Journal of clinical anesthesia
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Propofol was used for the induction and maintenance of anesthesia in a patient undergoing a laparoscopic tubal ligation. This new anesthetic has not been associated with postoperative ventricular arrhythmias. This report demonstrates the occurrence of supraventricular tachycardia deteriorating to ventricular tachycardia in a patient who received propofol. Included is a discussion of the possible causes of this event.
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This report describes the case of an 80-year-old woman with a long history of chronic, stable angina pectoris who underwent resection of an abdominal aortic aneurysm and placement of an aortobifemoral bypass graft under a combination of epidural and general anesthesia. Epidural morphine was administered postoperatively for pain management. The patient suffered a massive myocardial infarction (MI) in the immediate postoperative period but experienced no chest pain or discomfort similar to her usual anginal symptoms. The use of epidural and spinal opioids in the treatment of anginal pain is reviewed and discussed in terms of the possibility that such epidural opioid therapy may have masked this patient's anginal symptoms.
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To determine the impact of a low fresh gas flow rate on the duration of carbon dioxide (CO2) absorption by soda lime. ⋯ Because soda lime color indicators are unreliable, when a semiclosed breathing circle is used at a low rate of fresh gas flow without CO2 monitoring, the CO2 absorbent must be replaced more frequently.
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Comparative Study
Pharmacokinetics and effects of 9-amino-1,2,3,4-tetrahydroacridine in the immediate postoperative period in neurosurgical patients.
To determine the effects of intravenous (IV) 9-amino-1,2,3,4-tetrahydroacridine (THA) on postoperative somnolence in comparison to its pharmacokinetics. ⋯ The duration of the effects of THA as an antagonist of postoperative sedation was only about double that seen previously after the IV administration of physostigmine in a similar group of patients, although the elimination half-life of THA was six times longer than that of physostigmine. A larger dose of THA possibly could have been given to prolong the period of antagonism of sedation, but the profile of adverse effects seen even at the doses used precluded that option.