British journal of anaesthesia
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Two surgeons, in whom liver damage developed after occupational exposure to sub-anaesthetic doses of halothane, were found to have a circulating antibody which reacted specifically with halothane-altered hepatocyte membrane components. This antibody had been found previously only in those patients in whom severe hepatic necrosis developed after exposure to halothane and in no other form of liver injury. It may provide a specific diagnostic marker in patients in whom there are other possible causes of liver damage and could, therefore, remove the need for a challenge exposure and its attendant risks.
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A system to control the alveolar anaesthetic concentration of patients undergoing halothane anaesthesia with controlled ventilation is described. Parameters characterizing the alveolar concentration response are determined on-line from breath-by-breath measurement of the inspired and end-tidal concentrations and the mixed venous anaesthetic partial pressure is estimated throughout the procedure. ⋯ Off-line verification results illustrate the operation of the technique and in 20 cases the inspired concentration, as controlled by the anaesthetist, was compared with that predicted by the automated system. These results indicate the feasibility of the system as a method for the control of anaesthesia.
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Bilateral superior laryngeal nerve block was combined with topical application of local anaesthetic 140 times in 135 patients to anaesthetize the upper airway and facilitate tracheal intubation, laryngeal instrumentation, or to diminish the response to the endotracheal tube, in a patient already intubated. The technique was successful in 92% of attempts.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of meptazinol and pethidine given i.v. on demand in the management of postoperative pain.
Meptazinol and pethidine were compared under double-blind conditions in 20 patients, using an on-demand analgesic system to provide pain relief after upper abdominal surgery. The degree of analgesia, subjectively assessed, was good with both meptazinol and pethidine; although meptazinol produced significantly more nausea than did pethidine (P less than 0.01), there was no statistically significant difference in the frequency of other side-effects. Over 24 h average consumption of meptazinol was 2.4 times that of pethidine, suggesting that, when given by i.v. injection, meptazinol is less potent that pethidine.