Anaesthesia
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We report the case of a 38 year-old woman who presented initially as the driver in a road traffic accident with a Glasgow Coma Score of 14, agitated, tachycardic, tachypnoeic and hypertensive. The combination of an abdominal CT scan and clinical findings led to the decision to perform an emergency laparotomy. Her persisting symptoms and laboratory results revealed her to be manifesting acute thyroid storm; TSH of < 0.10 IU.l(-1), free T4 of 59.8 pmol.l(-1) and free T3 of 20.20 pmol.l(-1).
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This study evaluated the stability and the compatibility of mixtures of morphine sulphate, bupivacaine, and clonidine hydrochloride and of hydromorphone, bupivacaine, and clonidine hydrochloride, when used in constant flow implantable pumps under simulated clinical use conditions. The pumps were filled with drug mixtures and incubated at 37 degrees C for a period of 90 days. Aliquots were sampled monthly from the reservoir and catheter outlet and the drug concentrations analysed using validated chromatography methods. ⋯ Both drug mixtures were found to be stable over 90 days in the pump at 37 degrees C. All device materials retained acceptable mechanical performance following exposure. These results demonstrate that both drug mixtures are stable when maintained at simulated body temperature in an implantable infusion system for 90 days.