Canadian Anaesthetists' Society journal
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Comparative Study
Influence of laryngoscope design on heart rate and rhythm changes during intubation.
One hundred and twenty adult patients about to undergo surgery were premedicated with either meperidine or meperidine and atropine. After anaesthesia was induced with thiopentone and succinylcholine given, tracheal intubation was performed with the use of either a Magill or a Macintosh laryngoscope. There were no statistical differences in changes of heart rate and rhythm between the groups, as regards the type of premedication given or the design of laryngoscope used.
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Dantrolene--in vitro studies in malignant hyperthermia susceptible (MHS) and normal skeletal muscle.
Dantrolene sodium, a hydantoin analogue, is efficacious in the therapy of malignant hyperthermia (MH). In order to improve our knowledge of the mode of action of dantrolene, we have examined the influence of dantrolene sodium on: (1) twitch and resting tensions, in the absence and the presence of caffeine, of intact skeletal muscle fascicles; and (2) caffeine induced tension rises of single chemically skinned skeletal muscle fascicles. We have found that dantrolene appears to exert its beneficial action on malignant hyperthermia susceptible (MHS) skeletal muscle by an indirect action on the sarcoplasmic reticulum (SR). ⋯ To a lesser extent dantrolene inhibits caffeine induced contractures of skeletal muscle fascicles, probably by indirectly accelerating the uptake of calcium into the SR. Because the former effect is greater than the latter in vivo dantrolene sodium is effective only when given prior to total loss of calcium from the SR. Vigilant temperature and EKG monitoring of all patients during anaesthesia is, therefore, essential.
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A 17-year-old black female with pregnancy-induced hypertension (PIH) suffered cardiorespiratory arrest on arrival in the recovery room after Caesarean section under general endotracheal anaesthesia. Successful resuscitation included orotracheal intubation, complicated by severe laryngeal oedema. Causative mechanisms are discussed.