxation produced by a continous infusion of non-depolarizing relaxant was first used by Evans and Spencer Gray (1953), who advocated the use of a mixture of thiopentone and gallamine; respiration during all cases was spontaneous. Gallamine alone was similarly employed by Mclntyre (1953) in the treatment of tetanus.…”

mentioning

confidence: 99%

Tubocurarine Administration Based Upon Its Disappearance and Accumulation Curves in Anaesthetized Man

Ryan

1964

British Journal of Anaesthesia

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A method is described which results in smooth curarization and prompt recovery using minimal amounts of tubocurarine. Following an initial dose, usually 15 mg, paralysis is maintained by a continuous infusion delivering an amount per hour about equal to the initial dose. From a mathematical interpretation of this statement an equation for the exponential disappearance of tubocurarine from the extracellular water can be obtained. Controlled ventilation is used with a light level of halothane anaesthesia. No supplementary injections of anaesthetic or analgesic are necessary. Reversal with neostigmine is prompt and complete. The accumulation curve of tubocurarine has been described and its applications stated. The time required for it to reach equilibrium between the plasma and interstitial fluid has been calculated At any time following single or multiple doses of tubocurarine, the quantity remaining in the extracellular water may be determined from the equations; this also applies to tubocurarine delivered by infusion.

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confidence: 99%

Tubocurarine Administration Based Upon Its Disappearance and Accumulation Curves in Anaesthetized Man

Ryan

1964

British Journal of Anaesthesia

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“…Sir,-When referring to my use of tubocurarine to maintain neuromuscular blockade (Ryan, 1964), Drs Somogyi, Shanks and Triggs (1978) stated that I employed this drug in a manner similar to that of Evans and Spencer Gray (1953) who allowed their patients to breathe spontaneously. By 1964 most anaesthetists were using controlled ventilation and this was also my technique.…”

Section: Curare and Ventilationmentioning

confidence: 99%

Inadvertent Administration of 100% Oxygen During Anaesthesia

Paymaster

1978

British Journal of Anaesthesia

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“…Following cessation of infusion, plasma concentrations declined in either a mono-or bi-exponential form depending on the ratio of the hybrid disposition rate constants (P/a). In all instances a twocompartment open model was used to describe the time course of the plasma concentrations.The continuous administration of a non-depolarizing muscle relaxant to produce sustained neuromuscular blockade was employed first by Evans and Spencer Gray (1953). Following an initial, rapid infusion of gallamine, a slower infusion at the rate of 1 mg min" 1 was used, and the effects on abdominal muscular relaxation and spontaneous ventilation were observed.…”

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confidence: 99%

Combined I.V. Bolus and Infusion of Pancuronium Bromide

Somogyi

Shanks

Triggs

1978

British Journal of Anaesthesia

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SUMMARYAn i.v. bolus and concomitant infusion of pancuronium is proposed for use in prolonged anaesthesia. Plasma concentrations of pancuronium were measured in 16 patients receiving this regime. The desired steady-state concentration of 0.2 fig ml" 1 was achieved in most instances at approximately 45 min. Following the bolus, the neuromuscular twitch response decreased to low values or was abolished completely. Thereafter the response remained relatively constant or increased in intensity consistent with the mean steady-state plasma concentrations of 0.214 y.g ml" 1 (SEM 0.012) maintained by the infusion. When the infusion was stopped, the mean twitch height was 23% of control and increased thereafter at approximately 1 % per min, while plasma concentrations decreased by half in 69 min. One patient with renal artery stenoses exhibited complete neuromuscular blockade at a steady-state plasma concentration of 0.29 (zgml" 1 ; following cessation of infusion the twitch response was detected after 30 min (plasma concentration 0.20 (ig ml"" 1 ) and recovery was uneventful. Plasma clearance and apparent volume of distribution of pancuronium used to calculate the dosage regime were found not to differ significantly from those reported for a single dose. Following cessation of infusion, plasma concentrations declined in either a mono-or bi-exponential form depending on the ratio of the hybrid disposition rate constants (P/a). In all instances a twocompartment open model was used to describe the time course of the plasma concentrations.The continuous administration of a non-depolarizing muscle relaxant to produce sustained neuromuscular blockade was employed first by Evans and Spencer Gray (1953). Following an initial, rapid infusion of gallamine, a slower infusion at the rate of 1 mg min" 1 was used, and the effects on abdominal muscular relaxation and spontaneous ventilation were observed. Ryan (1964) employed a similar procedure for tubocurarine, based on the rate of disappearance and accumulation of the drug in anaesthetized man. Following an initial bolus dose (usually 15 mg) of tubocurarine, neuromuscular blockade was maintained by a constant infusion at a rate equivalent to the bolus dose per hour. By clinical assessment, the rate of infusion "remained remarkably constant in the majority of cases", although a few patients required a reduction in infusion rate during the 3rd and 4th hours.Miller and Eger (1976) determined the potency ratios of tubocurarine and pancuronium. Following a bolus dose, a continuously changing rate of infusion was administered to produce a constant 90% reduction of twitch tension. Plasma concentrations of drug(s) were not measured. For their study, calcula- tions were based on differences in the amount administered over different periods during the infusion of each relaxant. From the difference in potency ratios based on dose requirements for the first and last 30-min periods of observation, it was concluded that potency values determined by single injection techniques did not describe ad...

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Continuous Intravenous Thiopentone‐flaxedil*

Cited by 6 publications

References 3 publications

Tubocurarine Administration Based Upon Its Disappearance and Accumulation Curves in Anaesthetized Man

Tubocurarine Administration Based Upon Its Disappearance and Accumulation Curves in Anaesthetized Man

Inadvertent Administration of 100% Oxygen During Anaesthesia

Combined I.V. Bolus and Infusion of Pancuronium Bromide

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