0000000000088962

AUTHOR

Swen N. Piper

showing 9 related works from this author

The Effects of Sodium Nitroprusside-Induced Hypotension on Splanchnic Perfusion and Hepatocellular Integrity

1999

UNLABELLED The purpose of our study was to investigate the effects of sodium nitroprusside-induced hypotension on splanchnic perfusion and hepatocellular integrity. Thirty patients undergoing radical prostatectomy were allocated randomly to a sodium nitroprusside (SNP) or control group (control). Regional pco2 was measured using gastric tonometry, and the regional to arterial difference in partial pressure of CO2 and intramucosal pH were calculated. The cytosolic liver enzyme alpha-glutathione S-transferase and standard liver enzyme markers (alanine aminotransferase, aspartate aminotransferase, and gamma-glutamyltransferase) were also measured. Mean arterial pressure in the SNP group was 50…

MaleNitroprussideMean arterial pressuremedicine.medical_specialtyPartial PressureVasodilator AgentsUrologyHemodynamicsBlood PressurepCO2medicineHumansSplanchnic CirculationGastric tonometryAntihypertensive AgentsGlutathione TransferaseProstatectomybusiness.industryLiver DiseasesCarbon DioxideMiddle AgedIsoenzymesOxygenAnesthesiology and Pain MedicineLiverAnesthesiaSodium nitroprussideLiver functionChemical and Drug Induced Liver InjuryHypotensionSplanchnicbusinessPerfusionBiomarkersmedicine.drugAnesthesia & Analgesia
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Cost analysis of target-controlled infusion-based anesthesia compared with standard anesthesia regimens.

2000

UNLABELLED With the development of new computer-assisted target-controlled infusion (TCI) systems and the availability of short-acting anesthetics, total IV anesthesia (TIVA) has become increasingly popular. The aim of this study was to compare costs of TCI-based anesthesia with two standard anesthesia regimens. Sixty patients undergoing elective laparoscopic cholecystectomy were randomly divided into three groups. Group 1 (TIVA/TCI) received TIVA using a propofol-based TCI system and continuous administration of remifentanil; Group 2 (isoflurane) underwent inhaled anesthesia with isoflurane, fentanyl, and N2O; Group 3 (standard propofol) received fentanyl and N2O and a continuous infusion …

Adultmedicine.medical_specialtyCost-Benefit AnalysisRemifentanilAnesthesia GeneralFentanylPacuRemifentanilDrug Delivery SystemsPiperidinesMedicineHumansInfusions IntravenousPropofolInfusion PumpsAgedbiologyIsofluranebusiness.industryMiddle Agedbiology.organism_classificationSurgeryFentanylRegimenAnesthesiology and Pain MedicineIsofluraneAnesthesiaAnestheticAnesthetics Inhalationmedicine.symptombusinessPropofolPostoperative nausea and vomitingAnesthetics Intravenousmedicine.drugAnesthesia and analgesia
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Retracted: Do patients profit from physostigmine in recovery from desflurane anaesthesia?

2007

Background:  Physostigmine is the drug of choice in the central anticholinergic syndrome, but has also been used in post-operative mental derangement secondary to sedatives and volatile anaesthetics. The aim of this double-blind, randomized, prospective study was to determine whether physostigmine alters recovery after desflurane anaesthesia. Methods:  One hundred patients undergoing urologic or surgical procedures were enrolled to receive either NaCl 0.9% (n= 50) or 2 mg of physostigmine (n= 50) at the end of general anaesthesia with propofol, fentanyl, cisatracurium and desflurane. Times to extubation, stating name, birthday and place of residence, and obeying commands such as eye opening…

