Anaesthesia
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Case Reports Comparative Study
Vecuronium block in the myasthenic patient. Influence of anticholinesterase therapy.
The neuromuscular block of vecuronium was investigated in two myasthenic patients undergoing thymectomy. The first patient had no pre-operative anticholinesterase therapy, the second patient was given pyridostigmine 60 mg 4 hourly, continued until the morning of surgery. In the two patients, neuromuscular block of vecuronium was monitored by electromyography. The results suggest that the neuromuscular block of vecuronium may be decreased by pre-operative preparation of the myasthenic patient by pyridostigmine.
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Comparative Study
The Finapres 2300e finger cuff. The influence of cuff application on the accuracy of blood pressure measurement.
Blood pressure measurements associated with malapplication of a finger cuff were compared with contemporaneous intra-arterial pressure data in seven volunteers to determine the influence of cuff application on the accuracy of the Finapres 2300e. Systolic readings in all cuff positions differed from arterial line data by more than the recommended standard and tight and loose cuff applications under and over-read respectively, in all subjects. The results show the Finapres to be sensitive to small degrees of finger cuff malapplication which contribute to the bias on direct arterial comparison and limit the reliability of the instrument in clinical practice.
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Case Reports
The management of anaesthesia for caesarean section in a patient with paroxysmal ventricular tachycardia.
We describe the successful management of general anaesthesia for Caesarean section in a patient with poorly controlled paroxysmal ventricular tachycardia of pregnancy. The use of alfentanil before laryngoscopy and tracheal extubation ensured cardiostability without compromising maternal or fetal wellbeing. General anaesthesia allows prompt cardioversion. We believe that in the presence of a life-threatening unstable cardiac rhythm this consideration outweighs any theoretical advantage of regional blockade.
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Comment Letter Case Reports
Unexpectedly high spinal anaesthesia following failed extradural anaesthesia for caesarean section.