British journal of anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
General anaesthesia for caesarean section in severe pre-eclampsia. Comparison of the renal and hepatic effects of enflurane and halothane.
In a randomized study of patients undergoing Caesarean section, either enflurane (mean 0.24 MAC-h) or halothane (mean 0.23 MAC-h) and 50% nitrous oxide in oxygen were administered to women (n = 12) with severe pre-eclampsia-eclampsia and to 16 healthy pregnant patients with normal renal and hepatic function. No evidence of nephrotoxicity was found in any pre-eclamptic or normal patient. ⋯ Postoperative liver function tests showed no important changes from preoperative values, although reductive metabolites of halothane were not measured. In patients with severe pre-eclampsia there appears no contraindication to enflurane or, probably, halothane as volatile supplements during general anaesthesia.
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Letter Case Reports
Atracurium v. suxamethonium in a case of organophosphorous poisoning.
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Comparative Study
Subarachnoid blockade with bupivacaine. A comparison with cinchocaine.
Subarachnoid anaesthesia was induced in 40 patients with 0.5% bupivacaine 3 ml with no glucose, 5% glucose or 8% glucose, or with hyperbaric cinchocaine. The injections were made in the lateral position and the patients turned supine immediately. The onset, extent and duration of sensory and motor blockade, the quality of anaesthesia, cardiovascular effects, and the frequency of side-effects were studied. ⋯ Cinchocaine produced a longer duration of action at T10 and T12 than the hyperbaric bupivacaine solutions. No advantage was seen when 8% rather than 5% glucose was used. The glucose-free bupivacaine produced intense blockade of long duration and was suitable when a lower level of blockade was adequate for the proposed surgery.
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Case Reports
"Failed intubation" in obstetric anaesthesia. An indication for use of the "Esophageal Gastric Tube Airway".
The management of failure to intubate the trachea during emergency Caesarean section in a 116.7-kg woman is described. General anaesthesia was continued with the aid of a Gordon and Don Michael Esophageal Gastric Tube Airway. The forward displacement of the larynx caused by the tube in the oesophagus improved the patency of the airway.