Canadian Journal of Anesthesia/Journal canadien d anesthésie

Moffitt, Emerson A.

doi: 10.1007/bf03006774pmid: 624100

Steward, D. J.; Volgyesi, G.

doi: 10.1007/bf03006775pmid: 624104

SummaryA stabilometer has been used to measure changes in the activity of postural muscles during the later stages of recovery from anaesthesia. It is concluded that stabilometry might be a useful tool with which to measure and record the extent of recovery and that this might be especially useful for use after out-patient surgery.

Oyama, T.; Matsuki, A.; Kudo, T.; Kudo, M.; Yamashita, M.; Ishihara, H.

doi: 10.1007/bf03006776pmid: 23893

SummaryThe effect of haemorrhage on endocrine function and the anti-shock effects of methylprednisolone were investigated in 32 mongrel dogs. Plasma concentrations of antidiuretic hormone (ADH), epinephrine, norepinephrine, aldosterone and cortisone were measured simultaneously during and following haemorrhagic hypotension. Other parameters, such as urine volume and osmolality, serum and urine electrolytes and blood glucose were also determined simultaneously during the procedure. Dogs anaesthetized with pentobarbitone were bled so that the mean arterial pressure decreased to 50 mm Hg, which was maintained for 15 minutes (group one) or for 30 minutes (groups two, three, and four). After the recovery of group one animals from the first hypotension by reinfusion of blood and hydroethylstarch, they were bled again to a mean arterial pressure of 50 mm Hg (second hypotension) and were allowed to remain at this pressure. In groups two, three and four there was no second hypotension.Plasma ADH concentrations were elevated 50 times control values on the first hypotension, but no appreciable increase was observed on the second hypotension. Plasma levels of epinephrine, norepinephrine and aldosterone increased 35, 7, and 5 times respectively during the first hypotension and 40, 10, and 5 times during the second hypotension, as compared to controls. Plasma osmolality correlated well with plasma ADH levels during the haemorrhage. Increased concentrations of plasma ADH, epinephrine and norepinephrine following haemorrhage had a tendency to decrease after the administration of fluids, but they were still higher than the preshock control levels. Methylprednisolone 15 mg/kg or 30 mg/kg administered intravenously before infusion of blood and hydroethylstarch caused a significant decrease of plasma levels of ADH and epinephrine to pre-shock control levels. Our data suggest that the administration of methylprednisolone could be beneficial in improving the shock state from an endocrinological point of view.

Ong, Bill Y.; Palahniuk, Richard J.; Cumming, Maureen

doi: 10.1007/bf03006781pmid: 23891

SummaryWe measured the volume and pH of the gastric content of 21 out-patients and 21 in-patients under general anaesthesia. Gastric tubes were inserted after induction of anaesthesia, and gastric fluids were withdrawn for pH determinations. Gastric volumes were measured by a dilution technique using polyethylene glycol as the indicator and also by measurement of the volume aspirated through agastric tube. Out-patients had a mean gastric volume of 69 ± 17 ml while inpatients had a mean volume of 33 ± 4 ml. The average gastric pH for the out-patients was 1.8 ± 0.2 and for the in-patients 2.0 ± 0.3. Four outpatients had more than 75 ml of gastric fluid of pH less than 2.0. Aspiration through a gastric tube did not empty the stomach completely and the volume thus obtained gave a falsely low estimate of the gastric volume.

Pflug, A. Eugene; Aasheim, Geordis M.; Foster, Charlene; Martin, Roy W.

doi: 10.1007/bf03006783pmid: 624105

SummaryThis study involves ventilation of the lungs with warmed humidified anaesthetic gases during prolonged elective abdominal operations. Tympanic, oesophageal and toe temperatures were compared between twenty warmed and twenty un-warmed patients at various times during operation and recovery. Fifty per cent (10/20) unwarmed patients shivered in the recovery room, while none of the warmed patients shivered. Our data indicate that pulmonary ventilation with warm humidified anaesthetic gases provides heat transfer by the lungs, preventing hypothermia during operation and post-anaesthesia shivering is prevented by maintaining the patient normothermic in both the operating room and the recovery room.

Elelsen, O.; Stovner, J.

doi: 10.1007/bf03006787pmid: 624108

SummaryA 19-year-old girl suffering from active dermatomyositis was given suxamethonium 60 mg during anaesthesia for termination of pregnancy. A prolonged suxamethonium action occurred which was explained by the finding of homozygous atypical plasmacholinesterase in her blood. Although no fasciculations were seen immediately after injection of the drug, a period of fasciculations progressing from the extremities to the head and trunk occurred during recovery of muscle tone. No hyperpyrexia or elevation of serum creatine phosphokinase occurred. This was ascribed to the steroid therapy she received. Plasma from four other patients suffering from dermatomyositis was also investigated and one young woman, also pregnant, was found to be heterozygous for the atypical enzyme.

Batra, Y. K.; Bali, I. M.

doi: 10.1007/bf03006788pmid: 624109

SummaryElectromagnetic interference from diathermy apparatus can be a real hazard in a patient with a demand pacemaker. A case is reported in which the cutting current of transurethral electrocaut ery deactivated an implanted pacemaker, while coagulating current did not alter pacemaker activity. Therefore frequent short bursts of cutting current were used for successful resection of the prostate. This case emphasizes the need for vigilant care of patients with demand pacemakers requiring transurethral resection.