British journal of anaesthesia
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A patient developed persistent symptoms and signs suggestive of partial spinal cord infarction after an operation involving the use of the hyperlordotic position. This position involves extension at the waist, such that both the head and feet are below the level of the waist. It is employed to increase surgical access to the abdomen. Where this position is adopted for a prolonged surgical procedure, existing risk factors for spinal cord ischaemia should urge caution in the use of epidural analgesia.
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In some patients passage of a pulmonary artery flotation catheter (PAFC) into the pulmonary artery may be difficult and time consuming and the prolonged manipulation can cause ventricular arrhythmias. A simple clinical method used during general anaesthesia is presented to allow rapid passage of a PAFC into the pulmonary artery. ⋯ This method may reduce the risk of ventricular arrhythmias, and could be particularly useful in high-risk critically ill patients.
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The effects of halogenated anaesthetics on cross-bridge (CB) kinetics are unclear. As halogenated anaesthetics do not markedly modify the intracellular calcium transient in the diaphragm, we used an isolated rat diaphragm preparation to assess the effects of halothane and isoflurane on CB kinetics. ⋯ In the rat diaphragm at therapeutic concentrations, halogenated anaesthetics do not significantly modify CB mechanical and kinetic properties.