Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Chronic headaches are difficult problems to manage effectively. A select group of six patients with headache symptoms (throbbing headaches, located in the frontal or occipital areas; aggravated by ambulation and relieved by recumbency) resembling post-dural puncture headache received epidural blood patches using autologous blood for their chronic headaches. Five of the six patients obtained effective and sustained pain relief. ⋯ The mechanism of action of the blood patch in these patients is unclear. It is possible that the headache may have been caused by a low pressure cerebrospinal fluid state, due to an unknown anatomical or physiological defect of the ventriculo-spinal system. Further studies are needed to evaluate this treatment modality.
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The effects on erythrocyte fragility of two general anaesthetic agents (halothane and ethanol) and succinylcholine were examined using preparations from 13 normal and four malignant hyperthermia susceptible patients. Erythrocyte fragility was determined by the degree of haemolysis induced in solutions of decreasing osmolarity of NaCl. Halothane caused haemolysis of erythrocytes in an isoosmolar solution, being more potent at 42 degrees C than at 32 degrees C. ⋯ Succinylcholine 10 mM did not significantly alter the susceptibility of erythrocytes to lysis by halothane. No differences in erythrocyte fragility were observed between preparations from normal and malignant hyperthermia susceptible patients under any of the conditions tested, despite the inclusion of malignant hyperthermia triggering agents in some instances. Although sampling a larger patient population might reveal slight differences between the groups, erythrocyte fragility tests do not appear to be useful in differentiating malignant hyperthermia susceptible from normal patients.
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Comparative Study
Intraoperative respiratory complications in patients with upper respiratory tract infections.
A retrospective survey of 3,585 patients aged newborn to 20 years was performed to investigate the prevalence of intraoperative respiratory complications in patients with symptoms of upper respiratory tract infections (URIs). There were no significant differences in complication rates between asymptomatic patients (1.61 per 100) and those with symptoms (1.64 per 100); however, patients who were asymptomatic but had a recent history of an URI had a significantly higher complication rate (5.31 per 100; p less than 0.05) than the asymptomatic patients. ⋯ Results from the study suggest no increased risk of respiratory complications for patients presenting with uncomplicated URIs. However, patients who were asymptomatic but had a recent history of an URI showed a significantly increased risk for the development of intraoperative complications.