Anaesthesia
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A case of unsuspected acute amphetamine abuse by a 22-year-old girl which led to serious intracranial hypertension during anaesthesia for a neurosurgical procedure is described. It was difficult to maintained anaesthesia with an intermittent positive-pressure ventilation technique using muscle relaxants, N2O and O2 and supplements of fentanyl despite large doses of pancuronium and fentanyl. The differing effects of chronic and acute amphetamine dosage on anaesthetic requirements are reviewed.
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An obstetric patient had a subarachnoid block during attempted extradural analgesia for labour. The sensory block extended to T1 and was accompanied by hypotension. The analgesia lasted 3 hr. after which sensory and motor function recovered quickly. The local anaesthetic agent used was 2% 2-chloroprocaine.