British journal of anaesthesia
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Twelve cats were assigned equally to two groups, one with normal, and the other with artificially-increased intracranial pressure. When suxamethonium was administered to these animals, the intracranial pressure increased in both groups, irrespective of their baseline intracranial pressure. When the same dose of suxamethonium was administered after pretreatment with thiopentone in both groups of animals, the intracranial pressure again increased from the control values.
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Anterior fontanelle pressure responses to tracheal intubation in the awake and anaesthetized infant.
In order to define the changes in intracranial pressure which occur during tracheal intubation in young infants, a Ladd transducer was used to monitor anterior fontanelle pressure (AFP) non-invasively in awake (group 1, n = 14) and anaesthetized (group 2, n = 10) infants during intubation of the trachea. Heart rate and systolic arterial pressure were also recorded. In quiet, undisturbed infants, AFP (mean +/- SEM) was similar in groups 1 (9.6 +/- 0.5 mm Hg) and 2 (8.7 +/- 0.8 mm Hg); with crying, AFP increased significantly in both groups. ⋯ Neither heart rate nor systolic arterial pressure changed significantly in either group during laryngoscopy--when compared with measurements in the quiet state. It was concluded that AFP increases significantly during intubation and during crying in the infant. The response to intubation is only partially attenuated by the prior administration of general anaesthesia.
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An infusion of 0.1% trimetaphan was administered to eight cats with artificially increased intracranial pressure (ICP) in order to decrease their mean arterial pressure (MAP) from 121 +/- 9.5 (SEM) to 58 +/- 4.6 mm Hg in less than 1 min. All cats developed an increase in intracranial pressure (ICP) (from 16 +/- 1.4 to 23 +/- 3.2 mm Hg) accompanied by a partial rebound in MAP. ⋯ In nine of the 12 cats with an ICP increase, that increase was initiated before the partial MAP rebound. We conclude that trimetaphan causes clinically significant ICP increases in cats with increased ICP, that partial rebound in MAP frequently exacerbates these increases in ICP, and that rapid induction of hypotension tends to increase the frequency with which trimetaphan increases ICP.
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The anaesthetic experience gained during general professional training is reviewed, indicating the spectrum of patients managed and training received. The experience gained was broadly in line with the guidelines recommended by the Faculty of Anaesthetists. The advantage of movement between hospitals at a junior level is noted, as is the value of a case record book, for both the individual and the Anaesthetic Department.