British journal of anaesthesia
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Systemic mastocytosis is an uncommon disorder of mast cell proliferation in connective tissues. Mast cell degranulation may occur on exposure to various stimuli and drugs. ⋯ Intradermal skin testing is useful in predicting the sensitivity to drugs that may be used during anaesthesia. We present a patient with systemic mastocytosis who underwent uneventful cholecystectomy.
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We have studied, in the monkey, the critical volume for the production of severe pneumonitis following pulmonary aspiration of gastric contents. Aspiration of 0.4 ml kg-1 and 0.6 ml kg-1 at pH1 produced mild to moderate clinical and radiological changes, but no deaths. ⋯ At 1.0 ml kg-1, 50% of the animals died--a mortality rate considerably less than that reported previously in animal studies. If these results were to be extrapolated to humans, the critical volume for severe aspiration could be increased from 25 ml to 50 ml (0.8 ml kg-1), considerably reducing the percentage of patients perceived to be "at risk".