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Journal ArticleDOI

Incidence and clinical importance of perioperative histamine release: randomised study of volume loading and antihistamines after induction of anaesthesia

TL;DR: The histamine-related disturbances under anaesthesia were remarkable for their severity (even with small rises in histamine concentrations), for the prevalence of bradycardia, and for the absence of skin signs.
About: This article is published in The Lancet.The article was published on 1994-04-16 and is currently open access. It has received 136 citations till now. The article focuses on the topics: Antihistamine & Haemaccel.
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Journal ArticleDOI
TL;DR: Diligent reporting of adverse drug reactions is an essential means of alerting clinicians and drug companies to potentially new causes of previously reported reactions.
Abstract: Haemaccel (polygeline) is frequently used as a plasma expander in the critical care setting. Allergic reactions to polygeline occur infrequently and may manifest as hypotension, bronchospasm, dyspnoea or skin reactions including facial oedema. A marked increase in reactions during 1999 prompted investigation of the possible mechanism. Review of reports suggested an association with perioperative use and concomitant use of angiotensin converting enzyme inhibitors. A change in the manufacturing process was later identified as the probable cause of many of the recent reactions and the production process has since been modified. Diligent reporting of adverse drug reactions is an essential means of alerting clinicians and drug companies to potentially new causes of previously reported reactions. (author abstract)
Journal ArticleDOI
07 Aug 2014
TL;DR: Bir α2 adrenoreseptor agonisti olan xylazine uygulamasina bagli olarak kopeklerde bradikardi, hipotansiyon, hipopnea, bulanti ve kusma gibi yan etkiler gorulebilmektedir olan mepyramine maleate’in etkinliginin arastirilmasi amaciyla yapildi
Abstract: Bir α2 adrenoreseptor agonisti olan xylazine uygulamasina bagli olarak kopeklerde bradikardi, hipotansiyon, hipopnea, bulanti ve kusma gibi yan etkiler gorulebilmektedir. Bu calisma xylazine hydrochloride’e bagli olusan bulanti ve kusmanin onlenmesinde bir H1 reseptor antagonisti olan mepyramine maleate’in etkinliginin arastirilmasi amaciyla yapildi. Calismada 30 kopek kullanildi ve kopekler 10’arli 3 gruba ayrildi. Calismada antihistaminik uygulamasinin yapildigi an 0. dakika kabul edilerek, birinci guruptakilere 1 mg/kg, ikinci gruptakilere 2 mg/kg dozda intramuskuler (i.m.) mepyramine ve ucuncu gruptakilere ise esit miktarda i.m. serum fizyolojik enjeksiyonu yapildi. Butun kopeklere bu enjeksiyonlardan 20 dakika sonra 2,2 mg/kg dozda i.m. xylazine enjekte edildi. Xylazine enjeksiyonundan sonra birinci ve ikinci gruptakilerden birer kopek kusarken ucuncu gruptakilerden sekiz kopek kustu. Ucuncu gruptakilerden dokuzunda bulanti gozlenirken, birinci grupta 2 ve ikinci grupta 3 kopekte bulanti saptandi. Birinci ve ikinci gruplarda mepyramine uygulamasindan sonraki 40., 60. ve 80. dakikalarda (xylazine uygulamasindan sonraki 20., 40. ve 60. dakikalar) pulzasyon ve respirasyon onemli (P
References
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Journal ArticleDOI
TL;DR: 80 reports of randomised clinical trials in four leading general medical journals were reviewed and the reporting of the methodology of randomisation was inadequate, and the handling of comparisons of baseline characteristics was inadequate.

473 citations

Journal ArticleDOI
TL;DR: The electrocardiographic changes consistent with ischemia during the 4 day perioperative period were documented and characterized in 100 patients with or at risk for coronary artery disease undergoing noncardiac surgery and postoperative ischemic episodes were the most severe.

321 citations

Journal ArticleDOI
TL;DR: Pancuronium is suggested to be the least likely currently available agent to provoke a major anaphylactoid reaction and Predisposing factors in patients sensitive to muscle relaxants were: female sex, previous allergy and atopy.
Abstract: Sixty one patients who had suffered intra-operative anaphylactoid reactions were studied. Intradermal testing identified the causative agent in 84% of cases and, in 75% of these, muscle relaxants were responsible. Predisposing factors in patients sensitive to muscle relaxants were: female sex, previous allergy and atopy. The incidence of previous exposure was considerably higher than that reported in the literature. Pancuronium is suggested to be the least likely currently available agent to provoke a major anaphylactoid reaction.

130 citations

Journal ArticleDOI
TL;DR: The effects of increasing concentrations of three opioids were studied on the release of preformed and de novo synthesized chemical mediators from human peripheral blood basophils and mast cells isolated from skin tissues or lung parenchyma.
Abstract: Opioids differ in their capacity to cause release of histamine. The effects of increasing concentrations of three opioids (morphine, buprenorphine, and fentanyl) were studied on the release of preformed (histamine and tryptase) and de novo synthesized (prostaglandin D2 [PGD2] and peptide-leukotriene C4 [LTC4]) chemical mediators from human peripheral blood basophils and mast cells isolated from skin tissues or lung parenchyma. Basophils released < 5% of their histamine content and did not synthesize significant amounts of LTC4 when incubated with any of the opioids. Mast cells showed markedly different responses to the three opioids. Morphine (10(-5)-3 x 10(-4) M), in a concentration-dependent manner, induced histamine and tryptase release from skin but not from lung mast cells, up to a maximum of 18.2 +/- 1.9% and 13.0 +/- 4.1 micrograms/10(7) cells, respectively. Morphine did not induce de novo synthesis of PGD2 from skin mast cells. Buprenorphine (10(-6)-10(-4) M), in a concentration-dependent manner, caused histamine and tryptase release from lung but not from skin mast cells, to a maximum of 47.6 +/- 7.2% and 35.1 +/- 13.6 micrograms/10(7) cells, respectively. Buprenorphine also induced de novo synthesis of PGD2 and LTC4 from lung mast cells. Fentanyl (10(-5)-10(-3) M) did not induce histamine and tryptase release or the de novo synthesis of PGD2 or LTC4 from any mast cells. Histamine release caused by buprenorphine from lung mast cells was slow (t1/2 = 11.2 +/- 3.6 min) compared with that induced by morphine from skin mast cells (t1/2 < 1 min, P < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

113 citations