Anaesthesia and intensive care
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Anaesth Intensive Care · Aug 1976
Case ReportsBronchospasm associated with enflurane exposure--three case reports.
Three cases of severe bronchospasm occurring in known asthmatics following the administration of enflurance are described. Other commonly known causes of bronchospasm did not seem to be operative. Moderately high concentrations of halothane in the respired gases protected against the bronchospasm whereas a moderately high blood concentration did not. Although the authors have administered enflurane to other known asthmatics without producing bronchospasm, they feel it should be used with caution in such patients.
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Thiopentone and pentobarbitone reduce the time constant of decay of miniature end-plate currents when applied in anaesthetic concentrations to the neuromuscular junction. Such an effect at central synapses would lead to failure of synaptic transmission in the central nervous system and may reflect a common mode of action of many anaesthetic drugs.
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Anaesth Intensive Care · May 1976
Cerebral arterio-venous oxygen difference: a bedside test for cerebral death.
A bedside test is described which compares the patients cerebral arterio-venous oxygen difference with a predicted norm at various levels of arterial CO2 tension. In patients in coma depasse this difference is reduced and is unresponsive to variations in arterial carbon dioxide tension. The test also confirms lack of respiratory efforts in the presence of adequate carbon dioxide tension.
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Anaesth Intensive Care · May 1976
Reactions to rapid infusion of stable plasma protein solution during large volume plasma exchange.
Five per cent heat treated stable plasma protein solution (SPPS) has been rapidly infused into 25 patients, as fluid replacement during large volume plasmapheresis. Reactions were produced in 20 patients. ⋯ These observations support earlier reports of hypotension due to rapid SPPS infusion, and document the occurrence of subjective symptoms which may be the harbingers of a hypotensive reaction. In view of the known presence of a bradykinin-like substance in some heat treated plasma protein solutions, hypotension during SPPS infusion should be interpreted with caution in the light of these findings.