Anaesthesia
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Measurements of the vapour concentrations delivered by the EMO and Oxford Miniature Vaporizers (OMV) were made with both continuous (plenum mode) and intermittent (drawover mode) air flows. Leakage of ether, halothane and trichloroethylene vapours through the corrugated elephant tubing was also measured. Both vaporizers performed most consistently with the intermittent flows for which they were designed. ⋯ Minimal amounts of ether were lost through the tubing but halothane losses were appreciable, while losses of trichloroethylene were enough to reduce the concentrations available to the patient. The EMO is not suitable for plenum use with carrier gas flows below about 10 litres/min. The OMV is a useful plenum vaporizer although the outputs are generally lower than indicated at higher flows.
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A flexible fibreoptic laryngoscope was used to facilitate the passage of a long polyvinyl chloride tracheal tube into the left main bronchus during repair of a tracheo-oesophageal fistula situated near the carina in a patient in whom intubation with a double-lumen endobronchial tube was difficult. Close monitoring of neuromuscular transmission using a peripheral nerve stimulator also contributed to the successful anaesthetic management of this patient.