AdultMalemedicine.medical_specialtyPhysostigmineTime FactorsPhysostigminePlaceboStatistics NonparametricPacuFentanylDesfluranePostoperative ComplicationsDouble-Blind MethodmedicineHumansGeneral anaesthesiaProspective StudiesAgedbiologyIsofluranebusiness.industryGeneral MedicineMiddle Agedbiology.organism_classificationSurgeryAnesthesiology and Pain MedicineAnesthesiaAnesthesia Recovery PeriodAnesthetics InhalationShiveringFemaleCholinesterase Inhibitorsmedicine.symptombusinessPropofolDesfluranemedicine.drugActa anaesthesiologica Scandinavica
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Influence of dopexamine on hemodynamics, intramucosal pH, and regulators of the macrocirculation and microcirculation in patients undergoing abdomina…

2000

Abstract Objective: To investigate whether dopexamine hydrochloride beneficially influences splanchnic perfusion and regulators of the macrocirculation and microcirculation in patients undergoing surgery of the abdominal aorta. Design: Prospective, blinded, and randomized study. Setting: University-affiliated hospital. Participants: Twenty patients undergoing elective abdominal aortic surgery. Interventions: The patients were randomized to one of two groups. In the dopexamine group (DOP, n = 10), dopexamine, 1 μg/kg/min, was started before surgery and continued for 24 hours. In the control group (COG, n = 10), patients received saline solution as placebo. Extensive hemodynamic monitoring wa…

Aortabusiness.industrymedicine.medical_treatmentAbdominal aortaPulmonary artery catheterDopexamineHemodynamicsPlasma renin activityAnesthesiology and Pain Medicinemedicine.arteryAnesthesiamedicineCardiology and Cardiovascular MedicinePulmonary wedge pressurebusinessAbdominal surgerymedicine.drugJournal of Cardiothoracic and Vascular Anesthesia
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The heart in the elderly critically ill patient

2002

Cardiac complications such as myocardial infarction and congestive heart failure are the primary source of perioperative morbidity and mortality in elderly surgical patients. This is the result of structural and functional age-related changes in the heart and the vasculature and an increasing incidence of cardiovascular disorders. Appropriate perioperative management of the elderly patient should be based on the extent of functional compromise, the type and severity of pre-existing disease, and the invasiveness of the surgical procedure. Current studies suggest that appropriately administered medical therapy, particularly beta-adrenergic blockade, may reduce perioperative cardiovascular mor…

Heart FailureAgingClinical Trials as Topicmedicine.medical_specialtyCritically illbusiness.industryCritical IllnessIncidence (epidemiology)Psychological interventionAnemiaHeartDiseasePerioperativeCritical Care and Intensive Care Medicinemedicine.diseasePerioperative CareBlockadeRisk FactorsHeart failuremedicineHumansMyocardial infarctionbusinessIntensive care medicineAgedCurrent Opinion in Critical Care
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Low-Flow Desflurane and Sevoflurane Anesthesia Minimally Affect Hepatic Integrity and Function in Elderly Patients: Retracted

2000

UNLABELLED Hepatic blood flow is reduced in a dose-related manner by all inhaled anesthetics now in use. We assessed hepatic function in elderly patients anesthetized with desflurane or sevoflurane. We measured the cytosolic liver enzyme alpha glutathione S-transferase (alpha GST), the formation of the lidocaine metabolite monoethylglycinexylidide (MEGX), and gastric mucosal tonometry-derived variables as sensitive markers of hepatic function and splanchnic perfusion. Thirty patients, 70 to 90 yr old, were allocated randomly to receive desflurane or sevoflurane anesthesia. Anesthetic exposure ranged from 2.1-4.5 minimum alveolar concentration hours. No significant changes in standard liver …

MaleMethyl EthersMinimum alveolar concentrationLidocaineSevofluraneSevofluraneDesfluranemedicineHumansAgedGlutathione TransferaseAged 80 and overIsofluranebusiness.industryLidocaineAnesthesiology and Pain MedicineLiverGastric MucosaAnesthesiaAnesthetics InhalationAnestheticFemaleLiver functionSplanchnicbusinessDesfluranePerfusionmedicine.drugAnesthesia & Analgesia
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Economic aspects of different muscle relaxant regimens.

