British journal of anaesthesia
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We have recorded auditory evoked potentials before and during cardiopulmonary bypass in 10 adult patients undergoing cardiac surgery under moderate hypothermia to 27-28 degrees C. The immediate effect of bypass was a small decrease in latency and increase in amplitude of the early cortical response. ⋯ Reduction in core temperature to 25 degrees C resulted in an increase in latency and amplitude of the brain stem responses; below this temperature the amplitude decreased but latency continued to increase until the auditory evoked response trace became completely flat between 21 and 19 degrees C. These changes were reversible on rewarming.
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Comment Letter Case Reports
Malignant hyperthermia and compartment syndrome.
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Randomized Controlled Trial Comparative Study Clinical Trial
Recovery after electroconvulsive therapy: comparison of propofol with methohexitone anaesthesia.
We have studied prospectively 39 patients receiving a course of electroconvulsive therapy (ECT) for major depressive disorder; they were allocated randomly to receive either propofol or methohexitone for anaesthesia. Recovery after the third ECT treatment was assessed by finger tap and digit symbol substitution tests at 15, 30, 45, 60 and 90 min after induction. ⋯ There was no significant difference in psychometric recovery for drug type, duration of the seizure or initial severity of depression. These results suggest that the more rapid recovery rates noted with propofol in other procedures are not evident after electrically induced seizures.
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Editorial Comment
Volume preloading, spinal hypotension and caesarean section.
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I have evaluated in vitro methods of increasing the flow rate of clear fluids through an i.v. cannula at room temperature. These included, alone and in combination: increasing the height of a gravity-fed system; increasing the i.v. cannula diameter, manual compression of the lower drip chamber and the use of pressure bags. ⋯ The combination of these two tripled the overall flow to nearly 600 ml min-1. Manual compression of the drip chamber, despite producing peak pressures of more than 100 cm H2O, was an inefficient method of improving flow compared with an external pressure bag.