Canadian Anaesthetists' Society journal
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We have described our technique of caudal anaesthesia in children. This technique was used for relief of post-operative pain in 120 patients. ⋯ The surgeons, the parents and recovery room personnel were satisfied. There were no surgical or anaesthetic complications.
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We report our further anaesthetic experience with Etomidate in 100 patients. The cardiovascular and respiratory systems were not significantly affected but intraocular pressure was reduced. ⋯ The myoclonic movements often seen with Etomidate anaesthesia were transient and have so far not created any major problem; they were reduced by a slower speed of injection but unaffected by diazepam premedication or pretreatment with low dose of a non-depolarizing muscle relaxant (pancuronium). Etomidate is a satisfactory alternative to thiopentone in situations where depression of the cardiovascular and respiratory systems are undersirable or where barbiturates are otherwise contraindicated and is a usefull addition to the induction agents in our anaesthetic practice.
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The effects of enflurane-pancuronium anaesthesia on cardiovascular haemodynamics were studied before operation in six patients with valvular heart disease. A ten per cent decline in cardiac index and a 20 per cent decline in stroke volume were the only changes observed. Mean arterial, pulmonary arterial, contral venous, and pulmonary capillary wedge pressures were unaffected, as were systemic vascular resistance and pulmonary vascular resistance. The authors therefore conclude that enflurane-pancuronium anaesthesia causes only minimal cardiovascular depression in patients with valvular heart disease.
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This study involves ventilation of the lungs with warmed humidifed anaesthetic gases during prolonged elective abdominal operations. Tympanic, oesophageal and toe temperatures were compared bewteen twenty warmed and twenty un-warmed patients at various times during operation and recovery. Fifty per cent (10/20) unwarmed patients shivered in the recovery room, while none of the warmed patients shivered. Our data indicate that pulmonary ventilation with warm humidified anaesthetic gases provides heat transfer by the lungs, preventing hypothermia during operation and post -anaesthesia shivering is prevented by maintaining the patient normothermic in both the operating room and the recovery room.