Anaesthesia
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Twenty patients undergoing microlaryngoscopy were anaesthetised with thiopentone and nitrous oxide. Half of the patients received 1.0-1.5 mg of fentanyl during anaesthesia, the effect of which was antagonised by naloxone 0.4 mg intravenously and 0.4 mg subcutaneously. The other patients served as controls and received saline instead of fentanyl and naloxone. ⋯ However, there were no significant differences between patients given fentanyl with naloxone, and those given saline, in respect of arterial pressure, heart rate or dysrhythmia during recovery. No patient vomited, or appeared nauseated when observed afterwards in the operating room. One patient vomited several hours after naloxone.
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Pre-oxygenation was studied in 12 fit volunteers and 20 patients using an oxygen flow of 8 litres/minute delivered from a standard anaesthetic machine via a Magill or Bain breathing attachment. End-tidal nitrogen concentrations of 4% or less were achieved within 3 minutes; the fastest times were achieved using the Magill breathing system when the reservoir bag was filled with oxygen prior to application to the face. Gas-tight fits of face masks on patients were found to be essential.