Lancet
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Hydrogen peroxide levels were measured in the breath condensate of 43 patients receiving mechanical ventilation. In 16 patients the mean breath condensate peroxide level was 1.68 +/- 0.35 mumol/l on the day they met diagnostic criteria for adult respiratory distress syndrome (ARDS). ⋯ Plasma lysozyme, a measure of in-vivo neutrophil turnover, was significantly higher in ARDS than in non-ARDS patients (9.2 +/- 2.2 U/ml v 3.4 +/- 1.1 U/ml). These findings support the hypothesis that neutrophil activation and oxidant production are involved in the pathogenesis of ARDS.
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Eight patients undergoing abdominal surgery received epidural analgesia with 0.5% plain bupivacaine at a fixed dose rate (8 ml/h) for postoperative pain relief. Mean sensory level of analgesia (pin prick) was assessed hourly and regressed from a mean preoperative level of T3.7 (+/- 0.3 SEM) to T10 (+/- 0.7) at an average of 8.9 +/- 1.4 h post skin incision (range 4-16 h). ⋯ Simultaneously, pain score decreased to 0.3 +/- 0.3. This synergistic effect of systemic morphine on the extent of neural blockade with epidural bupivacaine may have an important role in improving postoperative pain relief.