Hand or machine? A second look at ventilators.
نویسنده
چکیده
I agree that lignocaine is not a reliable alternative to a beta blocker in the management of adrenergically induced disturbances (Scott, Davie and Stephen, 1971). Lignocaine is a cell membrane stabilizer with a special affinity for neuromuscular tissue and is effective when given intravenously in relatively enormous doses. Like propanidid it may inactivate the baroreceptor mechanism to cause reflex stimulation of the cardiac sympathetic nervous system (Johnstone and Barren, 1968). This may explain its ineffectiveness in the management of sinus tachycardia. As an anti-dysrhythmic agent it is preferable to a beta blocker in patients with severe myocardial insufficiency, metabolic acidosis and other toxic states in which sympathetic blockade is not desirable. The membrane stabilizing effect of propranolol, alprenolol and oxprenolol when given intravenously in doses of 2 to 5 mg must be as infinitesimal as that caused by a similar dose of lignocaine. Strictly speaking the dose of a beta blocker cannot be defined precisely. The beta blocker competes with catecholamines for the occupation of the receptor site. The size of the dose is dictated by the severity of the adrenergic stress, i.e. the amount of circulating catecholamines. Practolol 5 to 20 mg or more i.v. may be required for the adequate control of adrenergic oyeractivity of the hearts of anaesthetized and atropinized patients, according to the degree of adrenergic stress.
منابع مشابه
Validation of the utilization of a specific spray machine to apply general herbicide (Glyphosate) for controlling weeds in chickpea farms in dry land areas of Iran
Weeds are a serious problem of chickpea cultivation in rain-fed areas of Iran and economic feasibility of crop production is mostly challenged by the method of control. In this study, two types of weed control strategies which are common in the country, including hand removing and hand removing + mechanical application, were compared with application of general herbicide (Glyphosite) using a sp...
متن کاملSecond-Hand Smoke Exposure at Home in the United States; Minorities’ Diminished Returns
Introduction: Educational attainment and poverty status are two strong socioeconomic status (SES) indicators that protect individuals against exposure to second-hand smoke. Minorities’ Diminished Returns (MDRs), however, refer to smaller protective effects of SES indicators among ethnic minority groups such as Hispanics and Blacks, compared to non-Hispanic Whites. This...
متن کاملCritique of Research Book (Art)/ Structure or Text: A Look at the Art of Plot Forming, Shaapur Azimi
متن کامل
Endoscopic Middle Ear and Mastoid Surgery for Cholesteatoma
Introduction: To reduce incidence of residual cholesteatoma following ear surgery; and to reduce the need for second look “open” mastoidectomy using endoscopic mastoidotomy. Ten-year retrospective chart review of 249 primary cholesteatoma cases (1994-2004) with a minimum follow-up of two years. The first objective was to evaluate the effectiveness of otoendoscopy in reducing the incidence of “...
متن کاملIntegrated Inspection Planning and Preventive Maintenance for a Markov Deteriorating System Under Scenario-based Demand Uncertainty
In this paper, a single-product, single-machine system under Markovian deterioration of machine condition and demand uncertainty is studied. The objective is to find the optimal intervals for inspection and preventive maintenance activities in a condition-based maintenance planning with discrete monitoring framework. At first, a stochastic dynamic programming model whose state variable is the ...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
- British journal of anaesthesia
دوره 43 8 شماره
صفحات -
تاریخ انتشار 1971