Anaesthesia
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Comparative Study
Clinical evaluation of double-burst stimulation. Its relationship to train-of-four stimulation.
Double-burst stimulation was compared with train-of-four stimulation in 23 adult patients receiving atracurium. Train-of-four was interrupted in 11 subjects every 2 minutes by one double-burst stimulation, and re-applied 6-30 seconds later; the height of the first double-burst response, compared with its control, was depressed slightly more than T1. The relationship between double-burst stimulation ratio and train-of-four ratio was indistinguishable from the line of identity. ⋯ Fifteen anaesthetists were asked to detect fade manually in the second part of the study, while train-of-four was recorded on the opposite arm. One hundred and fourteen determinations were made in 12 patients. Fade was detected manually more often with double-burst stimulation than with TOF.
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Case Reports
Respiratory tract infection and anaesthesia. Haemophilus influenzae pneumonia that developed under anaesthesia.
A 2-year-old boy with symptoms of a minor upper respiratory tract infection developed Haemophilus influenzae pneumonia that presented as hypoxaemia under anaesthesia for minor emergency surgery. The patient required 72 hours of mechanical ventilation in an intensive care unit after the anaesthetic and thereafter made an uneventful recovery. The value of pre-operative chest radiology and the possible contributory effect of anaesthesia are discussed.