Annales chirurgiae et gynaecologiae
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Clinical Trial Controlled Clinical Trial
Circulatory responses to laryngoscopy and endotracheal intubation in patients with and without cardiovascular disease. Effect of prophylactic practolol.
The effect of small intravenous doses of practolol (0.2 mg/kg body weight) on the circulatory response to laryngoscopy and endotracheal intubation, when administered with atropine (0.01 mg/kg b.w.) prior to anaesthesia was studied in 39 patients with and without cardiovascular disease. Practolol diminished significantly the rise of mean arterial pressure and pulse rate affected by laryngoscopy and endotracheal intubation when performed under thiopentone-succinylcholine anaesthesia. ⋯ The small practolol dose used had no adverse circulatory effects. It is suggested that the administration of a small prophylactic dose of practolol is useful in preventing the excessive cardiovascular response due to laryngoscopy and endotracheal intubation.
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A case of cardiac rupture secondary to blunt chest injury and its successful surgical repair is described. A review of the literature based on eleven previous similar cases is given.
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Comparative Study
Comparison of thiopentone versus althesin for caesarean section.
Thiopentone and Althesin were compared in 50 patients undergoing general anaesthesia for Caesarean section. The patients were divided into group A (24 mothers) were thiopentone (3.5 mg/kg) was used for induction and group B (26 mothers) where Althesin (80 mu1/kg) was employed. Blood samples for estimating the maternal and umbilical venous and arterial blood pH, pCO2, BD and pO2 were taken at the time of delivery. ⋯ The umbilical venous and arterial pH, pCO2 and BD were well within the normal physiological range and there was no significant intergroup difference. The only significant differences were the lower umbilical venous and arterial pO2 values in the Althesin group. The clinical condition of the newborn (Apgar score) showed no significant difference between the two groups.
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105 valve replacements with the Björk-Shiley tilting-disc prosthesis have been performed in 99 patients with an overall mortality of 12%. The hospital mortality for 73 single aortic valve replacements was 10%, for 24 single mitral valve replacements 13%, and for 5 double valve operations 20%. ⋯ The follow-up period of the first patients with aortic valve replacement is 4 1/2 years, and that of those with mitral valve replacement over 2 1/2 years. The most common late complication in patients with mitral valve replacement was a paravalvular leak (19%), whereas in patients with aortic valve replacement slight haemolytic anaemia (4%) and late thromboembolism (3%) occurred most frequently. 84 of the 87 survivors showed manifest clinical improvement in their preoperative status and increased exercise tolerance.
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A case of intussusception of the appendix caused by an adenovillous papilloma in the appendix is reported. The condition was combined with acute appendicitis. ⋯ The aetiology is briefly discussed. The treatment is operative with removal of the appendix or an appropriate resection.