2000

Objective At a time of cost reduction in medical care efforts to manage the ever-increasing costs of new pharmaceutical drugs become increasingly important. Costs of four different muscle relaxant regimens including the new intermediate-acting neuromuscular blocking drugs (NMBD) cisatracurium and rocuronium will be analyzed. Methods Eighty patients undergoing laparoscopic cholecystectomy were prospectively studied. All patients received standardized general anaesthesia with desflurane/fentanyl. Muscle relaxation was achieved with atracurium, cisatracurium, vecuronium, or rocuronium with 20 patients in each group. Intraoperatively muscle relaxants were added to maintain two twitches of the t…

AdultMaleTime Factorsmedicine.drug_classCritical Care and Intensive Care MedicineDrug CostsPacuFentanylDesfluraneIntraoperative PeriodMedicineHumansGeneral anaesthesiaAnesthesiaAndrostanolsProspective StudiesRocuroniumAgedAged 80 and overPostoperative CareNeuromuscular BlockadeVecuronium Bromidebiologybusiness.industryMuscle Relaxants CentralMuscle relaxantGeneral MedicineMiddle Agedbiology.organism_classificationAnesthesiology and Pain MedicineMuscle relaxationTreatment OutcomeCholecystectomy LaparoscopicAnesthesiaEmergency MedicineAtracuriumFemaleRocuroniumbusinessmedicine.drugNeuromuscular Nondepolarizing AgentsAnasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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RETRACTED ARTICLE: Hemodynamics, intra-mucosal pH and regulators of circulation during perioperative epidural analgesia

2000

Objectif: Etudier les effets de l'analgesie peridurale perioperatoire sur l'hemodynamie, la perfusion splanchnique et les regulateurs de la circulation. Methode : Vingt patients subissant un pontage aortique infrarenal ont ete repartis au hasard en deux groupes : un groupe GP recevant l'analgesie peridurale avec bupivacaine (15 ml a 0,125 %) avant l'operation, suivis de 10 ml de bupivacaine a 0,125 % et de 1 mg de morphine 8 h et 16 h apres l'operation; un groupe temoin GT sans catheter epidural. Le monitorage comprenait un catheter de l'artere pulmonaire et un tonometre gastrique. Les regulateurs de circulation etaient mesures sur des echantillons de sang : avant l'analgesie peridurale (T …

Anesthesiology and Pain MedicineCarbon dioxide bloodArterial diseasebusiness.industryAnesthesiaPerioperative careMedicineGeneral MedicinebusinessAspartic EndopeptidasesAortic diseaseCanadian Journal of Anesthesia/Journal canadien d'anesthésie
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Retracted: Cerebral effects and blood sparing efficiency of sodium nitroprusside-induced hypotension alone and in combination with acute normovolaemi…

2001

The combined reduction of oxygen-carrying capacity and perfusion pressure during the combination of acute normovolaemic haemodilution (ANH) and controlled hypotension (CH) raises concerns of hypoperfusion and ischaemic injury to the brain. Forty-two patients undergoing radical prostatectomy were prospectively allocated to receive CH induced by sodium nitroprusside (mean arterial pressure (MAP) 50 mm Hg), a combination of CH+ANH (post-ANH haematocrit 29%; intraoperative MAP 50 mm Hg), or standard anaesthesia (control). Serum levels of the brain-originated proteins neuron-specific enolase (NSE) and protein S-100, blood loss, transfusion requirements, adverse effects, and postoperative recover…

Mean arterial pressurebusiness.industryLitermedicine.diseaseCentral nervous system diseaseAnesthesiology and Pain MedicineAnesthesiamedicineSodium nitroprussidebusinessPacked red blood cellsComplicationAdverse effectPerfusionmedicine.drugBritish Journal of Anaesthesia
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