British journal of anaesthesia
-
Letter Case Reports
Atracurium v. suxamethonium in a case of organophosphorous poisoning.
-
The potential mutagenicity of isoflurane was investigated by the sister chromatid exchange (SCE) test using peripheral blood lymphocytes from patients before and after anaesthesia. Thirty patients, aged 18-59 yr (median 29.5 yr), were anaesthetized for minor orthopaedic operations with isoflurane and nitrous oxide in oxygen for 37-90 min (median 64 min). Venous blood samples were drawn before the induction of anaesthesia, immediately after completion of anaesthesia and on the following day. ⋯ In 11 cigarette-smoking patients (average 10 cigarettes per day), SCE was increased the day after operation when compared with SCE before the induction of anaesthesia (P less than 0.02). This might reflect differences in SCE formation attributable to the patients' smoking habits, but further studies of SCE in cigarette smokers are required to elucidate this. It was concluded that there was no indication, from the SCE test, of a mutagenic effect of short-term exposure to anaesthetic concentrations of isoflurane and nitrous oxide in oxygen.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Effects of ketamine anaesthesia on the metabolic response to pelvic surgery.
The effects of ketamine anaesthesia on the metabolic and endocrine response to pelvic surgery were investigated, and compared with results obtained in a control group of patients anaesthetized with thiopentone and halothane. Ketamine anaesthesia before the onset of surgery was associated with a significant increase in blood glucose and plasma cortisol concentrations, and in heart rate. However, when surgery was established there were no metabolic, endocrine or haemodynamic differences between ketamine and halothane anaesthesia. We conclude that ketamine does not exacerbate the metabolic response to surgery.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Recovery characteristics following antagonism of atracurium with neostigmine or edrophonium.
The evoked reversal characteristics of atracurium were studied in 21 patients using edrophonium or neostigmine and a train-of-four pattern of stimulation. Reversal of residual atracurium -induced neuromuscular blockade was significantly more rapid using edrophonium compared with neostigmine. The ratio of the fourth twitch in the train-of-four to the first twitch--the T4 ratio--was significantly greater when the first twitch (T1) had recovered to 75% of control T1, using edrophonium compared with neostigmine. A T4 ratio of 0.5 was confirmed to be compatible with the reliable and safe reversal of atracurium -induced neuromuscular blockade.