British journal of anaesthesia
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Neuromuscular blockade was obtained with vecuronium 108 micrograms kg-1 in 44 patients undergoing diagnostic muscle biopsy as part of an investigation of malignant hyperthermia (MH) susceptibility. At the termination of anaesthesia doxapram 1.43 mg kg-1 was given in an attempt to antagonize postoperative respiratory depression. Rectal, muscle and skin temperatures, blood lactate concentration and venous PCO2 were measured before, during and after anaesthesia. ⋯ There were no differences between the three groups in rectal or muscle temperature, blood lactate concentration or venous PCO2 at any time. Doxapram did not prevent an increase in postoperative PCO2. It is concluded that vecuronium and doxapram may be safely administered to patients susceptible to MH.
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Comparative Study Clinical Trial Controlled Clinical Trial
Intraocular pressure changes during rapid sequence induction of anaesthesia: comparison of propofol and thiopentone in combination with vecuronium.
Intraocular pressure (IOP) was measured during rapid sequence induction of anaesthesia using thiopentone or propofol as the induction agent and vecuronium for neuromuscular blockade. Vecuronium was administered in a dose of 0.15 mg kg-1 approximately 35 s before the induction agent. IOP was measured with a handheld applanation tonometer before anaesthesia, following administration of the induction agent, immediately after tracheal intubation and cuff inflation and 1, 2 and 3 min later. ⋯ IOP following intubation in patients in whom anaesthesia was induced with thiopentone was not significantly different from baseline values, but showed a significant increase from the pressure before intubation. In contrast, IOP after intubation in the propofol group remained not only significantly less than the baseline value, but also showed only a minimal and insignificant change in comparison with values before intubation. The frequency of side effects was low in both groups except for a significantly greater reduction in arterial pressure in those receiving propofol.
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The dynamic performance of arterial manometers depends upon the values of the natural frequency fo and the damping factor beta. Satisfactory reproduction of all arterial waveforms requires that fo should be greater than about 13 Hz; for an fo of 13 Hz, beta should have a value of 0.5, but, as fo increases, an increasing range of beta values is permissible. ⋯ We also investigated the performance of a commercial device, the Accudynamic, designed to allow beta to be increased without affecting fo. We found that the Accudynamic worked well, allowing acceptable performance to be obtained from the Gould Disposable transducer with catheters up to 200 cm in length.