Anesthesia/anesthetics atropine

At least 1 week after their arrival, the rats are given atropine sulfate (0.4 mg/kg, i.p.) and anesthetized with sodium pentobarbital (50 mg/kg i.p.) or isoflurane gas (5%). When necessary, supplemental doses of sodium pentobarbital are given or isoflurane gas is adjusted to maintain anesthesia. The rats are hydrated with 0.9% saline (3.0 cc, s.c.) and given penicillin (0.05 cc 1500 units, i.m.). 

Anesthetic techniques that have minimized adverse effects include the use of muscle relaxants and, more recently, nerve stimulators to assess adequacy of relaxation, the introduction of very rapid acting, short-duration barbiturates, and the use of atropinic agents to minimize the cardiovascular response to a combination of a seizure and anesthesia (93). In addition, 100% oxygenation (adequacy monitored by a pulse oximeter) with positive-pressure ventilation can minimize related cardiac events and memory disruption. 

A 65-year-old woman, who had had normal preoperative serum electrolytes and a normal QT interval with sinus rhythm, received hydroxyzine and atropine premedication followed by thiopental and vecuronium for anesthetic induction. Endotracheal intubation was difficult and precipitated atrial fibrillation, which was refractory to disopyramide 100 mg. Anesthesia was then maintained with sevoflurane 2% and nitrous oxide 50%. Ten minutes later ventricular tachycardia ensued, refractory to intravenous lidocaine, disopyramide, and magnesium. DC cardioversion resulted in a change to a supraventricular tachycardia, which then deteriorated to torsade de pointes. External cardiac massage and further DC cardioversion were initially unsuccessful, but the cardiac rhythm reverted to atrial fibrillation 10 minutes after the sevoflurane was switched off. Two weeks later she had her operation under combined epidural and general anesthesia, with no changes in cardiac rhythm. 

The ability to dry up bronchial secretions and reduce laryngospasms (induced by some general anesthetics) has been the reason for using atropine and scopolamine as presurgical medication. It should be mentioned that scopolamine, which differs from atropine by the (3-6,7-epoxy bridge (Fig. 8-13), while it generally parallels atropine s pharmacological spectrum, does not share its cerebral and medullary stimulation rather it exhibits CNS depression and amnesia, properties applied to anesthesia in an adjunct capacity. 

In the Edo era (1603—1867), Seishu Hanaoka (1760-1835) succeeded in conducting the world s first anesthesia operation using an anesthetic comprised o Aconitum tuber and Datura metel (Solanaceae), etc. (the exact formula remains unknown). Among them, D. metel is known to afford atropine. In the meantime, P.F. von Siebold was involved in the so-called Siebold-Incident regarding S.japonica (Solanaceae), which also gives atropine. Details of these stories will be given in Chapter 3.2. 

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