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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The cardiovascular effects of intravenous droperiodol 5 mg were measured in 20 patients during steady state enflurane-nitrous oxide-oxygen or enflurane-oxygen anaesthesia, droperiodol produced significant decreases in SVR and BP and increases in HR and Qt which were maximal after five minutes, somewhat less five minutes, somewhat less five minutes later, and back to control values 15 minutes after administration. SV was not significantly altered by droperiodol during enflurane-nitrous oxide-oxygen at any time after administration. ⋯ These data demonstrate that droperidol produces a significant though transiet reduction of BP and SVR during enfluane anaesthesia which is associated with no change or an increase in Qt. Our findings suggest that droperidol causes minimal or no myocardial depression when used during potent inhalation anaesthesia and may have a place as an amnesic supplement and/or "afterload" reducer during light enflurance anaesthesia.