British journal of anaesthesia
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Although volatile anaesthetics afford protection against bronchospasm, their potential to reverse a sustained constriction of hyperreactive airways has not been characterized. Accordingly, we investigated the ability of halothane, isoflurane, sevoflurane and desflurane to reverse lung constriction induced by prolonged stimulation of the muscarinic receptors in guinea pigs sensitized to ovalbumin. ⋯ Volatile agents can reverse sustained MCh-induced airway constriction only transiently in sensitized guinea pigs. Isoflurane proved most beneficial in temporally improving lung function in the presence of a severe constriction of allergic inflamed airways. Desflurane displayed potential to induce further airway constriction.
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We describe the locked-in syndrome in a 31-yr-old patient after right upper lobectomy for suspected metastasis. After surgery, vertical eye movement was her only means of communication. ⋯ Post-mortem examination showed extensive metastatic tumour deposition in the ventral pons. We discuss the clinical features of this syndrome and factors that may affect onset, diagnosis and management.
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The coronavirus which causes severe acute respiratory syndrome (SARS) is a virulent and highly contagious organism. Of the 1755 SARS patients in Hong Kong, over 400 were healthcare workers. ⋯ These points are especially pertinent when anaesthetizing SARS patients for high-risk procedures such as tracheostomy. We describe the management of such a case.