Canadian Journal of Anesthesia/Journal canadien d'anesthésie

Churchill-Davidson, H.; Wise, R.

doi: 10.1007/BF03002127pmid: 14099689

1. The injection of a non-depolarizing relaxant drug (d-tubocuraraie) in the neonate leads to a neuromuscular block similar to that observed in an adult patient 2. There was no evidence of increased sensitivity of the hand muscles of the neonate tod-tubocurarme as compared with the adult. The possibility of increased ‘ sensitivity” of the respiratory muscles is discussed 3. The similarity between some aspects of neuromuscular transmission in the newborn and in patients with myasthenia gravis is described 4. The suggestion is made thatd-tubocuranne (well diluted) is more suitable than suxamethonium for producing muscular relaxation in the neonate

Gottlieb, Joel; Sweet, Robert

doi: 10.1007/BF03002128pmid: 14099693

Blood glucose levels were observed at 30-minute intervals in ten healthy male patients anaesthetized with methoxyflurane It was found that the blood glucose level was approximately 85 mg % throughout these anaesthetics It is concluded that methoxyflurane does not interfere with carbohydrate metabolism or alter sympathetic tone in the normal patient.

Ruston, F.

doi: 10.1007/BF03002129pmid: 14099688

The use of epidural anaesthesia in paediatric surgery is presented as a continuation of the preliminary reports which were published in 1954 arid 1957. The technique of epidural block has been modified by the advent of Carbocaine and Nesacaine so that Xylocaine is no longer in a singular position. The introduction of the modified Wagner Point needle has added greatly to the safety and facility of epidural block. Continuous epidural anaesthesia has been used in prolonged serious abdominal operations A reply has been attempted to the criticism of paediatnc epidural anaesthesia Safety measures have been emphasized. The author believes that although epidural anaesthesia can hold a position in the practice of paediatnc anaesthesia, yet it should not be used unless all the members of the surgical team have confidence in its application

Webb, Eric

doi: 10.1007/BF03002130pmid: 14099690

Si éanesthésiste, pai ailleurs bien qualifié, ne fait pas ľeffort de quitter sa confortable salle ďopération pour pénétrer dans le bureau du dentiste, ce champ ďaction demeure ouvert ou au médecin peu préparé, ou au dentiste qui peut être tenté de pratiquer simultanément la chiruigie et ľanesthésie. Nous ne pouvons permettre cela. Dans ľune ou ľautre eventualité, le malade est mal servi, et ľanesthésie recule au lieu ďavancei.

Dobkin, Allen; Israel, Jacob; Byles, Peter

doi: 10.1007/BF03002131pmid: 14099691

The experimental evaluation of intravenous. Innovan anaesthesia in healthy male subjects showed that this drug mixture, in a low dose, exerts a marked neuro and hypno sedative effect and, in higher doses, with N2O-O2 supplementation, produces unconsciousness accornpanied by depression of the sympathetic nervous system, as shown by the Horner’s syndrome, warm, dry extremities, engorged veins, and moderate depression of blood pressure. Cardiovascular depression appears to be minimal and of short duration and, in most of the subjects, the cardiovascular system remained remarkably stable during the action of this agent. Respiratory depression is intense for a short period and mild for a much longer period Hypertonic reactions, affecting the neuromuscular system, appear early as spasm of the thoracic, abdominal, and neck muscles, which would probably necessitate the use of muscle relaxants to ensure adequate pulmonary ventilation, and later as restlessness and dyskinesia of the muscles in the face and neck—which may require treatment with anticholinergic drugs such as atropine or cogentin Two subjects complained of the occurrence of hallucinations which lasted several days in one case Whether or not this disturbance was due to Innovan alone could not be established Representative liver function and metabolic tests indicate that Innovan is a relatively non-toxic substance in the dose range required for approximately one hour of general anaesthesia. The incidence of nausea and vomiting appears to be negligible after this anaesthetic.

