British journal of anaesthesia
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This paper describes the development of a microprocessor controlled anaesthetic machine comprising an integrated anaesthetic apparatus and monitoring system. Following prolonged reliability trials in the laboratory, changes have been made to major components which were described in earlier publications.
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Case Reports
Anaesthetic management for caesarean section in a patient with uncorrected truncus arteriosus.
We describe the successful management of a 25-yr-old primigravida with uncorrected truncus arteriosus, requiring an urgent Caesarean section for delivery of a live infant and we discuss the rationale of using the chosen drug combination and the importance of adequate monitoring in selecting an anaesthetic technique based on the pathophysiology of the congenital cardiac lesion.
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Randomized Controlled Trial Clinical Trial
Doxacurium chloride: a preliminary clinical trial.
The onset, duration of action and reversibility of doxacurium were studied in 27 anaesthetized patients, using doses of 37.5 micrograms kg-1 (1.5 x ED95) and 62.5 micrograms kg-1 (2.5 x ED95). Onset was slow and, whilst tracheal intubation was always possible 3 or 4 min after injection, the conditions were not ideal. With the higher dose a mean 97.6 (SD 5.2)% block of the response of adductor pollicis to ulnar nerve stimulation was obtained in 9.85 (6.17) min and recovery of the integrated EMG response to 20% of control took 102 min (42 min). ⋯ Antagonism of block with edrophonium 1 mg kg-1, whilst fast in onset, was rarely complete; with neostigmine 50 micrograms kg-1 antagonism was satisfactory. No adverse haemodynamic effect was seen, although a gradual onset of bradycardia, which responded to atropine or glycopyrrolate, was noted in 12 of the patients. No histamine release or other adverse effects were noted.