Anaesthesia
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Case Reports
Ketamine infusion. Its use as a sedative, inotrope and bronchodilator in a critically ill patient.
A patient with acute lymphatic leukaemia developed a bilateral fulminating Pseudomonas aeruginosa pneumonia and required controlled ventilation of the lungs. Marked agitation, hypotension and bronchospasm unresponsive to conventional bronchodilators presented a therapeutic challenge. ⋯ The clinical improvement was maintained for the 5 days during which ketamine was infused. Plasma concentrations of ketamine and its metabolites are reported.
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A case of transient sympathetic block of the arm following percutaneous intercostal nerve injections is described and the possible aetiology discussed.
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Case Reports
Combined unilateral high frequency jet ventilation and contralateral intermittent positive pressure ventilation.
The anaesthetic management of a patient who required right lower lobectomy for bronchial carcinoma associated with emphysema, pneumoconiosis and a previous thoracoplasty for pulmonary tuberculosis, is described. A technique of unilateral high frequency jet ventilation plus conventional intermittent positive pressure ventilation to the contralateral lung was used.
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The effects of suxamethonium 1.0 and 0.5 mg/kg were studied in myasthenic patients. Resistance was not encountered at the 1.0 mg/kg dose but was seen at the lower dose. ⋯ However, recovery from the non-depolarising block was not prolonged beyond the requirements of surgery. The neurophysiological basis for, and clinical implications of these findings are discussed.