Anaesthesia
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A method of intra-operative awakening which allows assessment of spinal cord function during Harrington rod spinal fusion for scoliosis is described. The anaesthetic technique is based on a standard muscle relaxant, N2O anaesthetic sequence supplemented with intravenous morphine 0.1 mg/kg at the commencement of surgery and 0.2 mg/kg intramuscular premedication. ⋯ Five patients remembered being woken, but did not regard it as unpleasant. In one patient, this technique allowed intra-operative detection and correction of impaired motor function of the legs.
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Randomized Controlled Trial Clinical Trial
Droperidol and endotracheal intubation. Attenuation of pressor response to laryngoscopy and intubation.
The cardiovascular responses to anaesthesia, laryngoscopy and tracheal intubation were studied in 20 healthy adult patients. The mean arterial pressure increase following intubation was 1.60 mmHg (SEM +/- 3.52 mmHg) in patients to whom droperidol 150 microgram/kg was given intravenously before anaesthesia compared with a rise of 26.50 mmHg (SEM +/- 4.35 mmHg) in a control group of patients.
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A patient who reacted to both methohexitone and Althesin on separate occasions is described. On each occasion the reaction was delayed following anaesthesia. Underlying chronic infection had sensitised the patient's complement pathway, allowing it to be activated by two unrelated intravenous anaesthetic agents.
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A patient is reported who developed suxamethonium apnoea as a result of reduction in serum cholinesterase activity secondary to both pregnancy and plasmaphoresis. Had the enzyme studies been carried out before operation, regional rather than general, anaesthesia would have been used. In order to avoid the problems associated with prolonged paralysis we recommend the measurement of cholinesterase activity in all patients who have undergone plasmaphoresis and in whom anaesthesia involving the use of suxamethonium is contemplated.