thiopental and Urination-Disorders

The present prospective study investigates the impact of a standardized technique of spinal and general anaesthesia on the incidence and consequences of postanaesthetic complaints dependent on age and sex of patients.. 433 orthopaedic patients underwent lower limb surgery in spinal (group 1) or general (group 2) anaesthesia. Spinal anaesthesia was performed with 0.5% hyperbaric bupivacaine using a 26-gauge Quincke needle. General anaesthesia was induced with i.v. injection of thiopentone, fentanyl and atracurium and maintained with 65% nitrous oxide and 1-1.5 Vol% isoflurane in oxygen. On postoperative day 4, patients were interviewed for onset and duration of postoperative complaints.. The overall incidence of nausea/vomiting (P = 0.025) and sore throat (P = 0.0001) was higher in group 2. In addition, nausea/vomiting was higher in patients between 20 and 60 years in group 2 compared with group 1. While the incidence of urinary dysfunction was higher in men after spinal (P = 0.04), nausea/vomiting was more frequent in women after general anaesthesia (P = 0.008). Analgetic requirements (P = 0.013), time of postoperative surveillance (P = 0.042) and frequency of treatment of postoperative complaints (P = 0.0001) was higher in group 2.. Spinal anaesthesia was associated with a lower incidence of postoperative complaints and treatments and a shorter surveillance compared to general anaesthesia. Specific complications related to spinal anaesthesia did not depend on age or sex and may allow for recommendation of this technique even in younger and female patients undergoing orthopaedic surgery.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anesthesia, General; Anesthesia, Spinal; Anesthetics, Inhalation; Anesthetics, Intravenous; Female; Humans; Isoflurane; Leg; Low Back Pain; Male; Middle Aged; Nausea; Orthopedics; Pharyngitis; Postoperative Complications; Prospective Studies; Thiopental; Urination Disorders; Vomiting

The effects of FL-155, which was synthesized to develop a new orally-active anti-pollakiuria agent, on the rhythmic bladder contractions were studied in anesthetized rats. At a pressure exceeding 10 cm H2O in the bladder, a rhythmic bladder contraction was observed up to at least 120 min. This response was abolished by a spinal (C1 level) cut, cuts of both pelvic nerves, thiopental (3.0 mg/kg, i.v.) or lidocaine (1.0 mg/kg, i.v.); and atropine (0.01 mg/kg, i.v.) strongly inhibited the amplitude of the response. FL-155 and flavoxate, in intravenous (0.3-3.0 mg/kg and 1.0-3.0 mg/kg, respectively) and intraduodenal (12.5-100 mg/kg and 200-400 mg/kg, respectively) administrations, dose-dependently abolished the rhythmic bladder contractions, and FL-155 was 8-16 times more potent than flavoxate in intraduodenal administrations. These results suggest that the rhythmic bladder contraction in anesthetized rat may be a polysynaptic reflex through pelvic nerves and the central nervous system (supraspinal level), and FL-155 appears to be a candidate for an orally active anti-pollakiuria agent.

Topics: Animals; Atropine; Flavoxate; Lidocaine; Male; Periodicity; Piperidines; Rats; Rats, Inbred Strains; Reflex; Thiopental; Urinary Bladder; Urination Disorders

The feasibility of providing postoperative analgesia using thoracic extradural blockade following thoracotomy has been assessed. Extradural block was produced by intermittent injections of 0.5% bupivacaine with adrenaline 1:200,000 or a continuous infusion of 0.25% or 0.125% bupivacaine. The only toxic symptom was drowsiness which was most frequent after a continuous infusion of 0.25% bupivacaine and with arterial plasma bupivacaine concentrations above 1.5 mug/ml. Arterial hypotension was a troublesome complication with all techniques although stability of arterial pressure was more easily achieved with a continuous infusion technique. However, this produced a high incidence of urinary retention. Practical aspects and effectiveness of providing extradural analgesia in patients following thoracotomy are discussed.

Topics: Aged; Anesthesia, Epidural; Bupivacaine; Epinephrine; Female; Fentanyl; Halothane; Humans; Hypotension; Male; Middle Aged; Pain, Postoperative; Thiopental; Urination Disorders

Topics: Anesthesia, General; Child; Chlorpromazine; Fractures, Bone; Humans; Hypertension; Male; Meperidine; Nitrous Oxide; Oxygen; Promethazine; Radius Fractures; Tachycardia; Thiopental; Ulna; Urination Disorders