General anaesthesia with halothane and drug absorption. The effect of general anaesthesia with halothane and diazepam on postoperative gastric emptying in man

Pharmacokinetic and pharmacodynamic interactions in anaesthesia. A review of current knowledge and how it can be used to optimize anaesthetic drug administration

This review describes the basics of pharmacokinetic and pharmacodynamic drug interactions and methodological points of particular interest when designing drug interaction studies. It also provides an overview of the available literature concerning interactions, with emphasis on graphic representation of interactions using isoboles and response surface models. It gives examples on how to transform this knowledge into clinically and educationally applicable (bedside) tools.

The effect of spinal analgesia and surgery on peroperative drug absorption and gastric emptying in man

Paracetamol 20 mg kg-1 dissolved in 200 ml of water was given by mouth to seven patients undergoing minor orthopaedic surgery in spinal analgesia, and again 2 weeks later. The rate of paracetamol absorption was significantly delayed by spinal analgesia and surgery, indicating an inhibition of peroperative drug absorption and gastric emptying. The effect of spinal analgesia on gastric emptying was not able to normalize the delayed peroperative gastric emptying produced by surgery, and suggests that surgery is an important factor in peroperatively delayed gastric emptying.

Inaccuracy of peranesthetic gastric intubation for emptying liquid stomach contents

To assess the accuracy of the method of peranesthetic gastric intubation for emptying the liquid stomach contents, this procedure was tried on 80 patients undergoing general anesthesia. Half of the patients had a double-barrelled 16F-Argyle Salem sump tube, length 120 cm, size 16 CH, and the other half had a single-barrelled stomach tube, length 80 cm, size 25 CH. After emptying the stomach with the tubes 25 ml of glucose was given through the gastric tube to half of the Salem tube group and half of the stomach tube group. Similarly 100 ml of glucose was given to half of the Salem tube group and half of the stomach tube group. After instillation of glucose 25 ml or 100 ml, the Salem tube recovered 21.0 +/- 9.1 ml (mean +/- s.d.), median 24 ml, range 6-36 ml or 86.8 +/- 26.9 ml, median 92 ml, range 18-136 ml, respectively, and the stomach tube 17.1 +/- 10.8 ml, median 18 ml, range 2-34 ml or 54.0 +/- 28.5 ml, median 50 ml, range 14-104 ml, respectively. This indicates that the method of gastric intubation for emptying the liquid stomach contents is inaccurate.