Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jul 1998
Case ReportsAsymptomatic methaemoglobinaemia and its implications.
Anaesthetists are well trained to detect subtle skin signs of life-threatening situations such as cyanosis in hypoxia. However, cyanosis resulting from drug-induced, asymptomatic methaemoglobinaemia is rare and is likely to go undetected preoperatively. Patients presenting with asymptomatic methaemoglobinaemia may, therefore, offer a dramatic challenge to the unprepared anaesthetist. We report a case of methaemoglobinaemia secondary to dapsone ingestion that was diagnosed intraoperatively.
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Acta Anaesthesiol Scand · Jul 1998
Dose-related cardiovascular effects of amrinone and epinephrine in reversing bupivacaine-induced cardiovascular depression.
To ascertain the efficacy of amrinone and epinephrine in reversing bupivacaine-induced cardiovascular depression, we investigated the time course of recovery of cardiac function with 3 doses of both agents after bupivacaine administration. ⋯ Bolus amrinone may have a certain efficacy in reversing bupivacaine-induced cardiovascular depression, and improving cardiac contractility and relaxation dose-relatedly. In contrast to amrinone, bolus epinephrine remains indispensable for resuscitation, causing a rapid, massive, transient and dose-related rise in blood pressure. However, the use of amrinone may be limited predominantly by a decrease in systemic vascular resistance, while the use of epinephrine may be limited predominantly by the generation of serious ventricular dysrhythmias and lack of effectiveness on cardiac index and on cardiac relaxation.