Anaesthesia
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We compared the dose-response relationship and the neuromuscular blocking effects of mivacurium during infusions of esmolol in 40 anaesthetised rabbits. Train-of-four stimuli were applied every 10 s to the common peroneal nerve and the force of contraction of the tibialis anterior muscle was measured. Plasma cholinesterase activity decreased by 13% after esmolol infusion. ⋯ The duration of neuromuscular block with mivacurium 0.16 mg.kg-1 was prolonged by 30% with esmolol due to diminished plasma cholinesterase activity (p < 0.05). Heart rate and mean arterial blood pressure decreased by 15% with esmolol (p < 0.05). The results of this study show that, in rabbits, esmolol decreased plasma cholinesterase activity, antagonised the neuromuscular blocking potency of mivacurium and prolonged its neuromuscular blocking effect.
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Critical care services appear to face increasing demand. To attempt to identify factors which may predispose to such increases in demand, the patients and their treatment were reviewed. The patients' ages, referring specialty and their risk of hospital mortality were recorded on admission. ⋯ The patients' mean ages increased by 1 year per year. The number of patients referred from general surgery consistently increased. The proportion of patients receiving vasoactive drugs and pulmonary artery catheters declined as did the duration of respiratory and renal support.