British journal of anaesthesia
-
Comparative Study
Memory function after i.v. midazolam or inhalation of isoflurane for sedation during dental surgery.
Memory function was assessed with a recognition memory test in 40 dental patients before and after sedation with i.v. midazolam or inhalation of isoflurane. The two groups were comparable, but there was a significant impairment of memory (P less than 0.001) at the time of discharge for both words and faces after midazolam, but not after isoflurane.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of neuromuscular block in the diaphragm and hand after administration of tubocurarine, pancuronium and alcuronium.
The onset and offset of neuromuscular block in the diaphragm and in the adductor pollicis muscle were recorded using unilateral supramaximal stimulation of phrenic and ulnar nerves. Thirty patients were allocated randomly to receive tubocurarine 0.4-0.5 mg kg-1, pancuronium 0.07-0.08 mg kg-1 or alcuronium 0.2-0.3 mg kg-1. ⋯ There was a correlation between the time of spontaneous reappearance of twitch in the diaphragm and in the adductor pollicis only in the patients who received pancuronium (r = 0.97, P less than 0.05 for reappearance of the first twitch of the train-of-four of each muscle). The duration of paralysis in the diaphragm was less than 5 min in five patients who received tubocurarine and in one who received alcuronium; this corresponded to a period of paralysis in the adductor pollicis muscle of more than 25 min in each case.
-
We describe the successful management of a 26-yr-old achondroplastic dwarf undergoing elective Caesarean section under extradural anaesthesia. The patient had marked thoracolumbar kyphoscoliosis and clinical features which suggested that tracheal intubation would prove difficult. Block sufficient for surgery required only 5 ml of 0.5% bupivacaine and, apart from an initial unilateral block and mild intraoperative hypotension, her perioperative course was uneventful.
-
The porphyrias are inherited disorders of haem metabolism, acute attacks of which may be precipitated by anaesthesia, surgery and pregnancy. The principal clinical feature of the disease is an acute neuropathy. A patient with acute intermittent porphyria was given bupivacaine as part of a regional anaesthetic for Caesarean section. The course of anaesthesia was uneventful.