Canadian Journal of Anesthesia/Journal canadien d'anesthésie

Bodman, R.

doi: 10.1007/BF03006782pmid: 75050

Both d-tubocurarine and pancuronium release histamine in the skin: both have been shown to cause bronchospasm after intravenous injection. It is unlikely that skin testing with either drug will detect an individual susceptibility to bronchospasm, except as a non-specific test for atopy.

Pagano, Richard; Graham, Charles; Galligan, Michael; Conner, James; Katz, Ronald

doi: 10.1007/BF03006784pmid: 23892

A previously established rat model has been utilized to demonstrate that an acute inflammatory response occurs after high intravenous doses of lorazepam. This occurs only with high concentrations of drug equivalent to 20 times the normal clinical dosage in man. In contrast, water soluble RO 21-3981 produces no vascular pathology in any dosage evaluated. It appears that propylene glycol may play a role in the pathogenesis of the intravascular injury observed.

Spoerel, W.; Aitken, R.; Bain, J.

doi: 10.1007/BF03006780pmid: 272223

Although the Mapleson A system (Magill attachment) is more efficient in spontaneously breathing patients under anaesthesia, our clinical experience has shown that the Mapleson D system (Bain circuit) can be used safely for spontaneous respiration under suitable conditions. In 113 craniotomies under general anaesthesia with spontaneous breathing a mean Paco 2 of 39 ± 6 mm Hg was obtained with a fresh gas flow (FGF) ranging from 90 to 160 ml/kg; there was no difference between 15 patients with FGF of 93 ±4 ml/kg/min and a Paco 2 of 40 ± 6 mm Hg and 15 patients maintained on the highest FGF of 143 ± 11 ml/kg/min with a Paco 2 of 39 ± 5 mm Hg. Comparing the Bain circuit with the Magill attachment and the circle absorber in 101 unpremedicated young adults undergoing oral surgery under endotracheal anaesthesia with nitrous oxide and halothane or enflurane, we found the Bain circuit with 100 ml/kg/min (RMV 20 per cent higher than circle absorber, Paco, 40 ± 4 mm Hg) equally efficient than the Magill attachment with a FGF of 70 ml/kg/min (RMV 17 per cent higher than the circle absorber, Paco 2 39 ± 6 mm Hg). In the Bain circuit greater rebreathing by a reduction of the FGF to 70 ml/kg/min produced a 57 per cent rise in RMV with a Paco, of 42 ± 4 mm Hg; a slower respiratory rate induced by substituting enflurane for halothane did not improve the efficiency of the Bain circuit. In all patients the surgical stimulation induced about a ten per cent increase in RMV, inducing mild hypocapnia with the circle absorber (Paco 2 35 ± 5 mm Hg) and the Bain circuit with FGF of 140 ml/kg/min (Paco, 36 ± 3 mm Hg). It is concluded that suitable patients, anaesthetized to retain an adequate CO2 response, can be allowed to breathe spontaneously with the Bain breathing circuit.

Candy, J.; McQueen, M.

doi: 10.1007/BF03006785pmid: 624106

Succinylcholine apnoea is usually the result of a delay in hydrolysis of the injected muscle relaxant due to the presence of an inherited defect in the enzyme cholinesterase.

doi: 10.1007/BF03006790pmid: N/A

Batra, Y.; Bali, I.

doi: 10.1007/BF03006788pmid: 624109

Electromagnetic 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.

Westenskow, Dwayne; Jordan, William

doi: 10.1007/BF03006777pmid: 624101

Changes in whole body oxygen consumption due to bolus infusions of fentanyl and thiopentone given during ’balanced anaesthesia’ have been examined in 17 patients. It has been shown that fentanyl causes an average decrease in oxygen consumption of 4.9, 8.4, and 5.2per centat 5, 10 and 15 minutes after its infusion. Thiopentone causes an average decrease of 7.0, 8.8, and 1.9 per cent at 5,10 and 15 minutes after infusion. It is believed that the effects of fentanyl and thiopentone on oxygen consumption are caused mainly by decreases in cerebral and myocardial oxygen consumption.

Wade, John; Sørenson, Søren

doi: 10.1007/BF03006778pmid: 624102

Total cerebral ischaemia in rats caused a marked increase in the cisternal CSF potassium concentration but little change in CSF sodium or chloride concentration. The anaesthetic techniques studied (pentobarbitone, halothane/oxygen and nitrous oxide/oxygen/relaxant) did not effect the potassium increase following cerebral ischaemia. We conclude that the mechanism of barbiturate protection following cerebral ischaemia is different from that of hypothermia.

Ong, Bill; Palahniuk, Richard; Cumming, Maureen

doi: 10.1007/BF03006781pmid: 23891

We 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.

McKnight, D.; Marshall, B.

doi: 10.1007/BF03006786pmid: 624107

This paper presents a patient showing both the unusual syndrome of catamenial pneumothorax and a strong family history of malignant hyperthermia. The anaesthetic management is described and discussed.