Cox, J.; Spoerel, W.

doi: 10.1007/BF03002132pmid: 14099692

We believe that the results obtained with continuous epidural analgesia maintained with an electrically timed mechanical injection device are encouraging. It is our plan to continue this type of treatment and to investigate the use of more flexible injection devices with a greater sterility factor than the one reported in this presentation. It is felt that the use of such a device contributes towards a more exact treatment and at the same time frees personnel from the constant pressure of observing a time schedule. The hazard introduced by a device such as this does not, in our opinion, exceed that of repeated manual injections given by a variety of persons. Like any other form of treatment, adequate supervision by nurses and physicians familiar with this technique is essential. With intermittent injections of constant volume and exact timing it has become evident that the main obstacle towards the maintenance of a continuous epidural analgesia is tachyphylaxis By this we mean a diminished duration of action of the local anaesthetic as well as a diminution of potency. At present there is no satisfactory explanation for this phenomenon.

Allabd, Eug; Guimond, Claude

doi: 10.1007/BF03002133pmid: 14099694

During the past four years halothane has been used for obstetrical anaesthesia in the great majority of cases. It was cur choice for 3657 deliveries and 138 Caesarean sections, approximately 65 per cent of our confinements and 44 per cent of our Caesareans.

Jobidon, Alfred; Paradis, Bernard; Labrecque, André; Douville, Gédéon

doi: 10.1007/BF03002134pmid: 14099695

Nous avons au cours de ce travail fait un bref historique de ľhexafluorénium. Nous en avons énuméié les principaux caracteres physicochimiques et pharmacologiques Quelques notions biochimiques ont été revues au sujet de ľacétylcholine et des cholinestérases La réalité et ľampleur de la potentialisation de la succmylchohne pai ľhexafluorénium ont été démontrées. Les différentes techniques ďutilisation du complexe hexafluorénium-succinylcholine ont ensuite été exposées Notre étude s’appuyait sur 50 anesthésies générales choisies au hasard. Après quelques explications sur les techniques ďanesthésie, de curarisation et de “ventimétrie” nous avons fait une analyse des résultats obtenus. La potentialisation de la succinylcholine par ľhexafluorénium est réelle et intense. Avec ľassociation hexafluorénium-succinylcholine il y a absence de la fibrillation musculaire et des effets muscariniques souvent imputables à la succinylcholine seule. Le pouls, la tension artérielle et le tracé électrocardiographique ont été remarquablement stables chez chacun de nos patients. La potentialisation de la succinylchohne par ľhexafluorénium nous a semblé plus prononcée avec ľusage du Penthrane et du “respirateur” automatique. Deux cas ont été étudiés en détail et portés sur nos tableaux II et III Ľun sert à illustrer notre technique de “ventimétrie”. Le second est un cas typique ďhypo-pseudo-cholinestérasémie. Ľassociation hexafluorénium-succinylcholine est indiquée dans les anesthésies prolongées où ľon désire éviter les effets secondaires des autres curansants, se mettre à ľabri ďune curarisation résiduelle, ou ménager une fonction rénale hypothéquée Elle est contie-indiquée dans les différentes affections où le taux de la pseudo-cholinestérase est susceptible ďêtre abaissé. Deux objections apportées à ľutilisation de ľhexafluorénium ont ensuite été réfutées. La succinylcholine potentialisée par ľhexafluorénium est une flèche additionnelle dans le carquois de ľanesthésiste. Tous les agents curarisants utilisés jusqu’ici sous de multiples modalités techniques conservent leur valeur et leurs indications. A côté ďeux, le couple hexafluorénium-succinylcholine mérite, croyons-nous, une place au soleil. On a, et avec beaucoup de raison, chanté les louanges de ľanesthésie potentialisée. Nous avons voulu par ce travail faire valoir les vertus de la curarisation potentialisée.

Brunelle, J.; Lepage, C.

doi: 10.1007/BF03002135pmid: 14099686

Intracranial subfrontal hypophysectomy is a serious procedure associated with some difficult problems of anaesthesia. The most important one is to prevent cerebral oedema caused by retraction of the frontal lobe for a long time.

Charlebois, P.

doi: 10.1007/BF03002136pmid: 14099687

Ľauteur rapporte trois cas inusités ďemphysème, c’est-à-dire de présence anormale ďair ou de gaz dans les tissus Dans le premier cas, il s’agit ďune primipare qui, durant la deuxième phase du travail, a retenu sa respiration et a poussé fortement pendant des heures Immédiatement avant la délivrance, on a noté un emphysème marqué sur la face, le cou et le thorax Des radiographies et un craquement synchronisé avec les bruits du cœur ont montré que la malade avait un pneumo-médiastin Ľévolution postpartum fut normale, et la malade reçut son congé au bout de quatre jours.