Anaesthesia
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Comparative Study
Monitoring of irrigating fluid absorption during transurethral prostatectomy. A study in anaesthetised patients using a 1% ethanol tag solution.
A simple, reliable method to detect absorption of irrigating fluid during transurethral prostatectomy is to tag irrigating fluids with 1% ethanol and monitor expired breath ethanol concentrations. This method correlated well (n = 0.79) with other existing methods of absorption monitoring in 20 anaesthetised patients. ⋯ The technique is non-invasive, repeatable, cheap and gives instant results. It can be used in anaesthetised or awake patients and can detect absorption of as little as 100-150 ml in any 10-minute period.
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Org 9426, a new steroidal non-depolarising muscle relaxant, which is stable in solution, was studied in 30 anaesthetised (thiopentone, fentanyl, nitrous oxide) male patients, ASA 1 or 2. A dose-response curve for Org 9426 was constructed and the ED90, mean (SD), was found to be 0.36 (0.031) mg/kg. ⋯ No signs of histamine release or cardiovascular effects were observed. Org 9426 thus has a faster onset of action than vecuronium bromide or atracurium dibesylate.
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A tube for bronchial intubation is described. A long (48 cm), small bore (5.0 mm internal diameter), cuffed, bronchial plastic tube is inserted coaxially within a large bore tracheal tube (10.0 mm) used for ventilation. ⋯ If the bronchial cuff is inflated the tube can be used either as a blocker or as a conduit for suction and conventional and differential ventilatory techniques. Early clinical experience suggests that the technique is an alternative method of facilitating one-lung ventilation.
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Case Reports
Caesarean section in undiagnosed Eisenmenger's syndrome. Report of a patient with a fatal outcome.
An obstetric patient is described in whom the first sign of cardiac disease was unexplained hypoxaemia during emergency anaesthesia for antepartum haemorrhage, with an eventual fatal outcome. The case highlights the importance of patient information at the booking clinic, and the implications of a raised haemaglobin in early pregnancy.
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We report three cases of chickenpox pneumonia in adults, all of whom required intermittent positive pressure ventilation. One patient developed a variety of complications, and another, a pregnant woman, required extracorporeal membrane oxygenation.